In-home care decision ‘partial victory’

The state Supreme Court today issued a ruling that reversed a 2007 lower court award of nearly $39 million in prejudgment interest in the case of Rekhter v. state Department of Social and Health Services.
This case dealt with a “shared living rule” a policy since the 1990s that was automated into the department’s client assessment process between 2003 to 2007. It reduced the amount of hours of care awarded to Medicaid clients with live-in providers by an average of 15 percent. The reduction reflected the Medicaid requirement that DSHS consider informal sources of support for clients, including how providers benefited from some of the home-care tasks, such as preparing meals and housekeeping.
In a 5-4 ruling, the Court also upheld the lower court’s decision to award the class of providers $57 million in contract damages. In the majority opinion, the Court held “a jury found that DSHS violated its duty of good faith and fair dealing in the performance of a specific term of its contracts with providers. This verdict accords with relevant law and we affirm it.”
“This is a partial victory for the Department,” said Bill Moss, assistant secretary with the DSHS Aging and Long-Term Support Administration. “There is no doubt that providers do an outstanding job of serving our vulnerable population. It is rewarding work, but can be difficult and stressful.
“But when dealing with limited funds, it is critical to do everything possible to stretch and leverage funds to sustain services and to care for the greatest number of folks with personal care needs,” Moss said.
In 2007, the Supreme Court ruled in another case – Jenkins v. DSHS – that the automatic reduction aspect of the shared living rule was invalid because it was inconsistent with a federal Medicaid requirement. DSHS repealed the rule and reassessed the needs of home care clients, who were individually assessed to determine whether an increase in a public assistance award was warranted.
In today’s split ruling, a dissent authored by Justice Stephens stated those in this class of providers could not claim their contracts because federal law governs how Medicaid benefits are determined.
DSHS is nationally recognized for its innovative, long-term care programs and is ranked as second in the nation by AARP in its 2011 state scorecard on Long-Term Services and Supports for Older Adults, People with Disabilities, and Family Caregivers. Additional information can be found at:
DSHS does not discriminate and provides equal access to its programs and services for all persons without regard to race, color, gender, religion, creed, marital status, national origin, sexual orientation, age, veteran’s status or the presence of any physical, sensory or mental disability.