A former regional manager for Missouri’s Medicaid home-care assessment program has sued the state health department, alleging it saddled a mostly Black team of St. Louis assessors with the most dangerous and difficult caseloads, then fired her after she reported the pattern. Anjali Salik, who oversaw operations in St. Louis and St. Louis County, filed the lawsuit Wednesday claiming the department ran what her attorneys describe as a two-track system dividing assignments by race.
According to the lawsuit, as reported by the St. Louis Post-Dispatch, Black workers on Salik’s team were routinely expected to take home visits in predominantly Black neighborhoods, while white colleagues could avoid those same calls. Salik says the disparity showed up in outcomes, not just assignments: one Black team member walked out of a home visit after discovering a dead body and a wounded child inside a residence, and another was held hostage during a police standoff while conducting an assessment. The suit alleges Black workers faced more adversity on the job as a direct result of how caseloads were divided.
A Manager Who Pushed Back
Salik says she tried to fix the imbalance starting in 2019, seeking more equitable workload distribution across her staff, according to the newspaper’s account. Her lawsuit alleges her team also received less recognition from the department despite including one of the state’s highest-producing assessors. Salik was fired, the suit claims, after she reported the alleged discrimination against herself and her team to superiors.
The lawsuit also details what Salik describes as a pattern of being passed over. She alleges the department denied her a promotion in 2018 in favor of a white applicant who had no experience in the division, and later passed her over again for a position at a statewide call center, a project the suit says Salik herself had proposed. In a separate promotion, the suit alleges a white woman was selected for the role despite having barely any supervisory experience.
The Agency’s Response
The Missouri Department of Social Services’ Division of Senior and Disability Services declined to comment on Salik’s claims, per the Post-Dispatch report, and Salik’s former supervisors did not respond to the paper’s requests for comment. DSDS operates under the Missouri Department of Health and Senior Services and is responsible for conducting in-home functional assessments that determine whether Medicaid recipients qualify for nursing-facility-level care, according to the Missouri Department of Health and Senior Services. Assessors evaluate whether elderly and disabled residents need personal care, meal assistance, or respite services to remain safely in their homes…