Samantha A. v. Department of Social and Health Services, 171 Wash. 2d 623

Summary

The Washington Supreme Court held that DSHS regulations reducing Medicaid personal care service hours for children based on age and co-residence with a parent violated federal Medicaid comparability requirements. The court invalidated WAC 388-106-0213 and WAC 388-106-0130(3)(b) to the extent the latter authorized the invalid rule. It also upheld the superior court’s award of attorney fees under RCW 74.08.080 and awarded fees and costs on appeal.

Holdings

1. WAC 388-106-0213(2) and (3) violate federal Medicaid comparability requirements because they reduce Medicaid personal care hours through irrebuttable age- and parent-based presumptions without considering the individual recipient's actual needs or whether those needs will continue to be met.
2. WAC 388-106-0130(3)(b) is invalid to the extent that it authorizes the invalid reductions in WAC 388-106-0213.
3. The superior court properly awarded Samantha reasonable attorney fees and costs under RCW 74.08.080, and Samantha was also entitled to reasonable attorney fees and costs on appeal.

Questions Presented

1. Whether WAC 388-106-0213 violates federal Medicaid comparability requirements by automatically reducing children's Medicaid personal care hours based on age and residence with a legally responsible parent.
2. Whether the superior court properly awarded Samantha attorney fees under RCW 74.08.080 rather than applying the Equal Access to Justice Act's fee cap.

Disposition

affirmed