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Judge amends preliminary injunction, restores attendant care for plaintiffs

Last Updated 1 month by Amnon J. Jobi | Amnon Front Page

INDIANAPOLIS (INDIANA CAPITAL CHRONICLE) — Just one month after ruling that a state agency no longer had to pay two mothers attendant care wages for the care of their medically frail sons, a federal judge reversed course Tuesday after the state failed to secure in-home skilled nursing services for the families.

“Defendant Indiana Family and Social Services Administration (FSSA) is preliminarily enjoined to allow the Individual Plaintiffs to continued receiving medically necessary attendant care services from their mothers in the amount approved by FSSA immediately before the policy changes challenged in this litigation took effect on September 1, 2024, until in-home skilled nursing services are secured for the Individual Plaintiffs,” U.S. District Court Judge Tanya Walton Pratt said in the two-page ruling.

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The amended preliminary injunction is part of a lawsuit seeking to halt FSSA’s transition from attendant care provided by parents to Structured Family Caregiving, which reimburses at a lower, per diem rate rather than an hourly one.

Two Hoosier sons and their mothers sued, saying they wouldn’t be able to secure the nurses needed to provide care while they worked outside of the home. The only income for both families was attendant caregiving because their sons’ needs — which included seizure care, gastrostomy tubes and more — required too much of their time to work another job and the state has a shortage of nurses.

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Regardless of the constraints and reported difficulties securing outside care, FSSA transitioned an estimated 1,400 families away from attendant care in July with the exception of the two families involved in the lawsuit. Pratt ruled last month that they, too, would transition and the state would have to take “immediate and affirmative steps” to secure nursing services.

The state’s decision to curb parental use of attendant care, which many older Hoosiers utilize, came on the heels of a $1 billion budget shortfall caused, in part, by an unanticipated use of long-term care services and supports. To control costs, FSSA opted to push parents out of the program, which didn’t have federal approval to include parents or guardrails like maximum hourly limits — unlike other states.

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The ACLU of Indiana, representing the two mothers, didn’t rule out expanding the lawsuit to include other families in the future at an August hearing. The court hasn’t yet set a date for a hearing on whether or not to permanently halt the transition away from attendant care.