Close this search box.

Medicaid Eligibility Lost After Recipient Moves From District

Print Article

JULY 15, 2002 VOLUME 10, NUMBER 2

Although many of the legal problems facing the elderly and the disabled are addressed through state laws, the underlying problems are regional, national or even universal. Though the national medical program for the elderly and disabled, Medicaid, is partially funded and broad guidelines set by the federal government, program administration is handled exclusively by states. Another area of interstate problems is guardianship law, which is almost entirely state-specific. A recent case arising, ironically enough, in the District of Columbia involves the interplay of all of those issues.

Gerald McKenzie is a 38-year-old developmentally disabled man. He was born in the District of Columbia and lived his entire life there until two years ago. During most of those years he received much of his care through the federal Medicaid program, but from providers located in D.C. and based on his eligibility in the District.

Mr. McKenzie’s aunt Sheridan Bacchus was appointed as guardian of his person in 1995, and he lived with her for the next five years. When she moved to suburban Maryland in 2000, he moved along with her. Although both of them now live at a Maryland address, Ms. Bacchus intended to keep Mr. McKenzie enrolled in the same day-care program he attended while living in the District. The District notified her, however, that Mr. McKenzie’s services were terminated immediately upon learning of his relocation.

Ms. Bacchus appealed the termination of services. She argued that Mr. McKenzie is completely unable to make a conscious decision to change his residence, and that she as guardian has the right to make that determination. Although he physically lives in Maryland, she insists, it is her intention that he remain a resident of the District.

The D.C. Court of Appeals ruled against Ms. Bacchus. The Medicaid law, said the court, requires the states and the District to provide services only to those who actually reside within their respective boundaries. Because Mr. McKenzie lives in Maryland, even though only about one mile from the District’s boundary, he will have to apply for Medicaid benefits with Maryland. McKenzie v. DC DHS, July 11, 2002.

Mr. McKenzie will probably be eligible under Maryland’s Medicaid program. He will, however, have to go through the application process again (eligibility for Medicaid in one state does not transfer to a new state when the recipient moves).

Fortunately, D.C. law expressly permits the guardianship to continue even though Mr. McKenzie now lives in Maryland. Some states require establishment of a guardianship in the new state and termination of the old proceeding. Even so, Ms. Bacchus may find it increasingly difficult to secure treatment and make decisions with an “out of state” guardianship.

Stay up to date

Subscribe to our Newsletter to get our takes on some of the situations families, seniors, and individuals with disabilities find themselves in. These posts help guide you in the decision making process and point out helpful tips and nuances to take advantage of. Enter your email below to have our entries sent directly to your inbox!

Robert B. Fleming


Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman


Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson


Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

Famous people's wills

Matthew M. Mansour


Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.