UPDATE (JANUARY 14, 2020): A Los Angeles Superior Court judge ruled that DHCS must create a process for reimbursing beneficiaries who were wrongly denied services, and notify beneficiaries across the state that they may qualify for in-home services under the spousal impoverishment provision. Read the press release.
Patrick Kelley is a 67-year-old veteran with primary progressive multiple sclerosis. First diagnosed almost 15 years ago, the disease has progressed and Mr. Kelley now has spastic quadriparesis and depends on assistance for all meals, bathing, grooming, and other essential activities. His 75 year-old wife is unable to fully care for him by herself, and the couple has exhausted their savings paying for caregivers.
Matthew Reed is a 62-year-old man who suffered a stroke, and has multiple sclerosis, Bell’s Palsy, and vascular dementia, and cannot perform basic activities of daily living, such as preparing food or using the bathroom unassisted. Mr. Reed needs constant supervision to live safely at home, but his wife must keep her job working nights to pay rent and meet the couple’s basic needs.
Both Mr. Kelley and Mr. Reed would like to remain at home, but both men may have to move into nursing homes because the state of California refuses to implement eligibility rules that would allow the men to qualify for Medicaid to pay for in-home care so they can remain at home with their families.
Many families like the Reeds and and Mr. Kelley and his wife Ms. Rogers are on the brink of financial ruin because California refuses to implement a federal law intended to keep people with disabilities out of institutions while ensuring their spouses do not become destitute.
If Mr. Kelley or Mr. Reed wanted to move into a nursing home, their care would be covered by Medicaid and their spouses would be able to keep sufficient resources to meet their basic needs. A federal rule has been in effect for three and a half years that requires states to apply the same Medicaid eligibility standards for those who prefer in-home care as they require for those moving into nursing homes. California has not implemented this rule, despite the urging of couples like the Reeds and Kelleys who face the terrible decision to confine a spouse to a nursing home simply so the other spouse can keep a minimum amount of assets to meet their basic needs.
The class action lawsuit was filed on July 6, 2017 in Los Angeles Superior Court by Justice in Aging, Bet Tzedek, Disability Rights California, and Western Center on Law and Poverty with pro-bono partner McDermott Will & Emery. Mr. Kelley’s father was a long-time Los Angeles Rams announcer. Watch a CBS story about Mr. Kelley and his father’s legacies here.
Opening Brief (November 8, 2019)
California Lawsuit Aims to Protect Spouses of Disabled from Financial Ruin–California Healthline, July 10, 2017