Washington Can’t Slash Budget for In-Home Care

SEATTLE (CN) - A group of disabled Medicaid recipients can block Washington state budget cuts that could have forced them into institutions by reducing in-home personal care, the 9th Circuit ruled.

The decision reverses the finding of a federal judge who refused to stop the state's Department of Social and Health Services from reducing "personal care services" that provide assistance with basic tasks like eating, bathing and dressing.

A majority of the court's three-judge panel said Friday that the Medicaid recipients "have shown that reduced access to personal care services will place them at serious risk of institutionalization" and are likely to prevail in claims for violations of the Rehabilitation Act and Americans With Disabilities Act (ADA).

Judge Johnnie Rawlinson dissented from her colleagues, however, pointing out the trial court's finding that the plaintiffs faced institutionalization because of their worsening medical conditions, not because of reduced personal care services.

She also called the Justice Department's "statement of interest," filed in support of the case, "bald" and "unreasoned." The statement said in part that "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 overtime and eventually enter an institution in order to seek necessary care."

Rawlinson disagreed that the Western District of Washington "abused its discretion" in denying the preliminary injunction.

The injunction will only affect the named plaintiffs, who were joined by Puget Sound Alliance for Retired Americans, The Arc of Washington health care provider, and Service Employees International Union Healthcare 775NW.

On remand, U.S. District Judge Thomas Zilly must determine whether to grant class certification.

Gov. Christine Gregoire ordered cuts to all state agency budgets in September 2010. To comply with the governor's order, the health department enacted an "emergency regulation" that reduced the base monthly hours of in-home personal services at the beginning of this year.

The department acknowledged that, "in some cases, a safe in-home plan of care will not be possible and clients may need to go to community residential or nursing facility settings," according to the majority opinion authored by Judge William Fletcher.

State officials say they will appeal the ruling.

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