LEGAL UPDATES

OCT 17, 2012 -- Court to Hear Unresolved Issues in Darling v Douglas Settlement Nov 8

In a letter to the court on October 11, 2012, Disability Rights California outlined a number of unresolved issues in the Darling v Douglas Settlement. On October 17, 2012, the court ordered a hearing for November 8, 2012 to address opt outs/managed care transition, QA review, and beneficiary hearing delays. Issues regarding CBAS assessments by managed care plans are not currently set for hearing.
>> DRC Letter to the Court (filed 10/11/12, 3 pages)
>> Court Order for Hearing (filed 10/17/12, 2 pages)

SEPT 15, 2012 -- DRC Files for Enforcement of Darling v Douglas Settlement in Federal Court

On September 15, 2012, Disability Rights California (DRC) filed a motion for enforcement of the Darling v Douglas settlement in federal court. The motion sets forth the problems experienced by class members throughout implementation of the settlement, and offers proposed solutions, including the appointment of a "Special Master" to oversee implementation. The motion asks for a hearing on September 27, 2012 or as soon as the court can schedule the matter.
>> Notice of Motion and Motion for Enforcement (Filed 9/15/12, 31 pages)

JUN 7, 2012 -- ADHCA Challenges District Court's Denial of Preliminary Injunction in Medi-Cal Rate Reduction Case
Appeal Filed in U.S. Ninth Circuit Court

On June 7, 2012, attorneys representing the Adult Day Health Care Association (ADHCA) filed a motion to appeal the district court's denial of a preliminary injunction in the Medi-Cal 10% rate reduction case. Read legal brief.

MAR 29, 2012 -- Court Hearing Postponed to April 27, so Parties Can Work to Resolve Allegations that DHCS Failed to Comply with Darling v. Douglas Settlement

A March 29, 2012 hearing before a federal district court judge was taken off calendar (postponed), at the request of both parties to allow more time to try and reach a resolution. The hearing was rescheduled for April 27, 2012 at 9:00 AM. On March 22, 2012, Disability Rights California (DRC) filed documents with the court claiming the California Department of Health Care Services (DHCS) failed to fully comply with the court approved agreement that settled a lawsuit between the State of California and the class of plaintiffs who include frail seniors and persons with disabilities authorized to receive Adult Day Health Care services as a Medi-Cal benefit.

• Civil Minute Order Filed 3/29/2012 (1 page)
• Notice of Motion and Motion for Enforcement of Stipulated Judgment and for Civil Contempt Sanctions Filed 3/22/2012 (38 pages)
• Proposed Order on Enforcement of Stipulated Judgment and Contempt Filed 3/22/2012 (10 pages)

MAR 22, 2012 -- DRC Files in Federal Court Seeking Sanctions Against DHCS for Failing to Comply with Darling v Douglas Settlement

On March 22, 2012, Disability Rights California (DRC), a legal rights advocacy organization, filed legal documents asking a federal district court to find the California Department of Health Care Services (DHCS) in contempt for failing to fully comply with a court approved agreement that settled a lawsuit between the State of California and the class of plaintiffs who include frail seniors and persons with disabilities currently authorized to receive Adult Day Health Care services as a Medi-Cal benefit. A federal district court hearing has been set for 9:00 AM on March 29, in San Francisco.

• Notice of Motion and Motion for Enforcement of Stipulated Judgment and for Civil Contempt Sanctions (38 pages)
• Proposed Order on Enforcement of Stipulated Judgment and Contempt (10 pages)

FEB 1, 2012 -- Legal Help for ADHC Providers Seeking Nonprofit Status

With the recent announcement by the California Department of Health Care Services that CBAS sites must be nonprofit organizations, many of the state's for-profit ADHC centers are facing significant financial implications and a tight timeframe to complete the process for obtaining nonprofit status. In response, CAADS prepared a Preferred Attorney List on February 1, 2012. The list includes legal firms in membership with CAADS which have experience with establishing a nonprofit organization and have expressed interest in working with ADHC providers on this complex process.

JAN 24, 2012 -- Federal Court Judge Approves Darling v. Douglas Settlement

On January 24, 2012 Judge Saundra Brown Armstrong gave final approval to a settlement in the case of Darling v. Douglas. The settlement agreement between the seven plaintiffs who represent a class of 35,000 Adult Day Health Care (ADHC) patients throughout California and the California Department of Health Care Services will transition Medi-Cal patients out of ADHC and into a new Community-Based Adult Services (CBAS) program offered through Medi-Cal managed care plans on or after July 1, 2012. CBAS will offer center-based skilled health and nursing care, therapies, transportation and other services to eligible low income seniors and persons with disabilities. View DRC press release.

