FOR IMMEDIATE RELEASE
CONTACT:
Kim Lewis,
Michelle Uzeta, Protection and Advocacy, Inc., Michelle.Uzeta@pai-ca.org;
Addressing the issue, WCLP Attorney Kim Lewis said, “For
years the State has consistently failed to determine eligibility for Medi-Cal
benefits in a timely manner. By comparison, the DMV is a model of efficiency.”
“The extent of the non-compliance is staggering,” added
Michelle Uzeta, an attorney with disability rights agency Protection and
Advocacy. “In a sample of 2,188 Medi‑Cal disability applications from
2005, not one had received an eligibility decision within 90 days.” The median
amount of time taken to decide those applications was 226 days ‑ nearly 2
½ times the legal limit. At present, there is a backlog of approximately 10,000
to 12,000 applications that have been pending more than 90 days.
“This suit has been brought on behalf of people who are
poor, disabled and in desperate need of medical attention,” said Bay Area Legal
Aid attorney and health law specialist Mike Keys. “They cannot afford to pay
for their medical care and yet
The lawsuit alleges that one
Petitioner Ivana Zelaya was seriously injured in an
automobile accident in August of 2005. She experienced brain hemorrhaging and a
lacerated liver, was in a coma for three weeks and hospitalized for months. An
application for Medi‑Cal filed on her behalf immediately after the
accident was not approved until 10 months later after intervention by legal
counsel. While waiting for approval of her application, Ms. Zelaya was unable
to obtain critical health care, including medially critical neurological tests
and treatment for serious physical pain.
“When I came out of
the coma I was so sick that I could not walk or talk,” said Zelaya. “I needed
treatment and medical care but couldn’t get it while I was waiting for
Medi-Cal. I didn’t have the money to pay and became severely depressed thinking
that other people were willing to let me die because of money.”
Another petitioner had a similar experience, filing an
application for Medi‑Cal in April 2005 and not receiving an eligibility
determination until February 2006. In that instance, the delay caused the
petitioner to forego needed testing for cancerous nodules in her lungs, and to
declare bankruptcy because of medical bills she had incurred while waiting for
her Medi‑Cal application to be processed.
The lawsuit will seek an order that requires State
officials to comply with the requirement that Medi-Cal applications based on disability
be processed within 90 days, and to implement procedures to address both the
backlog and the emergent health care needs of individuals whose applications
have been pending for more than 90 days.
####
Bay Area Legal Aid (BayLegal) is the federally funded
legal aid program for the
Protection and Advocacy, Inc. is a private non-profit disability
rights agency established under federal law in 1997 to protect, advocate for
and advance the human, legal and service rights of Californians with
disabilities. PAI works in partnership with people with disabilities, striving
towards a society which values all people and supports their rights to dignity,
freedom, choice and quality of life.