On October 1, 2009, several disabled individuals requiring in-home support services filed this lawsuit in the U.S. District Court for the Northern District of California. The plaintiffs sued under the federal Americans with Disabilities Act, 42 U.S.C. § 12312, against the California Department of Social Services and California Department of Health Care Services. Due to recent budget cuts, the defendants planned on cutting funds for In-Home Supportive Services (IHSS) needed by the plaintiffs.
The plaintiffs, represented by attorneys from Disability Rights California, in addition to other organizations and private counsel, sought a preliminary injunction and relief for attorneys' fees claiming that a change in state law affecting disbursement of IHSS benefits violated the Americans with Disabilities Act, the Medicaid Act, the Rehabilitation Act, the Due Process Clause of the Fourteenth Amendment, as well as the Medicaid Maintenance of Effort Clause of the American Recovery and Reinvestment Act. The purpose of the IHSS program was "to enable the aged, blind or disabled poor to avoid institutionalization by remaining in their homes with proper supportive services." Cal. Welf. & Inst. Code § 12300(a).
When this case was brought, state budget cuts affecting IHSS services were scheduled to occur on November 1, 2009. Over 130,000 people with disabilities would have been affected by the implementation of IHSS budget cuts. IHSS services provide personal care for disabled people, along with services such as meal preparation, laundry, and housecleaning. Service providers also receive pay from the IHSS program for caring for disabled people. In addition, seniors with disabilities utilize IHSS services to avoid living in nursing homes, which are more costly than at-home services (Disability Rights California, 2009).
Through the proposed budget cuts in California during this case, these services would have been eliminated or severely reduced for seniors and other disabled persons. The plaintiffs claimed that reducing or eliminating pay from providers would cause serious and irreparable harm to the disabled people they served. The cuts would place these individuals at risk of unnecessary institutionalization, in violation of the Americans with Disabilities Act under the 1999 Supreme Court precedent, Olmstead v. L.C.
On October 1, 2009, the plaintiffs filed a class action complaint for injunctive and declaratory relief against California Department of Health Care Services and California Department of Social Services. The complaint sought relief to "prevent over one hundred thousand low-income seniors and individuals with disabilities from losing critical services that enable them to remain safely in their homes." (Compl., V.L. v. Wagner, p.1).
The plaintiffs charged that implementing ABX4 4, the newest statutory provisions cutting IHSS funds, would have made thousands of current IHSS recipients ineligible for all IHSS services based on the Functional Index Score. Plaintiffs claimed ABX4 4 provisions would cause "immediate and irreparable" harm to IHSS recipients by depriving them of services necessary to remain safely in one's home. The Functional Index Score is a measuring system that plaintiffs charge does not determine eligbility or need amongst individuals, but rather measured data between counties. ABX4 4 was set to be implemented on November 1, 2009.
On October 5, 2009, the plaintiffs moved for a temporary restraining order and preliminary injunction, to halt defendants from mailing notices that IHSS benefits had been reduced or terminated. The timing of these mailings was crucial to the health of disabled people receiving IHSS services, as well as IHSS providers.
On October 14, the plaintiffs filed an emergency application for a temporary restraining order and requested an immediate hearing. The defendants had informed the plaintiffs that notices would be mailed to IHSS recipients beginning the next day, October 15, 2009, and would cut benefits for individuals. The plaintiffs claimed that the defendants failed to provide adequate notice and opportunity to be heard prior to depriving the plaintiffs of necessary IHSS services, thus violating due process, as well as the Medicaid Act's notice and hearing provisions. The plaintiffs asked the court on October 19, 2009, to issue a preliminary injunction to stop the Department of Health Care Services and Department of Social Services from sending out notices to IHSS recipients that their benefits would be ending.
On October 19, 2009, U.S. District Court Judge Claudia Wilken ruled that the state of California could not go ahead with cutting funding for In-Home Supportive Services affecting over 130,000 disabled people in California. In a written order and opinion on October 23, 2009, the Court ordered the defendants to ensure no delay in paying benefits to IHSS providers, even if defendants had planned on terminating their eligibility. The defendants appealed this order to the Ninth Circuit.
Between November 6 and 10, 2009, the defendants failed to follow the court orders and mailed incorrect time-cards to 6,000 IHSS providers and about 3,000 IHSS recipients. Some time-cards listed 0 hours for providers and terminated services for recipients.
At a November 19, 2009 hearing, Judge Wilken granted the plaintiffs' motion for civil contempt sanctions and enforced the preliminary injunction. The Court ordered the defendants to send supplemental checks to providers who were not paid for hours worked in November 2009. The Court further awarded reasonable attorneys' fees and costs incurred to the plaintiffs.
The officials had also failed to notify counties of instructions to issue paychecks for IHSS providers who received incorrect time-cards. On November 30, 2009, Judge Wilken ordered the officials to provide supplemental time-cards to IHSS providers. This order meant that IHSS providers were able to receive pay for all the hours they had worked for November in 2009.
In early 2010, the plaintiffs filed an amended complaint and the defendants filed a motion to dismiss that complaint. On April 23, 2010, the parties agreed to stay all district court proceedings pending the resolution of the defendants' appeal of the preliminary injunction grant.
While the preliminary injunction was in place and the district court litigation was stayed, the California legislature re-wrote the applicable statutes to modify the IHSS coverage formula. SB 73, which was signed by the Governor on June 30, 2011, aims to reduce all IHSS hours by 20%. The new regime under SB 73 would contain a number of exemptions and would also provide recipients with an opportunity to request additional service hours in light of the across-the-board reductions. SB 73 was set to take effect on January 1, 2012.
In light of SB 73, the plaintiffs amended their complaint and filed a motion for a temporary restraining order and preliminary injunction on December 1, 2011. The judge granted a temporary restraining order, and after a January hearing, issued an order enjoining implementation of SB 73 on March 2, 2012. The defendants again appealed this order to the Ninth Circuit.
Ultimately, the parties reached a settlement and submitted it for the court's approval on March 28, 2013. In an order on May 23, 2013, Judge Wilken granted final approval of the settlement. The settlement prevented the planned permanent 20% cut and replaced it with smaller temporary reductions. Following the California legislature's action on these changes, the parties moved jointly on August 7, 2013, to dismiss the case and pending appeals, including the appeal to the Ninth Circuit, as set out in the settlement. In an order filed September 3, 2014, Judge Wilken approved a modification to the settlement agreement submitted by both parties agreeing to cooperation in 2015 on legislation to authorize an assessment on home care services, and subsequent submission of the assessment to the Centers for Medicare and Medicaid Services (CMS) for approval. We do not have information about how CMS proceeded on the assessment. The parties agreed that the district court would retain jurisdiction for 30 months after the date of CMS approval or disapproval of the assessment.
The parties agreed to come back to the district court if there were problems with this process. The 2015 California state budget, SB 97, eliminated the remaining 7% cut to IHSS services starting July 1, 2015, and lasting until June 30, 2016. The legislature will need to address a funding source for avoiding this cut in the next yearly budget. Beth Kurtz - 04/12/2013
Kate Craddock - 10/29/2015