A contempt-of-court motion filed against the Department of Health Care Services was recently withdrawn by Disability Rights California, though adult day health care advocates said they might re-file later.
“We still think we’re right and the department is wrong,” said Elissa Gershon, a senior attorney at Disability Rights California. “But once we began having discussions, it became clear it wasn’t something that was as appropriate to bring before a federal judge.”
There were two main sticking points in the contempt filing, one of which has been worked out, Gershon said.
“We resolved the issue of presumptive eligibility, and the other piece we were not able to resolve. We were not able to agree at taking another look at the rejections,” Gershon said.
The two sides agreed on the group of ADHC beneficiaries who should be presumed eligible for Community-Based Adult Services, the new program created as part of a settlement of a lawsuit in December. The contempt filing claimed that the DHCS violated terms of that settlement.
The second issue revolves around beneficiaries who were first deemed eligible for CBAS through a state-run assessment, and then subsequently deemed ineligible.
Those ineligible beneficiaries can still exercise their rights through individual fairness hearings, and that may be a more appropriate venue for review than federal court, Gershon said.
“It’s a different kind of procedure. Those issues might better be resolved in individual hearings,” she said. “Then the question is, the judge would have to say, ‘Do I have enough to determine that the whole process is arbitrary?’ And that seemed to be a grayer area.”
About 80% of all ADHC beneficiaries were found eligible for the new CBAS program, DHCS officials said. Of the roughly 40,000 ADHC recipients, about 32,000 are now eligible, according to Norman Williams, deputy director of DHCS’s Office of Public Affairs.
The number of people who were first found eligible, and then reclassified as ineligible, is roughly 500 to 600, according to Gershon.