Arizona Center for Disability Law’s Recent Legal Victory


Arizona Center for Disability Law LogoSince 2000, the Arizona Center for Disability Law has been involved in a federal class action lawsuit against the Arizona Health Care cost Containment System (AHCCCS). 

Renaldo Fowler, Senior Staff Advocate
Arizona Center for Disability Law
DDNN Summer 2010

Ball v. Rodgers (formerly Ball v. Beidess) is the class action lawsuit filed in 2000 against AHCCCS, Arizona's Medicaid program. The lawsuit alleged that Arizona was violating the federal Medicaid statute, the Americans with Disabilities Act, and 504 of the Rehabilitation Act by failing to provide all of the attendant care, personal care, homemaker, and respite services authorized in ALTCS member care plans. In 2004, the Court ruled in favor of the Plaintiffs (ALTCS beneficiaries) and entered a permanent injunction against AHCCCS. The Court ordered AHCCCS to:

  • Provide all critical services without gaps in services. Critical services include personal care services such as bathing, toileting, dressing, feeding, transferring to or from beds or wheelchairs, and assistance with other similar daily activities.
  • Fix gaps in service within two hours.
  • Have back-up staffing on-call to fill in when unforeseeable gap occurs.
  • Implement an "expedited grievance system" where beneficiaries can report gaps in service via a hotline and a form.

close up of medical charts, stethescope and penArizona appealed the Court's decision to the Ninth Circuit Court of Appeals. On July 17, 2007, the Court of Appeals ruled that Medicaid beneficiaries have the right to sue to enforce their rights to choose HCBS in their home rather than a nursing home. However, the Court sent the case back to the District Court to decide whether:  (1) the Medicaid "free choice" provisions apply to Arizona, (2) whether Arizona violated the ADA and Rehabilitation Act, and (3) any modifications to the injunction are necessary.

On Monday, March 8, 2010, United States District Court Judge Earl H. Carroll issued yet another decision in favor of older persons and persons with disabilities in the long-running class action case, Ball v. Betlach.  The Court ruled that Arizona’s Medicaid program failed to follow the Court’s prior orders by not implementing a statewide hotline for beneficiaries to report gaps in critical home care services and by failing to require its program contractors to have back-up workers on-call to substitute for times when a gap in critical services occurs.

In response to this decision, Jennifer L. Nye, Staff Attorney for the Center said, “Plaintiffs have been complaining since the Court’s 2005 favorable decision that the Defendants had not complied with the Court’s order to have a hotline and require back-up workers. As a result of these failures, there continues to be hundreds of gaps in services each month, the majority of which are filled by family and friends because no agency back-up worker is available. The absence of a meaningful back-up system not only violated the Court’s orders, but also meant that class members were continually at risk for institutionalization if their informal back-up system collapsed. The Center is hopeful that this decision will mean better tracking and response to gaps in services.”