DEC 14, 2011 -- COURT ORDER GRANTS PRELIMINARY APPROVAL OF DARLING v. DOUGLAS SETTLEMENT

On December 14, the United States District Court for the Northern District of California issued an order granting preliminary approval of the Darling v. Douglas settlement agreement, directing notice to the class, and setting a scheduling order and fairness hearing. Before final approval may be granted by the court, members of the class are to be notified and afforded an opportunity to object in writing, and/or appear at the Fairness Hearing which will take place on January 24, 2012.

A copy of the notice to class members has been posted on the DHCS website at:
http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHCClassActionSettlement.aspx.

DHCS will mail the notice in English to all class members. Soon thereafter, notices in threshold languages will be mailed to participants and also posted to the DHCS website. Additionally, DHCS will fax copies of the class notice to all Adult Day Health Care Centers with instructions to post the notice in their centers.
>> View Notice to Class Members (8 pages)
>> View Court Order (70 pages)

DEC 1, 2011 -- ADHC SETTLEMENT AGREEMENT PROCESS MOVES FORWARD

On December 1, Disability Rights California filed the necessary legal documents to move forward with the settlement of the Darling v. Douglas case. On December 13, Plaintiffs and Defendants will jointly move for preliminary approval of the proposed Settlement Agreement. If the court approves the Class Notice, it will be sent to all ADHC participants on December 14.

On January 24, 2012, the court will conduct a Fairness Hearing as required for final approval of the settlement. In the meantime, Adult Day Health Care will continue as a Medi-Cal benfit under the State Plan Amendment to give the state and ADHC providers time to prepare for implementation of the new Community-Based Adult Services (CBAS) program which starts March 1, 2012.

>> Joint Notice of Motion and Motion for Preliminary Approval of Class Settlement Agreement, and for an Order Directing Notice to the Class and Scheduling a Fairness Hearing; Memorandum of Points and Authorities in Support of Motion (Filed 12/1/2011)
>> Settlement Agreement (Filed 12/1/2011)
>> Proposed Notice to Class (Filed 12/1/2011)

Watch for CAADS analysis and guidance on the CBAS transition to be posted here.

NOV 17, 2011 -- SERVICES TO CONTINUE FOR ADHC PATIENTS AND FAMILIES!
Federal Court Settlement Reached in Darling v. Douglas Case

Sacramento -- “Immense relief” and “joy” are the words that California Association for Adult Day Services Executive Director Lydia Missaelides uses to describe the sentiments of tens of thousands of elder, chronically ill and disabled patients after a major settlement was reached today in a lawsuit against the state brought on their behalf by Disabilities Rights California.

>> CAADS Media Statement (11/17/2011)
>> Disability Rights California Press Release (11/17/2011)
>> California Department of Health Care Services Press Release (11/17/2011)
>> Summary of Settlement Agreement (11/17/2011)

CAADS leadership will now convene to review the framework of the settlement agreement. Watch for CAADS analysis and guidance to be posted here.

NOV 14, 2011 -- Hearing Postponed to Nov 17, in ADHC Elimination Case Darling v. Douglas

Disability Rights California (DRC) and the California Department of Health Care Services (DHCS) have jointly requested that the preliminary injunction hearing, in the Darling v. Douglas ADHC benefit elimination case, be moved from November 15 to November 17, 2011. This brief court date postponement is necessary to enable the parties to finalize a settlement the details of which will be available on Thursday. For updates on the status of the hearing and any potential settlement, please check the following websites:
>> DRC: http://www.disabilityrightsca.org/advocacy/Darling-v-Douglas/index.html
>> CA DHCS: http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx

NOV 2, 2011 -- Judge in Darling v. Douglas Postpones Hearing Until NOV 15, 2011

OCT 31, 2011 -- U.S. Dept. of Justice Files Supplemental Statement in Darling v. Douglas Case

On October 31, 2011, the United States Department of Justice filed a supplemental statement of interest in the Darling v. Douglas case, in support of the Plaintiffs' Motion for Preliminary Injunction to halt the State from eliminating ADHC services unless and until adequate, appropriate, and uninterrupted services are provided.
>> Supplemental Statement of Interest of the United States of America, Filed 10/31/11

OCT 30, 2011 -- Plaintiffs File Supplemental Reply Brief and Supporting Documents in Darling v Douglas Case

