Arizona Center for Disability Law
FOR IMMEDIATE
RELEASE Contact:
Peri Jude Radecic, Director of Public Advocacy
June 22, 2005 (520) 327-9547, extension 24
Cell: (623) 308-5111
Arizona Center for Disability Law Files Class Action Lawsuit Against
Arizona Health Care Cost Containment System
Eligible Children
with Disabilities Denied Medically Necessary Incontinence Briefs
Tucson, June 22,
2005.....Today in federal court, the Arizona
Center for Disability Law (Center)
filed a class action lawsuit against the Arizona Health Care Cost Containment
System (AHCCCS), Arizona’s
Medicaid system. Plaintiffs in this case
are children with disabilities who are recipients of state Medicaid services
and need incontinence briefs because of their disabilities. Currently, AHCCCS will not cover incontinence
briefs for children with disabilities unless the child has experienced skin
breakdown, sores or infections.
“Arizona’s policy to wait until a child with a disability
develops skin breakdown and infection before covering incontinence briefs is
cruel as well as contrary to federal Medicaid law,” said Sally Hart, staff
attorney at the Center, who brought the lawsuit. “It is well recognized by Medicaid programs
across the United States
that incontinence briefs for children are medically necessary and must be
provided.”
The Center represents:
Rachel, Rebecca and Grace Ekloff. The Ekloffs live in Tucson, Arizona. Prior to 1997, the Ekloffs lived in New York, a state which
covered medically necessary incontinence briefs for their daughter Rachel. Rachel, age 10, has been diagnosed with
severe, low-function Down Syndrome, sensory integration disorder,
hypothyroidism, hypotonia and severe eczema.
Rebecca, age 5, has Down Syndrome and is severely developmentally
delayed. Grace, age 7, has Down Syndrome
and is profoundly mentally retarded. All
children are incontinent of bowel and bladder as a result of their disabilities
and all were denied medically necessary incontinence supplies as a result of
the AHCCCS policy. The Ekloffs must
spend approximately $320 per month for incontinence supplies for their disabled
children to participate in social, therapeutic and community activities.
Richard Harris is 8 years old and lives with his
family in Tucson, Arizona.
Richard 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).
Richard’s surgery to correct the hypospadias failed to ameliorate the
condition. Richard is incontinent of
bowel 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.
Caitlin Hoel is 14 years old and lives in Mesa, Arizona
with her family. Caitlin has Aicardi
Syndrome and requires medically necessary incontinence briefs because she is
incontinent of bowel and bladder.
Because of the AHCCCS policy, her family must spend approximately $120
per month for Caitlin’s incontinence briefs.
Kristina Richards is 16 years old and lives with her
family in Phoenix, Arizona.
Kristina has Spina Bifida, mental retardation and is paralyzed from the
waist down. She is incontinent of bowel
and bladder and requires medically necessary incontinence briefs which AHCCCS
will not cover. The cost to her family
is approximately $100 per month.
Nicholas Igras is 9 years old and lives with his
family in Scottsdale, Arizona.
Nicholas has profound Autism, profound mental retardation and is
non-verbal. He is incontinent of bowel
and bladder and requires medically necessary incontinence briefs which AHCCCS
will not cover. The cost his family must
spend is approximately $180 per month.
In the lawsuit, the Center argues that Arizona has failed to adhere to the legal
requirements set out in federal Medicaid statutes and regulations which
requires states to cover incontinence supplies for eligible children with
disabilities.
“There are special provisions in federal Medicaid law to
provide enhanced services to children,” said Jennifer Nye, staff attorney at
the Center and co-counsel on the case.
“This lawsuit is about making sure children in Arizona get all of the services they are
entitled to under federal law.”
A favorable ruling would not make Arizona the first state in the country to
pay for incontinence briefs for children with disabilities who are Medicaid
eligible. Research conducted by Center staff indicates as many as 36 other
states supply incontinence briefs for Medicaid recipients.
Ekloff v. Rodgers is a continuation of the Center’s
work to ensure that people with disabilities have the health care services they
need. The Center’s Health Care Services
Team handles issues ranging from the denial of assistive technology such as an
electric wheelchair to another class action lawsuit against AHCCCS, Ball v.
Rodgers, which was filed to remedy on-going problems with the provision of
adequate in home personal care attendant services for individuals enrolled in Arizona’s Long Term Care
Program.
Sally Hart and Jennifer Nye are the Center’s lead attorneys
on this case.
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The
Arizona Center for Disability Law is a not for profit public interest law firm,
dedicated to protecting the rights of individuals with a wide range of
physical, mental, psychiatric, sensory and cognitive disabilities. The Arizona Center
for Disability Law is authorized under various federal statutes to ensure the
protection and advocacy of all individuals with disabilities in the state.
100 North Stone
Avenue P Suite 305 P Tucson, Arizona 85701
(520) 327-9547 (Voice/TTY) P Fax (520) 884-0992
www.acdl.com P center@acdl.com