Three guardians for developmentally disabled Idaho residents have dropped their lawsuit against the state over Medicaid changes, reports AP reporter Rebecca Boone; click below for her full report. The attorney for the group said the shift to a single provider of residential habilitation services for such patients statewide will result in more work for law enforcement and emergency rooms.
Guardians of disabled men drop suit against Idaho
By REBECCA BOONE, Associated Press
BOISE, Idaho (AP) — Three guardians for developmentally disabled Idaho residents have dropped their lawsuit against the state over Medicaid changes.
Russell and Sandra Knapp and Jana Shultz last year sued Idaho Department of Health and Welfare Director Richard Armstrong and Medicaid Administrator Leslie Clement, saying the department's plan to consolidate some Medicaid-covered services would violate their wards' right to freely choose their own health care providers.
But the Knapps and Shultz decided to drop the lawsuit last week, because the consolidation was being implemented faster than the lawsuit could work its way through the court system.
"Ultimately, we got to the point where what we were talking about was bad policy — and the courts don't like to wade into policy issues," said their attorney, James Piotrowski.
Some adults with developmental disabilities — like the Knapp's ward, Jason Knapp, and Shultz' ward, Toby Shultz — live in certified family homes under a Medicaid program that aims to provide a family-style living environment for people who need assistance with daily activities.
Under the program, each certified family home must work with a residential habilitation agency, which provides them with training, oversight and quality assurance. Essentially, the residential habilitation agencies serve as experts in the state's policies and administrative issues, freeing up the certified family home providers to be experts in their own clients.
But last year, under pressure from lawmakers to cut its budget, the Idaho Department of Health and Welfare decided to have just one residential habilitation company oversee all the Medicaid-covered certified family homes in the state.
The switch, which took effect March 15 of this year, also cut the services available to the Medicaid clients. For instance, residents in certified family homes now will get face-to-face visits from residential habilitation employees only once yearly, as opposed to the quarterly or monthly visits they typically got under the old system.
U.S. District Judge B. Lynn Winmill stopped the state from implementing the plan for a time, but declined to renew the injunction in February, allowing the state to move forward with the plan.
In making that decision, Winmill said the first injunction was appropriate because the state had failed to get approval from the federal Medicaid program before making the residential habilitation changes. Winmill said he wouldn't renew the injunction because Idaho officials had since corrected that error.
The consolidation plan threatened to put several small residential habilitation providers out of business, Piotrowski said when he filed the lawsuit last year. Many of those small businesses were available around the clock to help their clients, he said, though they weren't necessarily reimbursed for those services.
On Tuesday, he said the department is now telling certified family homes to call 911 if their client has a crisis during the hours that the statewide provider is closed.
"The department has implemented its selective contract already, and we know the result of that is going to be a shift of a lot of work to already overworked service providers," Piotrowski said. "It's also shifting the problems that used to be solved by residential habilitation agencies to law enforcement agencies and emergency rooms, and you're going to see an increase in ER admissions and law enforcement calls."
Copyright 2012 The Associated Press.