When Susie Talevski sued the agency governing the care of her elderly father before his death, she hoped to get justice for her family. She did not expect the case to develop into a nationwide case. A ruling against her could strip millions of vulnerable Americans of power and hold states accountable for not receiving the benefits authorized by law.
“This case really took on a life of its own beyond what I could have foreseen,” said Talevski, a resident of Valparaiso, Indiana.
Talevski filed a lawsuit in 2019 alleging that her father’s rights were violated at a nursing home where he lived to receive care for his dementia.
“He couldn’t walk and talk… he couldn’t move,” Talevski said. “[The nursing facility] treated my dad like trash, like a dog. In fact, the dogs are treated better than that.”
In court filings, Talevski’s family claims that Gorgi Talevski tried his best to keep him asleep, his dementia was not properly managed, and he was accidentally transferred to facilities different offices a few hours away from the family home, which caused him to decline faster. Her father passed away a year ago, in October.
Talevski sued Health and Hospital Corp. of Marion County, the Indiana public health agency that owns the nursing facility. The agency, known as HHC, declined to comment on the case but has denied any wrongdoing. In court documents, it alleges that Gorgi Talevski was violent and sexually abusive, which affected his care. It tried to dismiss the lawsuit, saying Talevski had no right to sue. But federal courts said the case could go ahead.
So the public health agency made an unexpected move. It took the case to the nation’s highest court and raised a poignant question: Whether people who depend on initiatives partially funded by the federal government – such as Medicaid and nutrition, housing and disability programs – is it permissible to sue states when they believe their rights have been violated?
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A ruling in HHC’s favor could mean that millions of Americans who rely on federal assistance programs lose that right. The Supreme Court is scheduled to hear the oral arguments on November 8.
“Coming to an adverse decision would be catastrophic,” said Jane Perkins, an attorney at the National Health Law Program. “It would make these programs really stand out without a real execution mechanism.”
HHC of Marion County owns and operates 78 skilled nursing facilities throughout Indiana in a public-private partnership with the American Aging Community.
Perkins, who has sued numerous civil rights lawsuits for Medicaid beneficiaries, said the answer to the question of whether people who depend on federal assistance programs can sue for rights violations or not has been resolved for decades.
For that reason, she was shocked to learn that the Supreme Court had chosen to hear this case. The Supreme Court is required to review nearly 7,000 cases a year, and they generally agree to review only 1%-2% of them.
Perkins said she sees parallels between this case and the Supreme Court’s recent decision that overturned the constitutional right to abortion.
“The idea that the court will take this case and accept the question of whether you can enforce these laws is interesting,” Perkins said. “The recent court decisions – Dobbs in the context of abortion coming to mind – show the court’s willingness to ignore precedent.”
Since the Supreme Court agreed to review the case, at least 25 legal entities have filed amicus briefs, providing the court with information from people not directly involved in a case. Most sided with Talevskis — including members of Congress such as House Speakers Nancy Pelosi and Majority Whip James Clyburn, AARP, the American Cancer Network, the American Public Health Association, and the House of Representatives. Child Health Care Provider and Advocate. HHC Marion County will be represented by Lawrence Robbins, who argued 19 cases before the Supreme Court and represented Christine Blasey Ford in Justice Brett Kavanagh’s confirmation hearing. Talevski will be represented by Andrew Tutt of Arnold & Porter. Tutt recently argued and won a case before the Supreme Court to protect the redeployment rights of thousands of veterans and service members.
Programs that rely on federal money flowing from Congress to the states, like Medicaid, often come with a number of terms or requirements that states must follow in order to receive and use the funds. Civil rights lawsuits are one of the main enforcement mechanisms by which beneficiaries of such programs must hold public agencies accountable if those agencies violate their rights or fail to provide provide the services for which they are entitled.
There are other means of surveillance, which advocates of the Indiana state agency’s petition see as viable alternatives to lawsuits. One is federal oversight by the Department of Health and Human Services. The agency can investigate and threaten to withhold funding from state programs that do not comply with federal regulations. But this often involves lengthy legal processes that can backfire, stalling benefits for individual patients, instead of helping them.
“If [HHS] If they try to turn the money off, the state could take them to court immediately and get a restraining order,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. “People [would be] are left completely without their benefits, or suppliers are left completely without their payment. “
Former senior HHS officials say federal oversight is far from sufficient and that civil rights lawsuits remain an important enforcement mechanism. They say private enforcement through lawsuits is indispensable for nursing home residents, especially in places like Indiana, where the state owns the most nursing homes.
Former officials said in a brief hearing that a decision in favor of HHC would potentially increase the risk of waste, fraud and misuse of Medicaid funds, leading to widespread inaction. and leaves “millions of individuals, suppliers and other beneficiaries more vulnerable to violating their statutory rights. “
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Nearly 83 million Americans, a quarter of the US population, are enrolled in Medicaid. This means that HHS oversees more than half a trillion dollars in spending across all US states and territories – and the federal agency, former officials argue, lacks the logistical and practical capacity to do so. to “meaningful redress of individual violations in many cases.”
Indiana’s attorney general, Todd Rokita, is among allies who openly support the state’s position. Rokita, in a court filing along with 21 other Republican attorney generals, said civil rights lawsuits burden states and cripple them with legal costs, only to strain the pockets of attorneys rather than benefit Medicaid enrollees.
“The state has filed 1,200 civil rights lawsuits in the past three years alone,” Rokita said in a written statement.
Legal experts told Side Effects that the number Rokita cited is misleading because it includes all civil rights cases, not just those involving federal benefits programs, which is the focus of this case.
Emily Munson, an attorney with the Indiana Disability Rights advocacy group, said that if the Supreme Court rules in HHC’s favor, lawsuits like the 2015 case give Medicaid recipients the right to a expensive hepatitis C drugs may not be available in the future.
As states try to limit disability benefits in Indiana and across the country, civil rights lawsuits have given patients access to things like home support with daily tasks, called is taking care of the waiter.
Munson has filed similar lawsuits. She herself is disabled, and the prospect of a Supreme Court decision in Marion County’s favor terrified her.
“I rely on Medicaid to take care of my valet, fix my wheelchair,” Munson said, “and losing the ability to go to federal court if needed is very scary.”
During the most recent HHC board meeting in mid-October, the grandiose case was absent from the agenda. But as the meeting opened for public comment, state representatives, patients and advocates seized the opportunity to voice their concerns.
They have one request from the agency: withdraw the Supreme Court petition.
State Representative Robin Shackleford, an Indianapolis Democrat, and others in the legislature have voiced their concerns. Shackleford says many of her constituents are participating in Medicaid and SNAP, the Department of Agriculture’s supplemental nutrition program.
“They would be appalled… if they knew the board was the driver behind taking their rights away,” Shackleford said.
This story is part of a partnership that includes Side Effects Public Media – a public health news initiative based at WFYI, NPR and KHN.
Kaiser Health News is a national health policy news service. This is an editorially independent program of the Henry J. Kaiser Family Foundation not affiliated with Kaiser Permanente.
