Temporary freeze to home care cuts

Lawsuit against DHS

In April 2017, we filed suit against the Department of Human Services after the agency implemented across-the-board cuts to in-home care services for adults and children with developmental disabilities. For some people these cuts eliminated hundreds of hours of critical supports per month.

Several days later, DHS and DRO agreed to a temporary freeze to ongoing cuts to in-home care services. We began the process creating a long-term plan for assessing needs and providing fair notice to people with disabilities of changes to their services.

UPDATE: June 2018:  The U.S. District Court accepted a joint update from DHS—ODDS and DRO, and ordered the parties to give another update in six months. Some key takeaways are:

  • The preliminary injunction, which froze cuts to in-home care services, remains in effect. In-home service hours cannot be reduced at this time.
  • Beginning July 1, 2018, ODDS plans to test a new assessment tool – called the Oregon Needs Assessment (ONA) –but not tie service hours to the results of the ONA’s assessment yet. ODDS will pilot the ONA on all individuals with renewing service plans to ensure its quality and accuracy. These individuals will no longer be assessed using the prior tools (the ANA and CNA). The ONA will gather valuable information for service planning.
  • ODDS is currently targeting July 1, 2019 as the date when it will start using the ONA to set hours. Until then, the agency will continue developing the ONA.

Evaluation of Tool

  • Oregon Health & Science University (OHSU) reviewed:
    • How well the questions on the ONA measure what they are intended to measure (validity) and
    • How often different assessors record the same results when assessing the same person (reliability).
  • OHSU concluded “it is reasonable and appropriate to proceed with implementation of the ONA,” provided that ODDS implements OHSU’s recommendations to continue to assess reliability.

Concerns with Assessing Children’s Needs

  • OHSU found that too few children had been tested to know whether the ONA is reliable for assessing children. ODDS plans to continue working with OHSU to further evaluate the reliability of the ONA for children.

Setting Service Hours

  • People who receive services through ODDS will be divided into separate service level groups. For people who receive in-home services, an individual’s service group level will correspond to a range of support hours available to them. Contractors from Human Services Research Institute (HSRI), with input from ODDS staff and stakeholders, have begun the work of developing service level groups for the ONA. DRO is monitoring this process.

Exceptions Process

  • With input from DRO, ODDS has also begun the process of redeveloping its exceptions process.

More Work Ahead

  • We’ll work with ODDS to ensure the new assessment tool is finalized in a way that will meet the needs of Oregonians with I/DD.
  • We’re committed to ensuring that ODDS puts in place a fair and transparent process for getting exceptional services.
  • We’ll continue to make sure that when individuals’ services change, they get fair notice.

The parties will update the court again by December 10, 2018.

Relevant documents: Joint Status Report (June 4, 2018)

Court Orders a Stay of Lawsuit

Disability Rights Oregon and the Oregon Department of Human Services requested a six-month stay of the lawsuit, which means the lawsuit will be on hold while DHS works on improving the tool. The U.S. District Court has ordered that the stay will remain in place for another six months. The parties will update the court by December 5, 2017. The preliminary injunction, which freezes support hours cuts, remains in place as well. (June 12, 2017)

Preliminary Injunction

On April 19, 2017, Disability Rights Oregon and the Oregon Department of Human Services agreed to a temporary freeze to ongoing cuts to in-home care services, while the parties try to create a long-term plan for assessing needs and providing fair notice to people with disabilities of changes to their services.

This order is not a final fix, but it will allow services to remain in place as the case continues.A group of people with intellectual and developmental disabilities and their families filed a class action lawsuit in U.S. District Court against Oregon’s Department of Human Services (DHS). They claim that the state agency arbitrarily cut the number of in-home care hours that they rely on to meet their basic medical and social needs.

In-Home Care Services

People with disabilities who have substantial needs can receive in-home care assistance from personal services workers for a wide array of activities of daily living, including help with eating, food preparation, toileting, communication, behavioral assistance, medication administration, and bathing.

Nearly 8,000 adults and more than 3,000 children in Oregon accessed in-home care services between 2015 and 2017. The services are primarily funded by federal Medicaid dollars through Oregon’s Office of Developmental Disabilities, a division of DHS, and its contractors.

DHS’s Arbitrary Cuts

Last September, without explanation, DHS implemented across-the-board reductions to in-home care services, eliminating hundreds of hours of critical supports.

Lawsuit

On April 10, Disability Rights Oregon filed a class action lawsuit in U.S. District Court. We argued, on behalf of our clients, that the benefit cuts conflict with a fundamental principle of the Americans with Disabilities Act: People with disabilities who can live in and mix with the community should not be not unnecessarily isolated.

Relief Sought

The plaintiffs are asking the federal court to direct DHS to restore previous in-home care hours, change their assessment tool, and alter the process for providing notice of benefit changes to people with disabilities and their families. Plaintiffs also want DHS make the appeals process more meaningful.

People Impacted

The plaintiffs, several adults and one child, reside in Clackamas County, Harney County, Douglas County, and East Portland. These far-reaching cuts impact nearly every person in Oregon with intellectual or developmental disabilities who rely on in-home care.

Resources:

Preliminary Injunction
FAQ: Preliminary injunction
Order for preliminary injunction-April 19 2017
Motion for preliminary injunction
Release-People with developmental disabilities win temporary freeze to service cuts

Additional Resources
FAQ-Analysis of Legal Issues
Complaint – odds class action
Motion for class certification
DHS cuts to in-home care-press release-April 11 2017

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