Texas Man Obtains Injunction Against State Budget Cuts

Texas Man With Special Needs Obtains Injunction Allowing In-Home Care to Continue
Last Updated: 2/22/2010
A U.S. district court grants a Texas Medicaid recipient with severe developmental disabilities' request for a a permanent injunction barring the state from terminating his community-based waiver services after experts testified that placing him in a state home would kill him. Knowles v. Horn (N.D. Tex., No. 3:08-CV-1492-K, Feb. 10, 2010).
Ryan Knowles, a 26-year-old man with severe developmental disabilities, received round-the-clock care in his home under a Texas Medicaid waiver program administered by the Department of Aging and Disability Services (DADS). Because the cost of Mr. Knowles's care exceeded his individual cost limit under the waiver program, DADS attempted to place him in a state school. The U.S. District Court for the Northern District of Texas granted a temporary injunction preventing the state from cutting off his benefits and moving him to a school.
In the meantime, the state passed a rider to the DADS budget allowing DADS to continue funding a Medicaid waiver recipient's costly in-home care if there is no other living arrangement that would protect the recipient's health and safety. DADS refused to reevaluate Mr. Knowles, claiming that he could be treated in a state school. Mr. Knowles moved for a permanent injunction. In support of his motion, Mr. Knowles presented evidence that DADS gave the supposedly appropriate state school a rating of 22 out of 100, and he also introduced testimony from his treating physicians that Mr. Knowles would die if he were moved to the state school.
The same U.S. district court grants Mr. Knowles's motion, finding that "no harm could be more irreparable, and no remedy at law can adequately address the harm" Mr. Knowles faces if institutionalized. "Thus, despite Defendants' legitimate concerns over fiscal restraint, the balance of harms tilts decidedly toward Plaintiff."
For the full text of this decision, go to: https://ecf.txnd.uscourts.gov/cgi-bin/show_public_doc?2008cv1492-52