Preliminary Injunction Blocks California From Reducing Medicaid Benefits Due To Budget Cuts

On September 10, 2009, a federal district court in Northern California issued a preliminary injunction blocking significant cuts in California’s Adult Day Health Care program. Due to budget restrictions, up to 8,000 low income elderly and adults with disabilities were alleged to be at risk of institutionalization, hospitalization, injury or death because their daytime health and nursing care would be eliminated under planned budget cuts. The district court in Brantley v. Maxwell-Jolly (N.D.Cal., No. 09-3798, Sept. 10, 2009) determined that the proposed reductions placed California seniors at serious risk of institutionalization in violation of the Americans with Disabilities Act (ADA).

California’s Adult Day Health Care (ADHC) program serves seniors and people with disabilities who live in the community and receive Medicaid. To be eligible for ADHC services, an applicant must show that a lack of such services would result in a high risk of institutionalization. As part of its effort to balance the state budget, California enacted a law temporarily reducing ADHC services from five days a week to three days a week.

Lillie Brantley and several other ADHC recipients, on behalf of all ADHC beneficiaries, filed a civil rights class action lawsuit against the state alleging that the cuts violated the ADA, the Rehabilitation Act, federal Medicaid law, other federal laws and due process under the U.S. Constitution. The plaintiffs also sought a preliminary injunction blocking the program cuts, arguing that cutting ADHC services from five to three days per week would irreparably harm them and place them at serious risk of institutionalization in violation of the ADA’s “integration mandate.” (The “integration mandate” specifies that persons with disabilities receive services in the “most integrated setting appropriate to their needs.” The “most integrated setting” is defined as “a setting that enables individuals with disabilities to interact with non-disabled persons to the fullest extent possible.” This mandate “serves one of the principal purposes of Title II of the ADA: ending the isolation and segregation of disabled persons.” Citations Omitted.)  In its response, the state claimed that other community programs could make up for the service cuts.

The U.S. District Court for the Northern District of California granted the preliminary injunction after finding that the plaintiffs are likely to succeed on the merits of their claim. The court held that “the proposed reduction in ADHC services will place [the plaintiffs] at serious risk of institutionalization.” The preliminary injunction halted the reduction in ADHC services from five to three days per week. The case continues to determine if the Court’s injunction directing the state to provide ADHC services for five days each week should be made permanent and if restrictive new eligibility criteria, which would permanently end ADHC services for thousands of current participants, are illegal.

The plaintiffs in the Brantley case are represented by Disability Rights California, AARP Foundation Litigation, and the National Senior Citizens Law Center, organizations dedicated to advancing the legal rights of the elderly and disabled Americans.

The Court’s Order granting the plaintiffs’ motion for preliminary injunction can be found here – Order Granting Preliminary Injunction-9-10-09