The U.S. Court of Appeals for the 9th Circuit issued a preliminary injunction December 16 against cuts to Medicaid-funded personal-care services for 14 Washington State residents.
The U.S. District Court for the Western District of Washington, which had earlier dismissed the request for a preliminary injunction, will now hear their claims.
In September 2010, Gov. Chris Gregoire issued an executive order requiring state agencies to cut their budgets by about 6.7 percent. As a result, the state Department of Social and Health Services reduced the number of hours people with disabilities could receive for care for non-medical services, such as bathing, eating and dressing.
Though, the reductions were less for individuals with more severe disabilities, people receiving services through the program lost on average about 10 percent of their personal care hours.
Twelve Medicaid beneficiaries filed a lawsuit claiming that the cuts violate federal law by putting them at risk of having to leave their homes in order to receive proper medical care. The individuals were represented by attorneys from MacDonald Hoague & Bayless and Alshuler Berzon. The district court rejected a request to block the services through a preliminary injunction.
In its opinion, the 9th Circuit stated that the district court used an overly stringent standard when evaluating this claim, deferring to the argument of the U.S. Department of Justice supplied in a statement of interest brief on behalf of the 14 individuals.
“The integration mandate (Americans with Disabilities Act) prohibits public entities from pursuing policies that place individuals at risk of unnecessary institutionalization. Imminent risk of institutionalization is not required,” the DOJ stated. Rather, “the elimination of services that have enabled Plaintiffs to remain in the community violates the ADA, regardless of whether it causes them to enter an institution immediately, or whether it causes them to decline in health over time and eventually enter an institution in order to seek necessary care.”
When the Supreme Court upheld the ADA’s integration mandate in its 1999 decision Olmstead v. L.C., it ruled that states could be exempt from providing certain services if the cut represented a “fundamental alteration” to the state’s programs for providing services for people with disabilities.
In its order granting the preliminary injunction, the 9th Circuit said the district court was too quick to accept the state’s argument that preserving the personal care hours represented a “fundamental alteration,” noting that other courts have not regularly viewed budgetary concerns alone as a strong enough reason for skirting ADA requirements. Further, it stated that Washington State had failed to provide a plan for how it would cut services from other programs and that it was questionable whether the cuts would actually save the state money, considering the increased costs of institutionalized care.
The preliminary injunction against the cuts only pertains to the 14 individuals in the lawsuit because the lawsuit has not been granted class action status, which would mean that it represents the 45,000 individuals currently receiving personal care services through the state’s Medicaid program.