The man, a ward in Legal Aid’s GAIN Project — in which guardians for developmentally disabled adults are recruited, trained and mentored by the program manager, Diana Pitkaranta — had been approved for Medicaid benefits in 2002 when he was found in need of a guardian and nursing home care. His citizenship status was approved at that time, but upon review by the State of Wisconsin in 2017, no records documenting that status could be found. The ward could not help in the process because he was unable to communicate due to the effects of a stroke, seizures and dementia. He could not even identify himself. No family or friends could be identified. His benefits were terminated by the State of Wisconsin.
Attorney Penegor stepped in to represent him. With no case law to guide her, she argued that based on state Medicaid eligibility rules related to citizenship, the state could not revisit its citizenship determination. An Administrative Law Judge agreed, and afterwards, the state acknowledged the benefit of having some guidance in making future eligibility decisions.