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ACLU challenges state on Medicaid changes

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By MEGAN BANTA

The American Civil Liberties Union of Indiana has filed suit against the Indiana Family and Social Services Administration over changes to two of the agency's Medicaid waiver programs.

The ACLU filed the class-action lawsuit on Friday in U.S. District Court to challenge the way the FSSA now operates the Community Integration and Habilitation Waiver and the Aged and Disabled Waiver.

The programs are called waivers because federal officials have allowed the state to spend the money in ways that are different than traditionally permitted by Medicaid.

Marni Lemons, spokeswoman for FSSA, said the agency had not received or had time to review the case yet and had no comment on the lawsuit.

The ACLU is representing Karla Steimel, a 27-year-old with cerebral palsy and other medical conditions, and others.

Steimel currently receives treatment five days a week at a facility that allows her to live independently. But due to changes to the Medicaid home and community-based waiver programs, she will now be at risk of being placed in an institution to continue receiving adequate care, the suit says.

FSSA eliminated the wait-list for the CIH waiver in the fall of 2012 - but not by providing those on the list with services. Instead, the state revamped the program and restricted access to those who met "priority criteria."

Under the new rules, many people who once would have been eligible to receive services through the program - though they may have been waitlisted for up to 10 to 15 years - can never become eligible, the lawsuit said.

The state agency also recently determined that people with developmental disabilities will no longer receive services through the Aged & Disabled waiver unless they also need special services that require the assistance of a registered nurse, such as ventilation or medication administration.

Steimel has been on the wait-list for the CIH Waiver for more than a decade and has received services through the A&D Waiver for about eight years. But she only needs daily assistance with basic tasks, not skilled nursing services.

In January, FSSA informed Steimel that because of the changes to these programs, she is no longer eligible for either one. Steimel now is only eligible for a smaller waiver program, a change that will cut her benefits from 160 to 40 hours of services per month, according to the ACLU. That cut means she can no longer travel to her job daily, the lawsuit says.

Gavin Rose, a staff attorney with the ACLU of Indiana, said these changes will cause the state program to conflict with U.S. law.

"The Americans with Disabilities Act of 1990 requires that states provide services to individuals with disabilities in the least restrictive setting appropriate to their needs," Rose said. "Right now, Indiana is not living up to that mandate."

The lawsuit alleges that the agency's policies violate not only the ADA, but also the Rehabilitation Act of 1973. The suit seeks to reinstate the wait-list and eliminate the "priority criteria" for the CIH waiver. It also seeks to compel FSSA to provide notice to and an appeal opportunity for applicants who have been eliminated from the wait-list and to make the wait-list process move at a more reasonable pace.

Megan Banta is a reporter for TheStatehouseFile.com, a news service powered by Franklin College journalism students and faculty.

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