Lawsuit accuses California of imposing arbitrary Medicaid cuts

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Disability Rights California and the Western Center on Law and Poverty filed a lawsuit in federal court December 4 on behalf of a man with muscular dystrophy whose services were recently slashed for no other reason except that he turned 21 years old.

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Pablo Carranza is a part-time community college student and an avid fan of the Denver Broncos. However, he require services 24 hours a day, as his disability makes him permanently dependent on a ventilator.

Until recently, the state’s Medicaid program, known as Medi-Cal, covered 615 hours per month of in-home services at a cost of about $230,000 per year for Cerranza. Without these services, Cerranza, whose parents do the bulk of his care-taking activities, would most likely be forced to move into an institution.

In September, he was informed that the state’s Medicaid requirements impose a cap of $180,000 on in-home services for people over age 21. As a result, Cerranza would likely receive more than 200 fewer hours of services per month, despite there being no change in his health condition. Cerranza appealed, but was unsuccessful.

As the state’s regulations currently stand, Medi-Cal would pay as much as $270,000 for Cerranza to move into an institution. The lawsuit argues that the state, by failing to provide comparable services in a home-based setting, is violating the Americans with Disabilities Act’s integration mandate.

“Under the ADA, Defendants also have an obligation to use methods of administration that do not discriminate against individuals with disabilities such as Pablo,” according to the lawsuit, filed in the U.S. District Court for the Eastern District of California. “Defendants’ failure to ensure a smooth transition to adult services for Pablo and their decision to set funding levels for home care services that are biased in favor of institutional care result in discrimination against Plaintiff in the administration of the Medi-Cal program.”

The lawsuit also contends the program violates the Fourteenth Amendment Due Process Clause by failing to provide adequate notice and opportunity to be heard. According to the lawsuit, Cerranza’s family was informed of the service cuts by telephone, as opposed to in a written notice informing them of the reasons for the change and the process for filing an appeal.

“I do not want to spend the remainder of my life in an institution away from my family or suddenly die because my nurse was not there to help me.,” Carranza said in a Disability Rights California news release. “Like most people my age, I want to explore the world around me by going out, meeting new people, going to college, having a career and I really just want to have a chance to have a normal life.

“[To] be forced to go to an institution to live the remainder of my days away from my family …would be no different than spending the rest of my life in prison.”

2 thoughts on “Lawsuit accuses California of imposing arbitrary Medicaid cuts

  1. news article says:

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      Mark

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