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Under court order, DHS will restore in-home care services

The department has been sued by families of patients with intellectual or developmental disabilities who had services cut by the state.

By Claire Withycombe

Published on April 19, 2017 5:31PM


Capital Bureau

SALEM — The Oregon Department of Human Services will temporarily restore previous levels of in-home care services to people with intellectual and developmental disabilities under a court order won by plaintiffs who filed a federal lawsuit contesting recent cuts.

DHS determines every year how many hours of in-home care someone with an intellectual or developmental disability is eligible for.

Disability Rights Oregon, an advocacy organization that filed the suit last week, objects to how those decisions are made, saying the process is opaque.

The lawsuit alleges that under federal law, the agency violated the civil and due process rights of Oregonians receiving these services, as well as the Medicaid requirement that the Office of Developmental Disabilities Services must provide such services “as needed.”

Last year, the agency implemented a new assessment method on a rolling basis, which the lawsuit argues resulted in a reduction of in-home care hours for many people — although the amount of help they needed at home had not changed.

Not all people receiving in-home care services have yet felt reductions, because the changes have been implemented gradually.

Tom Stenson, litigation attorney with Disability Rights Oregon, said Wednesday’s order means any new assessment method DHS wants to use “effectively requires” court approval.

The lawsuit is still ongoing. DHS is “working on (its) plan to implement the agreement,” a spokeswoman said in an email.

Bob Joondeph, the group’s executive director, said that his organization also wants to make sure families had a transparent avenue to challenge a needs assessment.

“It’s great if they change the formula to work better,” said Joondeph, “But at the end of the day, what we want is that even with the new formula, we’d be able to explain to people why there’s a change and give them an opportunity to contest it.”

Joondeph said his organization had raised the issue and proposed solutions in private meetings with the agency, but filed a lawsuit after the agency did not act.

In 2013, after the expansion of Medicaid under the Affordable Care Act, and a specific federal funding option called the Community First Choice Plan that provided funds so people with disabilities could access community-based services, there were significant increases in those eligible for in-home care — and in costs to the state.

In 2015, Oregon legislators agreed to pay for the unanticipated costs in the upcoming budget cycle, but asked DHS to come up with a way to contain the rate of cost growth in the future. That became the method that advocates are now contesting in court.

Renee Kuhn, of Woodburn, says her daughter would need to enter adult foster care if the state cut her in-home care hours.

Khrizma Kuhn, 34, is severely disabled, requiring help with basic activities and care such as bathing and eating. She receives 20 hours of care a day, Renee Kuhn said. Her daughter underwent her annual assessment on Tuesday and she expected to learn the results Friday.

“We already told our caseworker to begin the steps to explore foster homes for our daughter, where she can access the services she needs,” Renee Kuhn, who also advocates for other families with children who have intellectual and developmental disabilities, said.

The Department of Human Services makes up a significant chunk of the state’s approximately $20 billion general fund budget, which lawmakers are busy trying to balance in the face of an approximately $1.6 billion shortfall.

Reducing in-home care for people with intellectual and developmental disabilities by 30 percent, as DHS had planned prior to the court order, would have saved the state’s general fund $6 million in the upcoming two-year budget.



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