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Pitts v. Greenstein

Settlements Ends Proposed Louisiana Medicaid Cutbacks


AARP Foundation Litigation (AFL) attorneys represented older and disabled Louisianans whose well-being was threatened by the state’s planned cuts to its Medicaid-funded Long Term-Personal Care Services Program (LT-PCS). The state and the plaintiffs recently reached a settlement that protects access to community services for those receiving more than 32 hours of services and expedites consideration of applications by new applicants for Medicaid community based waiver supports. The settlement is critical to preventing unwanted isolation in nursing homes of up to 6,000 people.


Louisiana allowed individuals who are eligible for the LT-PCS program to receive up to 42 hours of home- and community-based services each week. Program services include assistance with eating, bathing, dressing, walking, toileting and light household chores such as grocery shopping and laundry without which many recipients could not continue to live in their own homes. However, because of a budget shortfall the state proposed cutting back on LT-PCS. The proposed changes included cutting the maximum number of weekly hours to 32 hours, an action affecting as many as 11,000 people.

Louisiana residents, represented by AFL, the Advocacy Center for the Elderly and Disabled, and Steven Gold, a noted disability advocate, had filed a class action lawsuit against the state, arguing that in implementing its Medicaid cuts, the state chose to cut LT-PCS services arbitrarily. The Louisiana LT-PCS program originally was established as a result of a settlement agreement in 2003 that disposed of a lawsuit against the state. That agreement established the program with a cap of 56 hours a week; in response to an earlier round of budget cuts, a supplemental settlement reduced the hours to 42. Now the state was reducing those hours again.

The Americans with Disabilities Act (ADA) gives individuals receiving Medicaid a right to receive long-term supportive services in the most integrated setting appropriate to an individual’s needs and not to unnecessarily segregate them and isolate them in nursing homes. The U.S. Supreme Court in 1999 strongly upheld these principals, in a case in which AARP had participated as an amicus, Olmstead v. L.C. ex rel. Zimring.

Plaintiffs in Louisiana argued that without the current level of LC-PTS services, they would be forced into institutions which they do not want, removing them from their homes, leaving them isolated, violating federal and state law, and ultimately costing the state and federal government far more than the savings achieved by the LT-PCS cuts. Prior to the settlement plaintiffs received two favorable rulings from the District Court, one overruling the state’s motion to dismiss and the other certifying the case as a class action.

What’s at Stake

State budget cuts are difficult for everyone, but special vigilance is needed to ensure that the burden of the cuts does not fall disproportionately on the most vulnerable members of society. AFL attorneys have served as co-counsel in similar litigation in California, Florida, and Arizona.

Case Status

The settlement in Pitts v. Greenstein was approved by the United States District Court for the Middle District of Louisiana.

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Our legal advocacy initiatives  - conducted by AARP Foundation Litigation (AFL) - reflect nearly 20 years of work in federal and state courts across the country. Through our efforts, we support the Foundation’s four impact areas: Tackling Senior Hunger, Paving the Way to Stable Income, assuring the adequacy and availability of Safe and Afffordable Housing and Reconnecting People to Families and Communities, and ensure that those 50 and older have a voice in the laws and policies that affect their daily lives.