INDIANAPOLIS — The Indiana Protection and Advocacy Services Commission has filed a lawsuit in Indianapolis federal court against the Indiana Family and Social Services Administration surrounding upcoming changes to the state’s Aged and Disabled Medicaid Waiver program.
On July 1, the administration is expected to implement changes to the A&D Medicaid Waiver program, stating that at that point, parents or legal guardians of a minor (Legally Responsible Individuals) will no longer be allowed to provide attendant care and receive payments through the waiver program.
The FSSA made this announcement after there was a reported variance of more than $980 million in state funding compared to “previously anticipated expenses” in relation to the Medicaid program.
In a statement from the FSSA at the time, officials said that there were reported increases in attendant care expenditures under the waiver which was a “significant driver of the rapid and unanticipated growth” in the state’s Medicaid spend.
“Attendant care is a service under the waiver that provides unskilled care to older adults and people with disabilities, including children, with daily activities such as bathing, meal prep and household tasks,” the statement read. “The agency’s research further showed the increased expenditures were in part due to paying parents of minor children and spouses hourly to support daily activities for their loved ones. FSSA identified and selected a path that permits parents of minor children and spouses to continue to provide paid care to their loved ones in a fiscally sustainable way through another service called Structured Family Caregiving, while still receiving other eligible services on the Aged & Disabled waiver.“
The lawsuit argues that FSSA’s decision surrounding the program violates federal Medicaid rules, stressing that through the structured family caregiving service, FSSA fails “to ensure that providers of this service are paid a livable wage.” The lawsuit also argues that in order to receive the service, “families must forgo other services necessary for their children.,” putting them at risk to be institutionalized, which they said violates the Americans with Disabilities Act.
“Children with medically complex conditions often need near constant care and supervision. Parents and families have for years been able to cobble together a patchwork of services and caregivers, including serving as paid caregivers themselves, to ensure their children have what they need to live safely in the community,” Melissa Keyes, the executive director at Indiana Disability Rights, said in a news release from the ACLU of Indiana surrounding the lawsuit. “Now, FSSA is throwing a wrench in those plans without ensuring there are appropriate alternatives available.”
The lawsuit ultimately asks for a preliminary injunction to be implemented, preventing the FSSA from moving forward with the changes that would be implemented on July 1. The goal would be for LRI’s of enrollees in the A&D waiver to continue serving as providers of attendant care services through the program.
“Children with disabilities deserve the opportunity to live and thrive in their communities, not be forced into institutions,” Gavin Rose, the senior staff attorney at the ACLU of Indiana, said in the release. “We are committed to ensuring these children can remain safe and healthy at home with their families.”
