AHCCCS Administrator Denies Services to Severely Disabled Child, Strikes the Word "Unfortunately" from Judge's Ruling

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rocky.jpg
Jamie Peachey
Rocky Cruz and her mom, Valerie Revering.
Earlier this month, the director of the state's public-healthcare system upheld a decison denying services to Rocky Cruz, a severely developmentally disabled child. Her parents say they're pursuing legal options through the Arizona Center for Disability Law.

Rocky, the 5-year-old daughter of Manny Cruz and Valerie Revering of Glendale, has Down syndrome. Last month, Rocky's pre-school director told New Times the girl is definitely a candidate for institutionalization, and in her estimation, suffers from severe cognitive disabilities. At 5 -- as most kids are pre-reading and learning to write letters -- Rocky cannot use paint appropriately. She has just a couple of words, and can't identify simple shapes. She's not potty trained, and is a constant flight risk.

And yet she didn't come close to qualifying for services through the Arizona Long Term Care System, according to the state's own tool. (Services from ALTCS range from speech therapy to medical care and babysitting.) Rocky scored just below 24 on the test; she would have had to reach 40 to qualify. One reason might be because the test is administered to children 0 to 5, putting her at an automatic disadvantage since she was 4 years and 10.5 months at the time she took it.

Here's New Times' video of Rocky and her mom, together at home.

The state turned Rocky down twice, so her parents appealed, and last month, Administrative Law Judge Sondra Vanella ruled that Cruz is not eligible for services because she did not qualify using the state's tool. (Rocky's parents did not dispute that the test was administered properly; instead they argued it was the wrong test. State officials say it's the only valid way to measure whether a child is qualified.)

In her ruling, Vanella wrote, "Unfortunately, the ALTCS program does not cover everyone who needs therapies, only those whose condition is so severe that, but for the provision of home and commnity based services, they would requre institutionalization."

Apparently, Vanella's small expression of compassion did not sit well with the Arizona Health Cost Care Containment System (AHCCCS), which qualifies Arizonans for ALTCS. Acting on behalf of AHCCCS' director, Thomas Betlach, on June 5 Administrative Hearing Decision Administrator Todd Jensen upheld Vanella's decision and wrote in his order: "the word `Unfortunately'...is hereby stricken and is not adopted as part of this Decision...."

Since New Times' story on Rocky Cruz, Valerie Revering says service providers have come forward to offer the family help at reduced costs. But she's not done fighting.

"I'm still going to pursue a legal avenue with the Center for Disability Law because we were at a standstill for two important developmental years and I want the state to be aware of the damage their short sightedness caused, not only for Rocky but for a lot of other kids that have been denied services which were obviously necessary," Revering tells New Times.

Jennifer Carusetta, Chief Legislative Liaison for AHCCCS, says her agency does not keep statistics on how many developmentally disabled children are turned down each year for ALTCS. She did note that between January 2011 and April 2012, AHCCCS received almost 50,000 applications from people of all ages. Of those, 23 percent were initially approved.

There are no statistics available on how many kids were able to win services through an appeal.

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2 comments
Astrid
Astrid

This is absolutely unconscionable, Arizona.  My son, now 28, finally did qualify for ALTCS, but that was after his IQ testing showed that he had dropped to MoMR, and that was 11 years go.  That Rocky should not qualify now is unbelieveable --  that cute young girls is so obviously in need of exceptional supervision and care!!!   Was Psychological Testing even submitted?  Because, in the former ALTCS days, psychological test results (as performed by a qualified PhD psychologist) counted heavily in the qualification formula --  that is, they "added points" for lower levels.  My son's IQ exams from high school (required every 3 years to continue to qualify for Special Ed)  were submitted, and that added the extra points for qualification.  Had no Psychological exam (testing IQ) been done, he would not have qualified, either.

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