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Lawyer calls Medicaid order a partial victory

Federal judge says Medicaid agency likely violated federal law

INDIANAPOLIS (WISH) — A lawyer for two mothers of medically complex children on Wednesday praised a judge’s ruling that criticized the state’s removal of families from the attendant care program.

A federal judge ruled late Tuesday the Indiana Family and Social Services Administration (FSSA) likely violated the Americans with Disabilities Act when it ended two families’ reimbursement under the attendant care program. The FSSA ended parents’ eligibility for the program, which reimburses providers for the cost of providing care to people unable to perform basic life functions, in July as part of an effort to close a nearly $1 billion hole in the state’s Medicaid fund.

Judge Tanya Walton Pratt of the Southern District of Indiana ruled the FSSA likely violated the Americans with Disabilities Act’s integration mandate, which prohibits the unnecessary segregation of people with disabilities. Walton ordered the FSSA to immediately provide the two families with skilled nursing care and reimburse the children’s mothers under the structured family caregiving program, which provides a daily stipend for providing care rather than an hourly rate, as attendant care does. The order is a preliminary injunction pending further review of the case.

Gavin Rose, the ACLU of Indiana‘s senior staff attorney, said the order is a partial victory. He said Pratt rejected nearly all of the state’s arguments but he had hoped she would order the agency to keep the two mothers on the attendant care program. Rose said whether the order meets the families’ needs depends on how quickly the FSSA can connect them with in-home skilled nursing care.

“These are two families who have devoted their entire lives to doing something that very, very few people can and even fewer will,” he said. “They have children with very significant, potentially life-threatening conditions that they have spent years learning how to care for.”

Rose said the integration mandate is a key part of the lawsuit. Without access to in-home care, he said, the children affected are at risk of being forced into a nursing home. He said the state has an obligation to prevent that.

Rose said the ruling only affects the two families who filed the lawsuit. He said the ACLU is happy to represent other families in a similar situation but it is not likely to become a class-action lawsuit. In the meantime, he said he has asked the court to amend the order to keep the families on attendant care until the FSSA connects them with skilled nursing.

FSSA officials said they are reviewing the order but had no further immediate comment.