Ohio Federal Court Stays State Move to End Woman's Medicaid Private Nursing Care

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An Ohio federal court blocks the state’s attempt to eliminate Medicaid-funded private duty nursing (PDN) care for a woman with severe disabilities while she awaits a ruling on appeal.  Carpenter-Barker v. Ohio Department of Medicaid (S.D. Ohio, No. 1:15-cv-41, Feb. 15, 2018). Megan Carpenter, a young woman in her early thirties, has severe disabilities that prevent her from caring for herself.  In 2014, the Ohio Department of Medicaid (ODM) attempted to reduce the 128 weekly hours of PDN that Ms. Carpenter had been receiving for many years.     Ms. Carpenter’s mother, Cynthia Carpenter-Barker, sued ODM to prevent it from reducing her daughter’s PDN hours.  Ms. Carpenter-Barker’s complaint alleged that ODM failed to provide procedural due process in violation of 42 U.S.C. §1396a and that it violated the “integration mandate” of the Americans with Disabilities Act (ADA), 42 U.S.C. §12132, and the Rehabilitation Act, 29 U.S.C. § 794 et seq.  Her first claim was dismissed as moot in 2016.  The other two claims were dismissed on summary judgment in November 2017.  Ms. Carpenter-Barker appealed the summary judgment ruling and filed a motion to stay and for emergency injunction pending her appeal.  During the pendency of the appeal, ODM issued a letter stating it would completely eliminate Ms. Carpenter’s PDN as of February 8, 2018.  Guided by Federal Rule of Appellate Procedure 8(a)’s four factors for deciding a stay, Ms. Carpenter-Barker argued that her appeal would likely succeed on the merits because, inter alia, the lower court improperly assessed Ms. Carpenter’s medical needs.  She also argued that Ms. Carpenter would suffer institutionalization, injury, or death if PDN hours were eliminated, and that the precedential value of the case and public interest weighed in favor of a stay.  ODM argued that Ms. Carpenter was not at risk of irreparable harm, that in fact she never received the full 128 weekly hours of PDN, and that the public interest would best be served by using the money allotted to Ms. Carpenter for other Medicaid recipients.  The United States District Court for the Southern District of Ohio, Western Division, grants Ms. Carpenter-Barker’s motion to stay and orders ODM to refrain from reducing Ms. Carpenter’s PDN hours until a final ruling is issued on the appeal.  The court finds it is unlikely, though not impossible, that Ms. Carpenter-Barker will establish discrimination in violation of the ADA and the Rehabilitation Act rather than simply showing a medical need for PDN hours.  However, the court is most persuaded by the evidence that Ms. Carpenter would be irreparably harmed by a reduction or elimination of PDN hours and determines that a loss of medical benefits weighs heavily in favor of a stay.  With credible medical evidence that death is a real potential consequence, caution counsels that the stay be granted, the court finds.  A link to the court’s opinion will be provided when available.    Questions? Call us: (866) 296-5509

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An Ohio federal court blocks the state’s attempt to eliminate Medicaid-funded private duty nursing (PDN) care for a woman with severe disabilities while she awaits a ruling on appeal. Carpenter-Barker v. Ohio Department of Medicaid (S.D. Ohio, No. 1:15-cv-41, Feb. 15, 2018).

Megan Carpenter, a young woman in her early thirties, has severe disabilities that prevent her from caring for herself. In 2014, the Ohio Department of Medicaid (ODM) attempted to reduce the 128 weekly hours of PDN that Ms. Carpenter had been receiving for many years.

Ms. Carpenter’s mother, Cynthia Carpenter-Barker, sued ODM to prevent it from reducing her daughter’s PDN hours. Ms. Carpenter-Barker’s complaint alleged that ODM failed to provide procedural due process in violation of 42 U.S.C. §1396a and that it violated the “integration mandate” of the Americans with Disabilities Act (ADA), 42 U.S.C. §12132, and the Rehabilitation Act, 29 U.S.C. § 794 et seq. Her first claim was dismissed as moot in 2016. The other two claims were dismissed on summary judgment in November 2017. Ms. Carpenter-Barker appealed the summary judgment ruling and filed a motion to stay and for emergency injunction pending her appeal. During the pendency of the appeal, ODM issued a letter stating it would completely eliminate Ms. Carpenter’s PDN as of February 8, 2018.

