Hayley Cain & the Olmstead Ruling

Most people in the Shoals are familiar with Hayley Cain. Hayley is a 21 year old victim of cerebral palsy; she has normal intelligence. Unfortunately for Hayley and those like her, Medicaid in Alabama will not pay for home nursing or aides. To receive these benefits from state funded waivers, a patient must have an IQ below 70.

Now, both state senators Roger Bedford and Tammy Irons have announced they will try to change the law. We have to wonder if they will introduce opposing bills or work together to affect this change. Others have unsuccessfully tried to rectify this situation before, so it is nothing new. Our state legislature is aware of the problem and has been for years.

This brings us to what might be of real help to Hayley. In 1999, the US Supreme Court ruled on a similar case. In what has become known as the Olmstead Ruling, the Court stated:

"states are required to place persons with mental disabilities in community settings rather than in institutions when the State's treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities."

While Olmstead specifically mentions those with mental disabilities, others of normal or above normal intelligence have used this ruling to secure Medicaid funding in Alabama. Citizens with debilitating physical problems are now living independently or attending college with the help of Medicaid dollars.

Of course, these individuals did not secure these Medicaid services without an attorney...or a lawsuit. This may seem overly harsh and dramatic, but Hayley probably has a better chance of leading a normal life as the winner of such a suit than she will waiting for our state legislature to act.

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This is the story of Paul Boyd published November 18, 2010, in a Georgia law blog. Paul is very similar to Haylee...and he has sued the State. All of us should be watching the results of this suit. A member of your family could be the next to need such Medicaid services...or it could be you or me.

A quadriplegic since 1995, Paul Boyd has sued the Alabama Medicaid agency in an effort to get home-based care that would enable him to move out of a nursing home where he now lives.

Boyd argues that the agency would save money by letting him live in a house, with some assistance. He wants to live closer to the University of Montevallo campus, where despite his quadriplegia he is a graduate student in community counseling.

For the first 11 years after his paralyzing accident, Boyd living with relatives. Four years ago, when they were no longer able to serve as caregivers, he moved to a nursing home. However, the nursing home is 13 miles from the university campus.

There is no public transportation to get to his evening classes. He uses his scholarship money to pay a maintenance worker from the nursing home to drive his wheelchair-equipped van back and forth to campus.

You have to admire the indomitable spirit of folks like Mr. Boyd who are determined to live productive lives after a devastating injury. I find it extremely fulfilling to help such folks recover the resources necessary to restore as much of a productive life as possible.

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