Kansas Lawsuit Filed Against Huge Medicaid Cuts Denied

The Kansas Supreme Court last week said it lacked jurisdiction to take up a lawsuit filed on behalf of Kansans with disabilities. The action leaves open the door for litigation to be filed in a lower district court as groups representing the disabled reel from a 10 percent cut in Medicaid reimbursements.

The case stems from a 10 percent cut to funding for Medicaid reimbursements—money that Governor Parkinson (D) said he wants to see restored even as lawmakers battle a budget gap now exceeding $400 million. He called restoring the funds "critical."

The 10 percent cut, which was implemented in January, eliminates $22.7 million in state funds for Medicaid programs this year. Of that, about $6.2 million affected services for people with disabilities and mental health programs. The state-level cuts also meant the state lost significant matching federal funds, which pay about 70 percent of Medicaid costs.

The Kansas Department of Social and Rehabilitation Services has seen its waiting list for people with developmental disabilities seeking home and community-based services expand to 2,236 as of February 28. That is up from 1,397 in July 2008 and 1,655 in July 2009.
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Mississippi Health Care Association Files Suit to Stop Medicaid Cuts

The Mississippi Health Care Association, the Independent Nursing Home Association and dozens of nursing homes from across the state filed a lawsuit Thursday seeking to stop the Mississippi Division of Medicaid from making a planned $14 million cut in payments to providers.

The lawsuit filed in Hinds County Chancery Court late Thursday afternoon argues that state reserve funds can be used to shore up the Medicaid budget and the cuts are unnecessary.

The suit seeks an injunction to stop the cuts over the uncertainty of "adequate funding" for providers. The cuts are pending federal permission.

Mississippi Medicaid recently announced plans to cut $14 million in reimbursements to health care providers for services for the remainder of the fiscal year, which ends June 30, because of successive months of revenue collections below estimates. However, tax revenue collections were on target in March.

Calls by Democratic lawmakers to dip into state reserves to close the gap have been rebuked by Governor Barbour (R), who argues the state's savings needs to last for several years.

The largest chunk of money went to public education, and Medicaid was not on the restoration list. About $14 million of an $82 million budget patch-up plan approved by lawmakers, however, was provided via a stimulus-related federal government reimbursement to the Division of Medicaid.


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U.S. District Court Judge in Louisiana Agrees to Continue Community Services Pending Final Court Judgment on Cuts

Louisiana has agreed to continue round-the-clock supports to a man with developmental disabilities who is suing state health officials over planned cuts in services. Following the use of a new assessment tool, a determination was reportedly made to reduce 24-hour-a-day assistance to three to seven hours per day. Brian Stein’s parents filed a federal lawsuit last month over cuts they claim would force their son to be institutionalized. They sought a preliminary injunction while the U.S. District Court decided the merits; however U.S. District Judge Ralph Tyson signed off on an agreement between the parties March 8th to continue services pending the court's ruling. According to state advocates, the Stein lawsuit could be the first of many similar actions as the state moves to a new system of assessing individual service needs for individuals living in the community at the same time budget cuts are being considered. Thanks to Joe Aniello of UCP South Florida for forward the information to ANCOR!
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U.S. 9th Circuit Court of Appeals Rules Maintains Injunction Against California Regarding Wage Lawsuit

Thanks to Ron Cohen, President of UCP of Los Angeles, Ventura and Santa Barbara Counties for this news item. The Court today issued a decision against the Schwarzenegger Administration, upholding Federal District Court Judge Wilken's injunction that has blocked since June 2009 the reduction in the state's participation toward in-home supportive worker wages. The decision is a setback to the State of California, which on Monday won a ruling from the California State Court of Appeals on the issue of the Governor's line item vetoes, which that court declared was unconstitutional. The State could decide to appeal the 9th Circuit Court's ruling to the U.S. Supreme Court. The text of 21-page Circuit Court's opinion in Dominguez et al v. Schwarzenegger (formerly Martinez v. Schwarzenegger) and original federal district court case is available on the California Disability Action Center (CDCAN) website at http://www.cdcan.us/.
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Judge Orders New York City to Move Mentally Ill Out of Large, Institutional Housing

