California Adult Day Health Care Update - Court Stops Eligibility Restrictions

In a victory for plaintiffs in the budget-based battles over continuing coverage of Medicaid-funded home and community based services, a federal district court in Oakland today issued an injunction halting California’s plans to implement new, restrictive eligibility criteria for low-income seniors and individuals with disabilities who receive services at Adult Day Health Care centers.  The court found the plaintiffs were likely to succeed on a range of claims, including violations of the Medicaid Act’s reasonable standards and comparability claims, the Americans with Disabilities Act’s integration mandate, ADA and Rehabilitation Act methods of administration regulations, and the U.S. Constitution’s due process guarantee.  The court also concluded that the state’s fiscal crisis did not outweigh the public interest in providing access to healthcare for the most needy.   

The plaintiffs are represented by Disability Rights California, the National Senior Citizens Law Center, AARP Foundation Litigation, the National Health Law Program, and the pro bono firm of Howrey LLP.  Read the court's order here l Media coverage: San Francisco Chronicle

Medicaid Payment for Assisted Living: Current State Practices, and Recommendations for Improvement

This issue brief examines many of the most important issues in Medicaid payment for assisted living, and makes recommendations for policy changes at the federal and state levels. Among other things, the issue brief recommends that Medicaid-certified facilities be required to accept Medicaid from Medicaid-eligible residents, and not be allowed to demand or solicit “supplemental payments” from residents’ family members or friends. The federal government at a minimum should require that Medicaid-certified facilities not discriminate against Medicaid-eligible residents.

Read the issue brief here.  

NSCLC’s most recent issue brief provides an overview of the boundaries of a state’s home health service standard, including a discussion of the controversy in Missouri, in order to provide useful background for advocates trying to maximize the community-based options of persons with chronic needs.

Read the issue brief here.

Over 200,000 people may be eligible again; $500 million in retroactive benefits available

The settlement of the class action lawsuit (Martinez v. Astrue), brought by NSCLC and co-counsel, has ended the Social Security Administration’s policy of denying or suspending benefits for “fleeing to avoid prosecution,” based solely on the existence of an outstanding felony arrest warrant.   In addition to abandoning the illegal policy, SSA has agreed to repay benefits to many.

Learn more about Martinez v. Astrue: Martinez Settlement Website

LGBT Aging and Long-Term Care Fairness Survey 

We are still accepting responses for this survey l Read More l Click here to fill out the survey