One U.S. state is now being sued over a policy change that has triggered reductions in home care services for some of its Medicaid recipients.

The state being targeted is Arkansas. Advocates and legal representatives of those Medicaid recipients argue the reductions are “causing widespread harm.”

“The last time [Department of Human Services] provided any statistics, nearly 30% of the people on the ARChoices Medicaid home care program were being terminated,” Kevin De Liban, an attorney at Legal Aid of Arkansas, told Home Health Care News in an email. “It seems like state policy is favoring nursing homes over home-based care.”

ARChoices is an Arkansas Medicaid home and community-based waiver program. About 8,800 state residents currently use the program for help with activities of daily living (ADLs).

Legal Aid of Arkansas is a Jonesboro-based nonprofit organization that provides legal services for low-income state residents in civil cases.

In a lawsuit filed on Monday on behalf of Jacquelyn Dearmore, Legal Aid of Arkansas argues that the Arkansas Department of Human Services reduced Dearmore’s weekly home care services hours from 33 to 24. The reduction in hours is reportedly linked to a new assessment tool the state started using last year.

As a result of the reduced home care hours, Legal Aid of Arkansas argues that Dearmore, who has chronic myeloid leukemia, did not receive adequate care. That, in turn, led to increased skin problems from not being cleaned properly, the group’s complaint alleges.

The Arkansas Department of Human Services declined HHCN’s request for comment.

Monday’s lawsuit was filed in the U.S. District Court in Little Rock.

“Ms. Dearmore’s aides do not have enough time to meet all of her care needs in the house,” Legal Aid of Arkansas said in the lawsuit. “She has been forced to skip about one meal every day, lie in urine-soaked pads or clothing for periods several hours longer than before, take a shower only every other day instead of every day as she needs and wants to, use dirty towels or clothes because all of her laundry cannot get done, live in a dirty house because her incontinence means that she sometimes leaves urine trails around the house, and give up going outside of her house.”

The lawsuit, which names officials of the state Department of Human Services, also accuses the department of not providing proper notice of the reduced home care hours.

“We want to make sure that anyone who faces a cut in care gets a detailed explanation of the reasons for the cuts so they know how to fight it,” De Liban told HHCN. “We want to make sure that people who are fighting cuts get to keep their services while their appeals are pending.”

In 2016, a federal lawsuit regarding a Medicaid recipient not receiving detailed notice on their home care hours being reduced caused the department to overhaul its notices. If judges rule in Dearmore’s favor, it means that the department is failing to live up to its updated standards.

Dearmore’s complaint is the second that has been filed on behalf of a Medicaid recipient in Arkansas over the past two years.