On October 30, 2011, Disability Rights California (DRC) filed a supplemental reply brief and supporting documents in the case of Darling v Douglas. The hearing is scheduled for November 8, 2011 in the U.S. District Court for the Northern District of California.
>> Plaintiffs' Supplemental Reply Brief in Support of Motion for Preliminary Injunction (Filed 10-30-11)
>> Third Supplemental Declaration of Peter H. Behr Jr. (10-30-11)
>> Second Supplemental Declaration of Catherine Davis (10-30-11)

OCT 14, 2011 -- Disability Rights California Files Supplemental Brief in Darling v Douglas Case

On October 14, 2011, Disability Rights California (DRC) filed a supplemental brief in the case of Darling v Douglas. The hearing is scheduled for November 8, 2011 in the U.S. District Court for the Northern District of California.
>> DRC Supplemental Brief Filed October 14, 2011

OCT 3, 2011 -- Supreme Court Heard Oral Arguments October 3, 2011 in Douglas v. Independent Living Center of Southern California, et al.

Grant Bosse, Lead investigator for the Josiah Bartlett Center for Public Policy, wrote in an op-ed in the Concord Monitor on October 2, "The court must decide if federal regulations, including those not written into the Medicaid Act itself, are binding on states." At issue is "whether state officials have to put on a show before cutting Medicaid." Oral arguments in the Douglas v. ILC case were presented to the U.S. Supreme Court on October 3, 2011.
>> OCT 3, 2011 U.S. Supreme Court Transcript

Judge in Darling v. Douglas Postpones Hearing Until NOV 1, 2011

JUL 12, 2011 -- Disability Rights California Files Reply Brief in Darling v. Douglas

On July 12, 2011 DRC filed a brief in federal court on behalf of seven ADHC patients in response to the state's court documents opposing the plaintiffs motion to seek a preliminary injunction halting elimination of the ADHC benefit in the absence of appropriate alternative services.
>> JUL 12, 2011 DRC Brief

JUL 12, 2011 -- U.S. Department of Justice Issues Letter of Interest in Darling v. Douglas

On July 12, 2011 The United States Department of Justice submitted a favorable statement of interest to the court in the case of Darling v. Douglas. The statement supports the plaintiffs claims under the federal Americans with Disabilities Act, concluding a preliminary injunction is in the public's interest.
>> JUL 12, 2011 U.S. DOJ Statement of Interest

JUN 9, 2011 -- People With Disabilities Sue to Halt Elimination of Adult Day Health Care

June 9, 2011 Disability Rights California Media Release
Oakland, CA: Today, seven plaintiffs filed a motion for a preliminary injunction in a class action lawsuit on behalf of 35,000 low-income people with disabilities, including older adults. Filed in federal court, the case is called Darling et al. v Douglas, et al. C:09-03798 SBA. Plaintiffs seek to stop the state from eliminating Adult Day Health Care (ADHC) as a Medi-Cal benefit, as of September 1, without ensuring that affected people are not harmed, including by being hospitalized or placed in nursing homes.
>> JUN 9, 2011 Filing of Motion for Preliminary Injunction
>> JUN 9, 2011 Disability Rights California News Release

JUN 2, 2011 -- Judge Allows Supplemental Complaint to be Filed in Cota v. Maxwell-Jolly Case

Disability Rights California, as lead counsel, along with co-counsel National Senior Citizens Law Center; National Health Law Program; AARP Foundation Litigation; and Morrison & Foerster, LLP (pro bono) filed an amended complaint in the United States District Court for the Northern District of California on June 2, 2011 in the Cota vs. Maxwell-Jolly Case No. C 09-3798 SBA. The original case was in regards to the 2009-10 state budget action that limited ADHC patients to three days per week and instituted new strict medical necessity criteria, both of which were preliminarily enjoined.

The amended complaint adds to the original lawsuit the latest state action to eliminate ADHC as a state plan optional benefit without an adequate transition plan to protect beneficiaries from unnecessary institutionalization. Judge Saundra Armstrong issued an 11-page order to allow the complaint to be filed as an supplemental complaint. The new complaint has been renamed Darling vs. Douglas because of the death of lead patient plaintiff Harry Cota, the addition of four new plaintiffs and the change of director at DHCS. The Plaintiffs plan to file a third preliminary injunction in the case challenging the elimination of Medi-Cal funding for ADHC as soon as this week.
>> JUN 2, 2011 Second Amended Complaint for Injunctive and Declatory Relief
>> JUN 2, 2011 Order Granting Plaintiff's Motion to Supplement Complaint

MAY 28, 2011 -- Obama Administration Opposes Challenges to Medicaid Cuts

May 28, 2011 New York Times article by Robert Pear
WASHINGTON -- Medicaid recipients and health care providers cannot sue state officials to challenge cuts in Medicaid payments, even if such cuts compromise access to health care for poor people, the Obama administration has told the Supreme Court.
>> MAY 28, 2011 New York Times Article

