RALEIGH -- Advocates for people with disabilities have filed a federal class-action lawsuit seeking to block the state from cutting in-home care services to 4,000 low-income individuals who need extensive assistance to remain at home and out of an institution.
Today, the state Department of Health and Human Services ends its financial support for such in-home services as assistance with bathing, dressing, toileting, mobility and eating.
Without state help meeting these needs, the advocates say, people who are disabled and have no family or other caretaker available will likely end up in adult care homes, potentially costing taxpayers even more through Medicaid and Medicare payouts.
The lawsuit seeks an immediate injunction barring the state from implementing the cuts to services.
"People with disabilities have a legal right to live in the community when that placement can be reasonably accommodated," said Vicki Smith, the executive director of Disability Rights North Carolina, according to a news release. "The state is violating federal law by deciding to pay for a service for people with disabilities living in institutional settings and not pay for the same service for people with disabilities living in the community."
The Americans With Disabilities Act and the 1990 U.S. Supreme Court decision in Olmstead v. L.C. mandate that long-term care be provided in the setting most appropriate to the needs of individuals with disabilities.
State points to cost
Lanier Cansler, the secretary of Health and Human Services, said the planned cuts will "reduce inappropriate and unnecessary care" and help ensure those most in need of the services can get them.
"The program provides for an appeals process if any consumer believes the service decisions are incorrect," Cansler said in an email message. "If Disability Rights is successful, the delay in implementation could have a more than $40 million effect on next year's Medicaid budget."
In addition to Disability Rights, the lawsuit was filed by Legal Services of Southern Piedmont and the Washington-based National Health Law Program.
The plaintiffs named in the suit include a 59-year-old man with an intellectual disability; a 28-year-old woman with a traumatic brain injury and dementia; a 35-year-old man with cerebral palsy; two women in their 60s who have vision and orthopedic impairments; and a 48-year-old woman with bipolar disorder, arthritis and degenerative disc disease.
"This litigation addresses the state's institutional bias which is driven by the mistaken belief that people with disabilities are best served in institutional settings instead of the community," Smith said. "Not only is institutionalization a violation of federal law, it is immoral and will cost the state more money in the long run."
