A federal appeals court affirmed a lower court’s preliminary injunction Wednesday, allowing two Hoosier mothers to continue providing state-reimbursed caregiving services to their medically fragile children.
Plaintiffs, represented by the American Civil Liberties Union of Indiana and Indiana Disability Rights, argued that the children’s care was too intensive to transition from attendant care to another state program last August. With a statewide shortage of nurses, mothers also said they couldn’t use state services to hire an outside caretaker and had to take on the 24/7 responsibilities themselves.
“We are grateful that the courts have once again recognized that these children deserve to live at home with their families, not be forced into institutions,” said Gavin Rose, the ACLU’s deputy legal director. “Our clients have dedicated themselves to becoming specially trained in the needs of their children, and no one is better qualified to provide the round-the-clock care they require.”
Responding to a nearly $1 billion projected Medicaid shortfall, state leaders with the Family and Social Services Administration made several changes in 2024 and halted a program that paid parents to be caregivers to their children with medically complex conditions. The attendant care program for Legally Responsible Individuals paid parents an hourly, livable wage but roughly 1,600 families were transitioned to another service that paid a per diem stipend at a far lower rate.
Two mothers sued and were eventually granted a preliminary injunction, which the U.S. Seventh Circuit Court of Appeals affirmed this week. Previously, a federal judge in Indianapolis ruled that FSSA must secure in-home skilled nursing services for both children on top of program offerings. The state documented dozens of calls to nursing agencies, nearly all of which couldn’t do the work for one reason or another.
In filings, attorneys argued that the only other viable option for the mothers would be institutionalization, which one mother had previously tried and dismissed. The state has two such facilities equipped to handle such care.
“The Court’s decision recognizes the very real threat that these families faced following the changes to the Medicaid waiver in 2024, and the likelihood that these parents would have faced the unthinkable decision of having their children placed in an institution,” said Sam Adams, a senior attorney with Indiana Disability Rights. “This decision reinforces the understanding that children with complex medical needs are best served when they can remain at home with their families. The Court found that there are steps that FSSA can and must take to help ensure these children remain safely in their families’ homes.”
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