New Orleans – A federal judge approved settlement of a class action lawsuit that will enable children and youth with complex medical needs to get the in-home nursing they need to remain healthy, safe, and at home. The judge’s ruling will benefit hundreds of families with medically fragile children.
Four children who required nursing care but were not receiving the care they needed filed on May 5, 2019 against the Louisiana Department of Health, claiming that the State failed to fulfill its commitment to provide them and hundreds of other Medicaid beneficiaries like them with Medicaid in-home nursing services. The case was brought by the Disability Rights Louisiana, formerly the Advocacy Center, and the National Health Law Program. The Louisiana Department of Health agreed to program changes and other steps to improve this group of children’s access to nursing services and settle the case.
“These children are extremely vulnerable and at a heightened risk for institutionalization, irreversible medical problems, and death as a result of insufficient supports and services being provided by the Louisiana Department of Health,” said Christopher Rodriguez, the Executive Director of Disability Rights Louisiana. “This settlement will transform the lives of these children and thousands like them across Louisiana.”
Ms. Kodi Wilson, the mother of one of the plaintiffs who requires extensive care and constant support from medical equipment to survive described some of the challenges faced by children with complex medical needs. “Since my son has had a tracheotomy surgery and was placed on a ventilator 24/7, finding consistent and reliable skilled nursing care for him that can be provided in our home has been a real struggle. We have only had a few months of full coverage in nearly a decade.”
Ms. Wilson also highlighted how lack of support for children with complex medical needs hurts entire families. “I am facing health challenges due to lack of proper supports for him, and I see other parents struggling with the same issue. Parents shouldn’t have to choose between their own health and their child’s. I just felt it was time to try and fix this system for the long term so that families like ours can get the help they really need.”
Experiences like this are not unique. Many Medicaid-eligible children in Louisiana have been approved by the State to receive Medicaid in-home nursing care. Yet because the state lacks an effective system for arranging nursing and for parents to elevate issues when they experience them, many children make do with far fewer hours than they need. This creates an unacceptable risk of medical complications, hospitalization, and placement outside of the family home.
The stakes are high, and parents are forced to navigate a complex bureaucracy, while also taking care of their children with complex medical needs.
Jessica Michot, whose son Gabriel was one of the plaintiffs until his death last year, reflected on how this settlement will provide hope for other families. “Although my son, Gabriel, did not survive to see this lawsuit through the end, I am still hopeful that other individuals with medical complexities will now receive their prescribed skilled nursing hours. Not only will this mean a more consistent, better quality of care, but a better quality of life for the entire family.” She continued, “instead of performing numerous medical tasks daily, receiving these necessary hours will allow the families to spend more quality time together and create lasting memories.”
Elizabeth Edwards, attorney with the National Health Law Program, noted how this is an issue that affects many children who rely on Medicaid services to stay safely at home with their families. “The Medicaid obligations are clear – states must make sure that these children are not only approved for in-home nursing services, but that they receive these services. We are gratified that Louisiana has recognized that it has a responsibility to ensure these children receive in-home nursing services and is working to improve the system.”
For more information or comment from counsel about this matter, please contact Amitai Heller at [email protected] or 504.517.9102.
About Disability Rights Louisiana: Disability Rights Louisiana protects and advocates for the human and legal rights of all children, adults and seniors with disabilities. Our work aims to empower the disability community to live an integrated life, free from abuse, neglect and exploitation.
About the National Health Law Program: Founded in 1969, the National Health Law Program protects and advances the health rights of low-income and underserved individuals and families. The National Health Law Program advocates, educates and litigates at the federal and state levels. Our lawyers and policy analysts stand for the rights of the millions of people who struggle to access affordable, quality health care. Learn more at www.healthlaw.org.