After suffering a stroke and other significant health issues by the time he was in his early 60s, California resident Matthew Reed was unable to prepare food, use the bathroom independently or perform other basic functions. He couldn’t safely remain home alone, but his wife needed to work nights to pay their rent and other necessary expenses.
Along with many older adults in similar circumstances, Matthew preferred not to enter a nursing home—but the Reeds couldn’t afford costly in-home care.
A key provision of the Affordable Care Act requires states to expand their Medicaid eligibility (called Medi-Cal in California) to low-income married seniors in need of in-home medical care, like Matthew. For years, the State of California had failed to comply with federal law.
In partnership with Justice In Aging, Bet Tzedek, Western Center on Law & Poverty and Disability Rights California, a pro bono McDermott litigation team sought to force the state to implement the expanded Medi-Cal eligibility rules. A victory would extend critical financial assistance to people like Matthew and his wife, helping them secure in-home care and allowing them to recoup money for the benefits they were denied while waiting for the state to act.
At the request of Justice In Aging—a national organization that advocates for the health and economic security of low-income, older adults in the US—the McDermott team served as lead counsel in filing a class action complaint on behalf of Matthew and another client, Patrick Kelley, who also had been impacted by the state’s inaction.
The state fought the case at every step, forcing the legal team to engage in substantial statewide discovery. After several years, the case culminated in a bench trial, where the McDermott team served as lead trial counsel.
The court ultimately issued a judgment granting the team’s requested relief, finding that the state had violated its duties under California law and mandating that the state fully implement the expanded eligibility rules within six months. It also required the state to create a process for individuals to obtain retroactive monetary reimbursement for improperly denied eligibility determinations dating back to January 2014.
The court’s decision significantly expands the financial assistance available to tens of thousands of low-income, married seniors in California who suffer from substantial disabilities, but want to continue living at home with their spouses rather than at a nursing home or other long-term care facility.
Following the judgment, the McDermott team also negotiated an attorneys’ fees award totaling $700,000, distributed among all pro bono partners. McDermott donated our share of the fees award, in the amount of $162,752, to Justice In Aging, Bet Tzedek, Western Center on Law & Poverty and Disability Rights California.