Garcia v. Warring

No. 01-9078 (Mass. Super. Ct. Hampden County Aug. 1, 2002) ; Clearinghouse Number: 54834

Description

Medicaid Recipient Entitled to Reimbursement for Personal Care Attendant Services Provided by Her Daughter

Abstract

The court has held that plaintiff is entitled to Medicaid reimbursement for personal care assistance provided by her daughter. Plaintiff is a 74-year-old woman who has been diagnosed with psychosis and dementia. Defendant Massachusetts Division of Medical Assistance approved plaintiff for 44 hours per week of services from a personal care attendant on April 12, 2000, and increased the approval one year later to 56 hours per week plus two hours of care per night. In May 2000, after an adult day camp and five or six different care givers were unable to provide plaintiff the daily care she required, plaintiff’s daughter quit her job to act as plaintiff’s personal care attendant. In March 2001, defendant informed plaintiff that it would no longer reimburse her for personal care attendant services provided by her daughter. Plaintiff appealed, arguing that defendant’s decision was based on an error of law and arbitrary and capricious in violation of the Americans with Disabilities Act (ADA) and section 504 of the Rehabilitation Act. The court found that, although plaintiff is entitled to personal care attendant services, she has been denied those services because her disability prevents anyone other than her daughter to care for her. The court held that defendant’s refusal to grant a waiver of its regulations, which prohibit family members from providing personal care attendant services, violated the ADA. Accordingly, the court ordered defendant to restore personal care attendant payments to plaintiff for services provided by her daughter retroactive to March 2001 and to continue such payments for as long as plaintiff remains eligible for such services.

Additional Information

Attorney Information
Docket Date
2002-08-01 00:00:00+00:00

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