A decision in Disability Advocates, Inc. v. David A. Paterson, by Judge Nicholas G. Garaufis of Federal District Court in Brooklyn, followed his ruling in September that the conditions at more than two dozen privately run adult homes in New York City violated the Americans with Disabilities Act by leaving approximately 4,300 individuals with mental illness isolated in warehouse like conditions. The remedial plan offered by Judge Garaufis, drawn from a proposal presented by advocates was backed by the Justice Department, calls on New York to develop at least 1,500 units of supported housing a year for the next three years in New York City. That would give nearly all residents the opportunity to move out of adult homes. The state is considering an appeal, according to a one-sentence statement from Governor Paterson's officer.
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Federal District Court Bars Medicaid Non-Contract Hospital Payment Rates

A federal district court judge in California November 18th enjoined the California Department of Health Care Services from continuing a 10 percent reduction in the Medi-Cal (California's Medicaid program) reimbursement rate for non-contract hospitals (Santa Rosa Memorial Hospital v. Maxwell-Jolly, N.D. Cal., No. 08-5173 SC, injunction 11/18/09).

At issue in all the cases was the 10 percent Medi-Cal reimbursement rate cut contained in 2008 legislation (A.B. 5) aimed at addressing California's budget deficit. The hospitals argued that the rate cuts violated federal law because they were implemented solely for financial cost savings, and did not take into account a federal requirement that the state DHCS set hospital reimbursement rates to bear a reasonable relationship to hospitals' costs. The courts agreed, essentially finding that the DHCS had to rely on responsible cost studies before it could provide reliable data to justify the reductions. In his order, U.S. District Judge Samuel Conti of the Northern District of California noted that, ordinarily, the court would hold a hearing on the appropriateness of granting the non-contract hospitals' motion for a preliminary injunction barring the cuts. However, largely on the basis of the rulings by a federal district court in Los Angeles in August 2008, and the Ninth Circuit in July 2009, Conti found it was suitable to make his ruling without oral arguments. In July, the Ninth Circuit affirmed the lower court's ruling in Independent Living Center of Southern California Inc. v. Maxwell-Jolly (131 HCDR, 7/13/09).

“Based on the Ninth Circuit's decision, the Court finds that Plaintiffs are likely to succeed on the merits of their claim that these rate reductions violate state law,” Contin wrote. The ruling is available at http://op.bna.com/hl.nsf/r?Open=sfak-7y3unz.



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Florida Nursing Home Residents Win Suit Against the State

A class action lawsuit brought in 2008 on behalf of 8,500 Floridians by AARP Foundation, the Southern Legal Counsel, and National Health Law Program and others, said the state illegally forced residents to live in nursing homes instead of their communities, has been settled with the state agreeing to spend up to $27 million to resolve the lawsuit. The agreement calls for the improvements to be made during the fiscal year ending June 30, 2010. A federal court will monitor the settlement that requires the Florida Agency for Health Care Administration and the Department of Elder Affairs to improve the way they inform Medicaid nursing home residents about making the transition from nursing homes to community-based programs.
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Federal Judge Blocks Cuts September 9th to Adult Day Health Care Services

In a major victory for disability and senior rights advocates, a federal district court judge September 9, 2009 issued an order blocking California’s budget reductions to Adult Day Health Care services, saying that the cuts would likely be in violation of the federal Americans with Disabilities Act and Section 504 of the federal Rehabilitation Act. Federal District Court Judge Saundra Brown Armstrong issued a preliminary injunction – or temporary order – to stop the cuts until appropriate replacement services are in place. For a copy of the 24 page order, go to www.cdcan.us .
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Judge Decertifies Class Seeking Rights of Illinois Institutional Residents to LIve in the Community

