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NCLEJ and Colleagues Challenge Reduction in Medicaid Services for Adults with Severe Developmental Disabilities

NCLEJ has joined advocates from Legal Services of South Central Michigan and the Michigan Poverty Law Program as co-counsel in Waskul v. Washtenaw County Community Mental Health, a federal court appeal challenging county budget cuts in the State of Michigan that have resulted in significant reductions in Medicaid services for adults with severe developmental disabilities. These fiscal cuts have posed significant threats to the ability of these individuals to remain in their homes.

Michigan receives federal funding under a Medicaid waiver to assist people with developmental disabilities with critically needed activities of daily living necessary to allow them to live in their own homes, or in a community supported living arrangement setting. These individuals also receive personal assistance and support services necessary to aid them in participating in community activities, as well as community living supports designed to facilitate their independence and productivity and to promote inclusion in the community. If not for the availability of these home and community-based services, these individuals would require a level of medical care that is provided in intermediate care facilities. One core value of these services is the participant’s right to self-determination.

The State of Michigan has a long history of authorizing these services, which are seen as a more humane and cost-effective alternative to institutionalization. For fiscal reasons, the defendant county agency reduced the individually allocated budgets for the plaintiffs that allow their guardians to pay caregivers to deliver medically necessary services in the home. As a result, they have been placed at significant risk of being uprooted from their homes and institutionalized. For example, one of the named plaintiffs, who suffers from a developmental disability and severe autism, was faced with the loss of qualified caregiver staff, which in turn posed a threat to his ability to lead a stable existence in his home.

Plaintiffs allege that the cuts violate the Medicaid Act, which requires the provision of reasonably prompt and medically necessary services in the amount, duration, and scope sufficient to reasonably achieve their purpose. They also allege that the insufficient notices of the budget reductions issued by the defendant violated their rights to due process.

The federal district court denied the plaintiffs’ request for a preliminary injunction and they have appealed to the Sixth Circuit Court of Appeals. The appeal is currently pending.

For further information contact NCLEJ Senior Attorney Greg Bass at