APR 21, 2011 -- Disability Rights California Sends Letter to Centers for Medicare and Medicaid Services

On April 21, 2011, Disability Rights California (DRC-CA) sent a strongly worded letter to the Centers for Medicare and Medicaid Services (CMS) expressing concern about eliminating adult day health care as a Medi-Cal benefit in the absence of an orderly transition plan for ADHC patients, and urging CMS to withhold approval of the State Plan Amendment (SPA) to eliminate ADHC until a new program under a federal waiver is authorized by the Legislature and approved by CMS.
>> APR 21, 2011 Letter to CMS from Disability Rights California

DRC-CA and the litigation team consisting of AARP Legal Foundation, National Senior Citizen’s Law Center, National Health Law Center, and Morrison & Foerster, LLP, filed a motion on April 22, 2011, requesting the federal court to allow them to file an amended complaint to the 2009 Cota v Maxwell Jolly case. The court must grant permission to file an amendment to the existing complaint that resulted in the injunctions stopping the three-day cap and the restrictive eligibility language of 2010. This filing is a technical step that must occur before a formal amended complaint can be filed with the court. The amended complaint would argue that elimination of the ADHC benefit without assurance that all ADHC patients will be safely transitioned to other similar services in the community will place them at imminent risk of harm, including institutionalization, hospitalization, injury and/or death. The hearing on the motion to amend the complaint, originally set for May 10, 2011, was postponed.

OCT 27, 2010 -- Hearing Set for October 27, 2010 Postponed for State of California's Appeal of Cota v. David Maxwell Jolly -- the 2010 ADHC Medical Necessity Criteria Case

JUN 28, 2010 -- U. S. Dept of Justice Files "Friend of the Court" Brief on June 28, 2010 Supporting Disability Rights California Lawsuit Cota (Brantley) v. David Maxwell-Jolly -- the 2010 ADHC Medical Necessity Criteria Case

>> JUN 28, 2010 U.S. DOJ Amicus Brief

JUN 21, 2010 -- Disability Rights California Files Brief in U.S. Court of Appeals to Argue the Court Uphold Preliminary Injunction Issued by District Court in Cota (Brantley) v. David Maxwell-Jolly; Halt to Implementation of New ADHC Medical Necessity Remains in Effect

>> JUN 21, 2010 Answering Brief of Appellees

MAR 8, 2010 -- Why Elimination of ADHC as a Medi-Cal Benefit Would Be Successfully Challenged in Federal Court

>> MAR 8, 2010 DRC Brief

FEB 25, 2010 -- Preliminary Injunction by Federal Court in Brantley v. David Maxwell-Jolly Stops New ADHC Medical Necessity Criteria From Taking Effect

>> FEB 25, 2010 Overview with Links to Pleadings for the Case

FEB 24, 2010 -- Preliminary Injunction Ordered by Federal Court in Brantley v. David Maxwell-Jolly Stops New ADHC Medical Necessity Criteria From Taking Effect

On February 24, 2010, a federal court stopped new ADHC medical necessity criteria from taking effect March 1, 2010 as approved in the 2009-10 state budget trailer bill (AB4X 5). The state was also ordered to provide notice to ADHC Medi-Cal beneficiaries.

On August 18, 2009, Disability Rights California challenged in federal court the Medi-Cal budget cuts to the Adult Day Health Care program that temporarily limited beneficiaries to no more than three days per week attendance, leaving no alternatives for many older Californians with serious disabilities who needed care four or five days per week (Brantley v. Maxwell Jolly). The judge granted the motion for preliminary injunction on September 10, 2009.

On December 18, 2009 an amended legal brief was filed by Disability Rights California, and on January 19, 2010 a motion for preliminary injunction was filed challenging the legality of new ADHC eligibility and medical necessity criteria.

Pleadings for the case:
>> Complaint For Injunctive and Declaratory Relief 8/18/2009
>> Order Granting Plaintiffs' Motion For Preliminary Injunction 9/10/2009
>> First Amended Complaint For Injunctive and Declaratory Relief 12/18/2009
>> Notice Of Motion And Motion For Preliminary Injunction; Memorandum Of Points And Authorities In Support 1/19/2010
>> Order Granting Plaintiffs' Motion for Preliminary Injunction 2/24/2010

NOV 18, 2010 -- Federal Action on California DHCS State Plan Amendment

>> NOV 18, 2010 Action on 2008 Provider Rate Cut