On July 7, a federal district court issued an order decertifying an Illinois class in Elias v. Maram, a lawsuit seeking to provide individuals with developmental disabilities in Illinois the opportunity to live in the community.Advocates in Illinois had reached a settlement with the state to place 6,000 people in the community over a multi-year period. The suit, filed four years ago, alleges that Illinois does too little to offer community-based living options to people with disabilities as guaranteed in the Supreme Court’s 1999 Olmstead ruling. Under that decision, the court said that states have an obligation to provide care for people with disabilities in a community setting, where medically possible. However, according to the American Association for People with Disabilities, the Voice of the Retarded (VOR) rallied objections, leading the judge to decertify the class. The VOR stated their family members are best cared for in institutions and feared the settlement would divert funding from those facilities.
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Idaho District Court Issues Temporary Restraining Order April 28th Regarding HCBS Habilitation 15 Minute Unbundling and 55% Reimbursement

See Memorandum Opinion on Granting a Temporary Restraining Order on ANCOR's Medicaid One Stop Litigation web page. Read more!

Arizona Court Rescinds Injunction Against State Cuts to DD and Remands Case to Superior Court for Further Proceedings

UPDATE: Yesterday, an Arizona court granted a motion for emergency stay on the injunction issued in March. The state of AZ issued today a notice that provider rates will decrease by 10%.

On April 30, an appellate court in Arizona lifted an order from a lower court blocking the state from cutting funds for disability programs. In a preliminary injunction issued in March, a county Supreme Court moved to block the state from carrying out budget cuts to home and community-based services. The three-judge appellate court ruled unanimously to vacate the lower court’s ruling saying that the plaintiffs had not proven that the budget cuts violate state or federal laws. The judges have remanded the case to a superior court for further proceedings. Read more!

Idaho Judge Blocks Proposed Medicaid Cuts for Disability Programs

A federal judge in Idaho issued a temporary restraining order on April 28 blocking the state from cutting reimbursement rates for disability programs by as much as 55%. The law suit was brought by 16 Idaho providers who claimed that the proposed cuts would put them out of business, thereby forcing individuals with disabilities out of the community and into institutions. See previous WICs Live article on this case. Read more!

Providers in Idaho Sue State Over Budget Cuts

On April 3, 16 providers of supports and services to individuals with disabilities filed a lawsuit against the state of Idaho stating that budget cuts could force 900 people with disabilities to lose residential services. The groups have asked the Judge to grant a temporary order preventing the state from enacting cuts set to begin on May 1. If the state is allowed to continue with the cuts it announced in March, providers will be forced to go out of business because of inadequate reimbursement rates, the plaintiffs say, resulting in more individuals with disabilities being moved to institutional settings. The suit alleges that the cuts are in violation of federal laws that require reimbursement rates to be high enough to ensure that all Medicaid recipients in a state have equal access to community-based programs. Read more!

Provider Rates Restored in Arizona Under Preliminary Injunction

On March 11th Arizona providers, advocacy groups, consumers and their families won a court injunction to restore all provider rates to their pre-reduction levels. As a result 4,000 children and adults with developmental disabilities will not lose their services. The Arizona Department of Economic Security, Division of Developmental Disabilities plans to appeal the court decision. Thanks to Wendy Sokol of Soreo for keeping us updated on this case.

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Florida Court Dismisses Lawsuit over Cuts to Disability Programs

On January 23, a circuit court judge dismissed the lawsuit brought by an advocacy group that claims that cuts to service for the developmentally disabled will cause "immediate irreparable harm" to individuals with disabilities in Florida. The Advocacy Center for Persons with Disabilities argued that the state has unfairly denied residents the right to a hearing to appeal new limits on the services they receive. The group has a similar case under consideration in the Florida courts and a judge has ruled that they have not yet exhausted their options for hearing their grievances through state channels. Read more!