Family caregivers win legal victory

Paying family members who care for loved ones less than non-family member caregivers is “arbitrary” and in violation of the equal protection clause of the state constitution, the Minnesota Court of Appeals has ruled. The court ruling also questions the rationale of state officials in assuming that family members who provide personal care attendant (PCA) services are morally compelled to do so. The Dec. 17 appeals ruling was cheered by families whose caregivers sustained a 20 percent pay cut in 2011.

State officials have until mid-January to appeal the decision. The 2012 Minnesota Legislature was able to postpone the cut until July 2013 thanks to dollars repaid to the state by health care plans.

The legal fight isn’t finished on other fronts. The appeals court sent the issue back to Ramsey County District Court to settle the issue of attorneys’ fees for the PCA agencies and individuals who sued the state in October 2011. The pay cut was made during the Minnesota Legislature’s July 2011 special session, as a means of helping resolve a $5 billion state budget deficit. What frustrated families and disability rights advocates was that the cut was made with no public hearings or discussion.

The Court of Appeals decision reverses an April 2012 Ramsey County District Court ruling that the Minnesota Department of Human Services could pay relative caregivers just 80 percent of what nonrelatives receive. The Court of Appeals said that law imposing the cut is based on an arbitrary distinction between family member personal care attendants (PCAs) and non-family members.

The cut means some family member PCAs had their hourly wage drop from $10 to $8 or less an hour. The cut affected parents or adoptive parents of an adult child, siblings over age 16, an adult child, a grandparent, or a grandchild of the person receiving care.

Dozens of disability advocacy organizations opposed the 20% cut. Minnesota Consortium for Citizens with Disabilities (MN-CCD) pointed out that the cut not only jeopardized support services for many Minnesotans. The cut also devalued the sacrifices PCAs have made, and puts some Minnesotans with disabilities at risk of placements in more costly institutions, particularly in rural areas. The long-term effect could have been the closure of some PCA agencies, as the cut could have meant a loss of PCAs and related administrative revenues. If agencies did close, that in turn would create more problems in accessing services and ultimately result in more costly options, such as home and community-based waivers or nursing facilities.

In October 2011 home health care agencies Care Planners, Inc., Break-Thru Home Health Care, Inc., Healthstar Home Health, Inc., V-Care Home Health, Inc., United Home Health Care, Inc., Hmong Home Health Care, Inc., AbbeyCare, Inc., and Life Fountain Home Health Care, Inc., as well as several individuals, sued the state.

Ramsey County District Court Judge Dale Lindman granted a temporary restraining order against the cut that same month. But in March 2012 Lindman ruled that the cut would stand, and any changes would have to be made by state lawmakers.

The dispute was then appealed. In its 15-page ruling, the appeals court stated, “We agree with appellants that the rationale for the distinction advanced by the state is based purely on assumptions rather than facts. including the apparently unchallenged assumption that a moral obligation to provide care for a relative necessarily equates to a moral obligation to personally provide such care at a lower rate of pay. Additionally, the state has not provided any evidence about the effect on relative PCAs of a 20 percent reduction in income,” the court ruled. “Appellants provided some affidavits to the district court stating that such a reduction would result in relative PCAs themselves seeking public assistance.”

The cut was expected to save the state $24.1 million over the biennium. That amount has been reduced to about $17 million due to the delay in implementing the cut. The most recent figures from DHS estimated that during the two-year period beginning July 1, 2013, $30.7 million less would be paid to relative caregivers due to the reductions. Home care workers applauded decision by the Minnesota Court of Appeals ruling.

“I am thrilled and relieved at the court’s ruling, but it is only the first step,” said Darleen Henry, a home care worker from Rosemount who cares for her mother. “We need to make these jobs better so that people can afford to do this work for our elderly and people with disabilities, and that is why we want the same right as all other workers to form a union.”

“Working as a personal care assistant for my son, who has a severe form of multiple sclerosis, allows him to stay at home and saves taxpayers a lot of money,” said Clara Nakumbe, who lives in Minneapolis. “But I still have a mortgage and I still need to live, too, and that’s why I was so upset when legislators planned to cut family members’ pay—it threatened my ability to keep a house for me and my son.”

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