Filed on behalf of three Bay Area residents, the suit charges that the state is taking more than seven months on average to process disability-based Medi-Cal applications, instead of the 90 days they are allowed.
Meanwhile, some people who have no other way of paying for needed medical care are going without it, they charge.
Plaintiffs in the suit include Zhong Wu of Oakland, who applied in November 2004 while suffering severe abdomen and back pain, chronic fatigue and severe depression. He waited 10 months for an application decision and was hassled by bill collectors seeking medical expense payments, including more than $200,000 for surgeries, the suit says.
Another plaintiff, Ivana Zelaya of Santa Clara, suffered extensive head injuries and a lacerated liver in an August 2005 car accident, and was in a coma for three weeks, the suit says. Zelaya's mother applied for Medi-Cal, but Zelaya didn't hear back until this past June, forcing her to wait for neurological testing her doctor prescribed and medical help for pain so severe she often couldn't leave her apartment, it says.
In a sample of 2,188 Medi-Cal disability applications filed in 2005, none was processed in 90 days as required, the suit claims, and a 10,000 to 12,000 application backlog exists.
Ana Penate of San Francisco needed tests to determine whether she had a cancerous nodule on her lung. She didn't hear back on her application and as a result, couldn't get the tests for 10 months, and only after her lawyer got involved, the suit says.
Eva Baez, who is not a plaintiff in the suit but whose story appears as an example of the problems, died as she waited six months for her application to be processed, it says. She applied in January after being diagnosed with a liver tumor but did not hear back until June, and was unable to get some of the medical care she needed. She died a few weeks later, the suit says.
The groups filed the suit after getting numerous complaints about the state's handling of the applications, said Michael Keys of Bay Area Legal Aid, one of the three groups suing the state in an effort to fix the problem.
In a sample of 2,188 Medi-Cal disability applications filed in 2005, none was processed in 90 days as required, the suit claims. The state now has a backlog of 10,000 to 12,000 applications, the suit says.
Spokespeople for the departments of health services and social services, the state agencies named in the suit, said their departments have received it and are reviewing it. They did not comment further.
The suit was filed Tuesday in San Francisco Superior Court.
Contact Michele Marcucci at firstname.lastname@example.org.