A federal district court rules that Colorados Medicaid agency does not have to pay personal care attendants to drive a woman with disabilities to her medical appointments, despite the fact that she is incapable of attending her appointments without assistance and can't afford to pay for transportation. Taylor v. Colorado Department of Health Care Policy and Financing (D.Colo., No. 12-cv-00300-PAB-KMT, Feb. 25, 2013).
Leslie Taylor lives in a rural town in Colorado and receives Medicaid services because of a disability that confines her to a wheelchair and prevents her from driving. Ms. Taylor works with two personal care attendants, who are paid through the Colorado Consumer Directed Attendant Support Services (CDASS) program. Pursuant to state law, CDASS attendants are compensated for help they provide in the home, and are not paid for driving beneficiaries to medical appointments. The state also administers the Non-Emergency Medical Transportation (NEMT) program that reimburses drivers in rural counties up to $0.39 per mile for transporting Medicaid recipients to medical appointments.
Ms. Taylor's personal care attendants drive her to medical appointments without hourly compensation, relying only on the mileage reimbursement. Ms. Taylor asked the state to pay the attendants through the CDASS program for their time since Ms. Taylor was incapable of paying them a minimum wage and she needed their assistance to travel to her medical appointments. The state refused and Ms. Taylor filed suit against the Colorado Department of Health Care Policy and Financing, the state Medicaid agency, alleging that it was violating the Americans with Disabilities Act and the Rehabilitation Act because the NEMT program covers the full cost of transportation for Medicaid recipients who don't need personal care assistance but not for recipients who need additional assistance, resulting in discrimination against people with disabilities. The Department responded with a motion to dismiss.
The U.S. District Court for Colorado grants the Department's motion to dismiss, finding that Ms. Taylor was not denied access to benefits because of her disability. The court explains that "the benefit here is provided to all recipients living in rural areas at the same rate, regardless of disability . . . Ms. Taylor does not allege that non-disabled recipients are entitled to, or are provided with, mileage reimbursements or personal care that she has been unable to obtain. Rather, she alleges that the mileage reimbursement and the personal care services to which all recipients are entitled is insufficient to cover her particular medical needs . . . States have discretion to limit Medicaid services even when doing so deprives certain recipients of adequate care."