Q. About 6 months ago, I applied for Medi-Cal to help with my husband’s ongoing nursing home bill, and we are still waiting for a decision. I keep calling Medi-Cal, but nothing happens. The nursing home has been patient, but I do not think they can wait forever. Is there anything I can do?

A. Unfortunately, you are not alone. With the expanded eligibility for Medi-Cal provided under the Affordable Care Act, California counties have been flooded with Medi-Cal applications. The backlog at one point rose to 900,000 pending cases. The resulting delay in processing these applications has created great hardship for applicants, whose medical needs went unattended and health deteriorated while awaiting approval.

In one case, a mother’s son died of a pulmonary embolism while awaiting approval of his application filed seven months earlier. Sadly, two months after his death, his mother finally received the long awaited letter of approval.

Under the law, California counties are supposed to make decisions within 45 days of application, but for hundreds of thousands of deserving applicants this 45 day legal limit has been illusory. Finally, in the Fall of last year, a group of plaintiffs — including the mother referenced above — and a coalition of legal services organizations filed suit in Alameda County Superior Court seeking to put an end to this Medi-Cal application “limbo”. On January 20, 2015, in a case entitled Rivera vs. Douglas, a Superior Court judge issued an Order Granting Petitioner’s Motion For Preliminary Injunction, designed to put an end to the backlog, and indicated the judge’s intetion to make a further, more specific order to accomplish just that. As of this writing, the precise form of that more specific Order is still under consideration by the Judge. However, we expect that it will be issued very soon and that, once issued, it will direct the state to take specific and immediate actions, including the following:  (1) to grant provisional benefits in all cases pending more than 45 days where eligibility appears likely, and  (2)  to send written notice to all other applicants of their right to an Administrative Fair Hearing to secure a prompt ruling from an Administrative Law Judge on their pending applications.

So, there are several things you can do at this time: (1) write a letter to your eligibility worker making reference to the recent Rivera vs. Douglas case, [Alameda County Superior Court case # RG14740911], and ask that your husband be granted provisional Medi-Cal benefits immediately; (2) contact the Health Consumer Alliance (Legal Aid) for assistance at 1-888-804-3536, (3) make a written request for an Administrative Fair Hearing before a judge, sending the request to both your local Medi-Cal county office and the California Department of Healthcare Services, Appeals Unit, in Sacramento; and/or (4) seek guidance from an elder law attorney familiar with the Medi-Cal program. By pressing forward, my hope is that you will secure a favorable decision on your husband’s application in the very near future. Every good wish to you and your husband.

Alert:  On February 20, 2015, Judge Evelio Grillo of the Alameda County Superior Court issued the actual Preliminary Injunction in accordance with his earlier Order. That Preliminary Injunction will likely be followed, once again, by a more specific order requiring monitoring of the state’s compliance with the judge’s order.