State must be able to decide what is spent on in-home care

But a ruling by the US 9th Circuit Court of Appeals threatens that authority.


Does Washington state's government have the authority to establish what it spends?


Yet, that authority could be eroded or worse if a lawsuit succeeds that prevents the state from reducing funding for in-home care hours for Medicaid patients.

The San Francisco-based U.S. 9th Circuit Court of Appeals struck down budget cuts. The 2010 cuts were challenged in court by 14 disabled people who saw a reduction in home-care assistance in March 2011.

But Gov. Chris Gregoire and Attorney General Rob McKenna aren't going to appeal the decision to the U.S. Supreme Court. Instead, they are taking a different route to secure state authority to establish budget priorities.

It's a wise move. If the 9th Circuit's decision were to be upheld by the high court the state would essentially have a runaway budget train on its hands.

Gregoire and McKenna are going back to U.S. District Court to seek a final decision on how the state handles funding for Medicare patients.

According to the Olympian newspaper, Gregoire said the state's concerns about being able to make Medicaid budget cuts without violating the Americans with Disabilities Act were addressed in a letter received last week from the Department of Justice and the Department of Health and Human Services.

"The letter today from HHS and the U.S. Department of Justice affirms that, with appropriate process, Washington state can reduce its service level and still be consistent with federal law," Gregoire said.

The lawsuit came from Service Employees International Union 775 Northwest, which represents workers who provide the home health care. At issue in the case were the 6.3 percent across-the-board budget cuts Gregoire ordered in 2010 and that took effect in March last year. The cuts affected 47,000 people on Medicaid who received what are considered "optional" services that the state has elected to provide, The Olympian reported. The order meant many qualified for fewer hours of home-care assistance with washing, laundry, cooking and other chores.

"Our concern from the beginning has been that the 9th Circuit's opinion could be read to say that a state could not make even moderate reductions in its personal care services when it faces a budget crisis," Department of Social and Health Services Secretary Robin Arnold-Williams said last week in a statement.

It's a legitimate concern. The state should not be made to write a blank check for in-home care.

Yes, care for those who need it should be provided, but the state Legislature and state government must have leeway to determine funding within the available revenues.


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