Arizona Center for Disability Law
E. v. R.:
The Center represents:
R, Re, and G. The children
in this family live in Tucson,
Arizona. Prior to 1997, the
family lived in New York,
a state which covered medically necessary incontinence briefs for their
daughter R. R, age 10, has been diagnosed with Down Syndrome, sensory
integration disorder, hypothyroidism, hypotonia and severe eczema. Re,
age 5, has Down Syndrome and is severely developmentally delayed. G, age
7, has Down Syndrome and is profoundly mentally retarded. All children
are incontinent of bowl and bladder as a result of their disabilities and all
were denied medically necessary incontinence supplies as a result of the AHCCCS
policy. The family must spend approximately $320 per month for
incontinence supplies for their disabled children to participate in social,
therapeutic and community activities.
RH is 8 years old and lives
with his family in Tucson, Arizona. RH was born at 29 weeks,
weighed 700 grams or approximately 1.5 pounds at birth, and has been diagnosed
with developmental delays, periventricular leukomalacia and hypospadias (an
abnormal position of the opening from which urine passes). RH’s surgery
to correct the hypospadias failed to ameliorate the condition. RH is
incontinent of bowl and bladder and requires medically necessary incontinence
briefs. His family has to spend approximately $100 per month for
incontinence briefs as a result of the AHCCCS policy. These costs are a
significant financial hardship for the family as his father and mother receive
social security insurance/disability income as their sole source of
income.
CH is 14 years old and
lives in Mesa, Arizona with her family. CH has
Aicardi Syndrome and requires medically necessary incontinence briefs because
she is incontinent of bowl and bladder. Because of the AHCCCS policy, her
family must spend approximately $120 per month for CH’s incontinence briefs.
KR is 16 years old and
lives with her family in Phoenix,
Arizona. KR has Spina
Bifida, mental retardation and is paralyzed from the waist down. She is
incontinent of bowl and bladder and requires medically necessary incontinence
briefs which AHCCCS will not cover. The cost to her family is
approximately $100 per month.
NI is 9 years old and lives
with his family in Scottsdale,
Arizona. NI has profound
Autism, profound mental retardation and is non-verbal. He is incontinent
of bowl and bladder and requires medically necessary incontinence briefs which
AHCCCS will not cover. The cost his family must spend is approximately
$180 per month.
The legal theory upon which this
case was brought is that the federal Early Periodic Diagnostic Screening and
Treatment Program (EPSDT) statute, which is part of Medicaid, requires the AHCCCS
program to cover incontinent supplies for minors whose incontinence is a result
of their disability. The Center is
seeking declaratory and injunctive relief asking the Court to order AHCCCS to
cover diapers for members of the class.
The Center is also requesting that persons in this situation be
reimbursed for the briefs they have purchased since this lawsuit was
filed.
The Court has denied the State’s
Motion to Dismiss the Center’s lawsuit and has granted the Center’s request to
certify the case as a class action. The
class includes two subclasses. One is a
class of persons under the age of 21 who are eligible for AHCCCS services and
who need incontinence briefs as a result of a disability, the second is a class
of the children’s parents who have purchased incontinence briefs at personal
cost.
Please contact the Center’s
Healthcare Team if you would like more information.
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