SAN FRANCISCO (CN) - A federal judge certified a class action and granted a preliminary injunction to stop California from reducing in-home support services for elderly and disabled people.
Lead plaintiff David Oster sued California's Department of Social Services and Department of Health Care Services, challenging Assembly Bill X4 4 and Senate Bill 73, which mandate reductions to the state's In Home Support Services (IHSS) program. The agencies' directors, Will Lightbourne and Toby Douglas, were also named as defendants.
The class claimed that ABX 4 4 violated the Medicaid Act, which requires that states provide "sufficient benefits," by "terminating or reducing IHSS domestic and related services to individuals for whom such services have been deemed necessary pursuant to an individual service plan approved by the state," according to U.S. District Judge Claudia Wilken's order granting class certification.
The class also claimed that both ABX 4 4 and SB 73 "[fail] to ensure that Medi-Cal recipients under the age of 21 receive medically necessary personal care services required by the Early Periodic Screening, Diagnostic, and Treatment (EPSDT) provisions of the Medicare Act," the class certification order stated.
ABX 4 4, passed in July 2009, tightened eligibility criteria for participants in the IHSS program. Implementation of the bill was stayed in October 2009 after a lawsuit from program participants and the unions that represent IHSS providers.
SB 73, passed in 2011, contained "trigger" language to cut IHSS service hours by 20 percent if state revenue targets were not met. In November 2011, after it became apparent that revenue targets would not be met, the Department of Social Services sent letters to all 58 California counties, informing them that impending trigger cuts would take effect on Jan. 1, 2012.
According to the Wilken's order granting a preliminary injunction, certain groups of IHSS recipients would be exempted from mandatory reductions under SB 73. These include people with an AIDS or developmental disabilities waiver, recipients of in-home operations, multipurpose senior service programs, and nursing facility and acute hospital services.
Also exempted from the cuts are people with severe inside mobility problems, those receiving bladder, bowel or menstrual care, patients receiving transfer or paramedical services for bedsore care, those requiring help with eating, recipients authorized for the statutory maximum of 283 hours per month, and those assessed for protective supervision.
Those at risk of the 20 percent cut were sent letters and could contest the action, according to Wilken's order. County social service workers then assessed them for risks associated with the reduced services, to see if some or all of the IHSS hours should be restored.
In granting the preliminary injunction, Wilken rejected state lawyers' arguments that the claims are not ripe for adjudication.
"Plaintiffs' challenge to cuts mandated by SB 73 is not abstract," Wilken wrote. "The fact that some supplemental care applications may be granted to restore hours for individual IHSS recipients does not defeat the ripeness of the dispute plaintiffs have presented."
Wilken also rejected the state's argument that plaintiffs representing domestic workers' unions did not have standing, saying that they will suffer economic harm as a result of the cuts.
"Contrary to defendants' arguments, union plaintiffs' claims in this litigation are also germane to their organizational interests," Wilken wrote. "Union plaintiffs represent IHSS providers who are seeking to prevent the reduction of IHSS benefits, which will, in turn, lessen the amount of work available to their members."