Guided by Federal Rule of Appellate Procedure 8(a)’s four factors for deciding a stay, Ms. Carpenter-Barker argued that her appeal would likely succeed on the merits because, inter alia, the lower court improperly assessed Ms. Carpenter’s medical needs. She also argued that Ms. Carpenter would suffer institutionalization, injury, or death if PDN hours were eliminated, and that the precedential value of the case and public interest weighed in favor of a stay. ODM argued that Ms. Carpenter was not at risk of irreparable harm, that in fact she never received the full 128 weekly hours of PDN, and that the public interest would best be served by using the money allotted to Ms. Carpenter for other Medicaid recipients.

The United States District Court for the Southern District of Ohio, Western Division, grants Ms. Carpenter-Barker’s motion to stay and orders ODM to refrain from reducing Ms. Carpenter’s PDN hours until a final ruling is issued on the appeal. The court finds it is unlikely, though not impossible, that Ms. Carpenter-Barker will establish discrimination in violation of the ADA and the Rehabilitation Act rather than simply showing a medical need for PDN hours. However, the court is most persuaded by the evidence that Ms. Carpenter would be irreparably harmed by a reduction or elimination of PDN hours and determines that a loss of medical benefits weighs heavily in favor of a stay. With credible medical evidence that death is a real potential consequence, caution counsels that the stay be granted, the court finds.

A link to the court’s opinion will be provided when available.

An Ohio federal court blocks the state’s attempt to eliminate Medicaid-funded private duty nursing (PDN) care for a woman with severe disabilities while she awaits a ruling on appeal.  Carpenter-Barker v. Ohio Department of Medicaid (S.D. Ohio, No. 1:15-cv-41, Feb. 15, 2018). Megan Carpenter, a young woman in her early thirties, has severe disabilities that prevent her from caring for herself.  In 2014, the Ohio Department of Medicaid (ODM) attempted to reduce the 128 weekly hours of PDN that Ms. Carpenter had been receiving for many years.     Ms. Carpenter’s mother, Cynthia Carpenter-Barker, sued ODM to prevent it from reducing her daughter’s PDN hours.  Ms. Carpenter-Barker’s complaint alleged that ODM failed to provide procedural due process in violation of 42 U.S.C. §1396a and that it violated the “integration mandate” of the Americans with Disabilities Act (ADA), 42 U.S.C. §12132, and the Rehabilitation Act, 29 U.S.C. § 794 et seq.  Her first claim was dismissed as moot in 2016.  The other two claims were dismissed on summary judgment in November 2017.  Ms. Carpenter-Barker appealed the summary judgment ruling and filed a motion to stay and for emergency injunction pending her appeal.  During the pendency of the appeal, ODM issued a letter stating it would completely eliminate Ms. Carpenter’s PDN as of February 8, 2018.  Guided by Federal Rule of Appellate Procedure 8(a)’s four factors for deciding a stay, Ms. Carpenter-Barker argued that her appeal would likely succeed on the merits because, inter alia, the lower court improperly assessed Ms. Carpenter’s medical needs.  She also argued that Ms. Carpenter would suffer institutionalization, injury, or death if PDN hours were eliminated, and that the precedential value of the case and public interest weighed in favor of a stay.  ODM argued that Ms. Carpenter was not at risk of irreparable harm, that in fact she never received the full 128 weekly hours of PDN, and that the public interest would best be served by using the money allotted to Ms. Carpenter for other Medicaid recipients.  The United States District Court for the Southern District of Ohio, Western Division, grants Ms. Carpenter-Barker’s motion to stay and orders ODM to refrain from reducing Ms. Carpenter’s PDN hours until a final ruling is issued on the appeal.  The court finds it is unlikely, though not impossible, that Ms. Carpenter-Barker will establish discrimination in violation of the ADA and the Rehabilitation Act rather than simply showing a medical need for PDN hours.  However, the court is most persuaded by the evidence that Ms. Carpenter would be irreparably harmed by a reduction or elimination of PDN hours and determines that a loss of medical benefits weighs heavily in favor of a stay.  With credible medical evidence that death is a real potential consequence, caution counsels that the stay be granted, the court finds.  A link to the court’s opinion will be provided when available.

Ohio Federal Court Stays State Move to End Woman's Medicaid Private Nursing Care

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