Arizona Center for Disability Law

 

 

STATEMENT OF SALLY HART

Senior Litigation Attorney, Arizona Center for Disability Law

                                                                                                                                                                       

June 22, 2005

 

            Good morning.  Thank you for coming to hear about the new public interest lawsuit filed by the Arizona Center For Disability Law.

 

            My task this morning is to describe the legal foundation for Plaintiffs' claims in  Ekloff v. Rodgers.  Fortunately, it is quite simple.  The AHCCCS Administration's policy of denying incontinence supplies to children with disabilities violates  requirements of federal law.

 

            The federal Medicaid statute authorizes states to establish medical assistance  programs for eligible individuals.  These Medicaid programs are jointly funded by the federal and state governments.  Arizona has designed its Medicaid program -- called AHCCCS -- within a framework of options and requirements mandated by the federal statute.   AHCCCS is required to provide eligible persons like Plaintiff children with specific health care items and services, including medical supplies like incontinence briefs.

            AHCCCS has gotten around this requirement by covering incontinence briefs only as treatment after a beneficiary has developed open sores, but not to prevent such sores.  Ironically, this policy violates Defendants' own definition of "medical necessity" for health care.  The AHCCCS regulations state that "‘Medically necessary' means a covered service provided . . . to prevent disease, disability, or other adverse health conditions or their progression, or prolong life."  But the Defendants have made an exception to this definition in order to justify their refusal to cover incontinence briefs needed to prevent skin breakdown and allow beneficiaries to participate in educational and community activities.

 

            Furthermore, federal Medicaid  law expresses a special concern for the health care needs of children and youth under 21 years of age.   They are entitled to a broader than usual package of services called Early and Periodic Screening, Diagnosis and Treatment services.  EPSDT services include health care needed "to correct or ameliorate defects and physical and mental illnesses and conditions . . . , whether or not such services are covered by the State plan."  42 U.S.C. § 1396d(r)(5).  A recent decision by the 5th Circuit Court of Appeals held that a Louisiana policy denying coverage of incontinent supplies violated the protections of the  EPSDT statute.  S.D. v. Hood, 391 F.3d 581 (5th Cir. 2004).

 

            We are optimistic that the strong legal basis for this lawsuit will bring relief to children and their families throughout the State of Arizona.

 

 

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