Case Challenging Indiana's Shift of Many to Waiver Program Capping Services May Proceed

The 7th Circuit Court of Appeals reverses a lower court\’s grant of summary judgment in favor of the state, ruling that Indiana may have violated the Americans with Disabilities Act with a policy change that reassigned many developmentally disabled individuals to a capped waiver program, putting them at risk of institutionalization. Steimel v. Wernert (7th Cir., No. 15-2377, May 10, 2016).

Indiana offers three separate Medicaid waiver programs for people with developmental disabilities, along with services through its primary Medicaid program.  The Aged and Disabled (A&D) and the Community Integration and Habilitation (CIH) waivers offer slightly different services, but those programs have no cap on expenditures.  The Family Supports (FS) waiver also offers community supports, but it caps the services provided at $16,545 annually.  

In 2011, the Indiana Family and Services Administration changed its method for placing people into these waiver programs, with the result that many people who were previously receiving uncapped A&D services were transferred into the capped FS program.  Karla Steimel and several other plaintiffs sued the state, claiming that placement in the FS waiver violated the Americans with Disabilities Act\’s integration mandate, because it forced them to become institutionalized in their own homes due to the lack of community services provided.  A trial court refused to certify a class action and granted summary judgment in favor of the state.  The plaintiffs appealed.

The 7th Circuit Court of Appeals reverses the trial court\’s grant of summary judgment.  The court finds that \”[t]he plaintiffs in our case have provided evidence that they need constant supervision and, despite their best efforts, the services provided under the FS waiver have proved inadequate to prevent life-threatening gaps in care . . . At this point, the state had provided no evidence to the contrary and has decided that the plaintiffs are currently ineligible for the CIH waiver.  This is enough to raise a genuine question of fact about the adequacy of the CIH waiver as a safeguard against a serious risk of institutionalization.  The plaintiffs\’ claims are therefore ripe.\”  However, the court refuses to certify the class, finding the definition too vague.

To read the full opinion, go to:

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