On June 14, 2013, a disabled adult beneficiary of a state-run Medicaid waiver program who was also on a waitlist for another Medicaid waiver program filed this lawsuit in the U.S. District Court for the Southern District of Indiana. The plaintiff sued the Secretary of the Indiana Family and Social Services Administration and two heads of divisions of that agency in their official capacities under the Medicaid Act, 42 U.S.C. § 1396a(a)(3), 42 U.S.C. § 1983, Americans with Disabilities Act, 29 U.S.C. § 794, et seq. and Section 504 of the Rehabilitation Act, 42 U.S.C. § 12101, et seq. The plaintiff, represented by the ACLU of Indiana, asked the court for both declaratory and injunctive relief, attorney's fees and costs, and class action certification.

The plaintiff alleged that the defendant violated 42 U.S.C. § 1983, the "integration mandate" of the Americans with Disabilities Act, and Section 504 of the Rehabilitation Act by changing its eligibility requirements for Medicaid waiver programs and by not allowing an appeal from the policy change as required by the Medicaid Act, 42 U.S.C. § 1396a(a)(3). Specifically, the plaintiff claimed that the defendant [1] removed the waitlist for the Indiana's Community Integration and Habilitation Medicaid Waiver Program and established new "priority criteria" that limited access to the program that many and [2] instituted a new policy for Indiana's Aged and Disabled Medicaid Waiver Program and its Traumatic Brain Injury Medicaid Waiver Program require recipients to require "a nursing facility level of care." The plaintiff claimed both of these actions violated the "integration mandate" because they deprived disabled persons of the assistance they need to be integrated into the community. The plaintiff further claimed that the defendant failed to inform plaintiff that she could appeal her removal from the waitlist under the Medicaid Act and that the defendant provided no means for securing such an appeal.

On June 14, 2013, the plaintiff moved to have the case certified as a class action. That same day, the plaintiff also filed a motion for a preliminary injunction requesting that defendant be enjoined from removing plaintiff from the Aged and Disabled Medicaid Waiver Program pending further order of the court. The preliminary injunction was withdrawn without prejudice on September 23, 2013.

On March 24, 2014, the court denied the plaintiffs' motion for class certification. 2014 WL 1213390 (S.D. Ind. Mar. 24, 2014).

On June 26, 2014, the court dismissed the original named plaintiff's individual claims because they had become moot--she received a waiver--but she still retained the right to appeal the denial of class certification. The individual claims of intervening plaintiffs still remained.

Later in 2014, the defendants and the plaintiffs both moved for summary judgment. On Mar 27, 2015, the US filed a statement of interest in opposition to the defendants' motion for summary judgment. In May 2015, the court heard oral argument on the motions for summary judgment.

On May 28, 2015, the court dismissed another one of the individual plaintiff's claims because they had become moot--he received a waiver. He also reserved the right to appeal the denial of class certification.

On June 9, 2015, the court granted summary judgment to the defendants. The court concluded that the plaintiffs’ integration mandate claims were not ripe for review. The integration mandate focuses on the setting in which services are administered, not the amount of services received. The plaintiffs did not contend that the setting in which they received services had changed as a result of Indiana's policy change.

Subsequently, the plaintiffs appealed the denial of class certification, the dismissal of the individual plaintiffs, and the grant of summary judgment to the Seventh Circuit. On May 10, 2016, the Seventh Circuit reversed the summary judgement and affirmed denial of class certification. The court found that the State's narrow reading of integration mandate was unwarranted and that there was no reason to interpret it as only applying to "claims by people who literally have been institutionalized." The court held that "setting" does not necessarily refer merely to physical structures, finding that the text of the statute does not compel such a restrictive interpretation and that the integration mandate's protection would be undermined "if plaintiffs were required to segregate themselves by entering an institution before they could challenge an allegedly discriminatory law or policy that threatens to force them into segregated isolation." Indeed, the court pointed out that Indiana's institutions do not have capacity for most people who could be institutionalized. The court also pointed to the purpose of the ADA, which was to prevent outright discrimination. Ultimately, the court held that "the integration mandate is implicated where the state’s policies have either (1) segregated persons with disabilities within their homes, or (2) put them at serious risk of institutionalization." 823 F.3d 902.

The case then returned to the district court for further proceedings. On December 19, 2016, the parties filed a stipulation for dismissal after having reached a settlement, and the court ordered the case dismissed with prejudice the next day. The settlement agreement is not currently available. The case is now closed.

Brian Kempfer - 10/25/2013
Jessica Kincaid - 02/27/2016
Virginia Weeks - 03/17/2018


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