A federal court judge has ruled that the state must pay for incontinence supplies for disabled children in a class action lawsuit that included two East Valley families.
Before Friday’s ruling, children covered under Medicaid because of disabilities had their disposable briefs paid for only if they developed open sores. About 40 other states cover those supplies.
U.S. District Judge Raner Collins agreed with the Arizona Center for Disability Law, which argued that the Arizona Health Care Cost Containment System’s policy violated federal Medicaid law covering disabled children by denying them preventative care.
The state said the briefs were not medically necessary because they did not “correct or ameliorate” the disabilities, and the law did not require such preventative coverage.
“In addition to being illegal, it’s also wrongheaded,” said Jennifer L. Nye, an attorney with the public interest law firm. “Because it’s saying we’re going to wait for a kid to get sick before we provide them care. That’s really an awful thing to do to children.”
Plaintiffs in the case included a Mesa girl and a Scottsdale boy, whose parents spend up to $2,000 a year for their briefs.
“We’re very happy that the court ruled in behalf of developmentally disabled children,” said Leon Igras of Scottsdale, whose 10-year-old son, Nicholas, is autistic and mentally retarded.
About 6,000 children receive long-term care through the state. AHCCCS deputy director Tom Betlach said supplying diapers to children who are incontinent could cost up to $15 million a year. Betlach said he had just seen the ruling and had no further comment.
The state also must reimburse parents for their children’s incontinence expenses and pay attorneys fees.