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Texas spent $ 24 million in Medicaid funds to help babysit a toddler at Cook Children’s Medical Center, the Fort Worth hospital said in an April 16 appeal in the ongoing lawsuit over Tinslee Lewis.

Two-year-old Tinslee has spent most of his life at Cook Children’s. Born with rare heart disease, Tinslee was kept alive through medical attention and “extreme effort,” the hospital said in the appeal, in which he asked the 48th Fort Worth District Court to quickly set a trial date to decide whether life support care should be taken out of Tinslee.

“While this case was never about money – and Cook Children’s never considered finances when making an end-of-life decision,” the appeal says, “the state of Texas (through its manager of a Medicaid care program) is now threatening to bring the issue into this dispute. “

Tinslee’s mother, joined by family members and activist groups, has argued for two years that her daughter deserves to live and that she alone has the right to decide whether or when medical care should end. Trinity Lewis says her daughter may be cured and the hospital shouldn’t be able to decide her fate.

Tinslee is breathing on a ventilator and is sedated but conscious, Lewis said at a press conference in January 2020, and responds to touch and stimulation like any baby would. Lewis has previously described her daughter’s “sassy” personality and says she enjoys having her nails painted.

But the hospital says Tinslee can’t feel anything except pain. In several court proceedings, doctors have said Tinslee has no chance of recovering and that every day is torturous for her.

“This child should not be forced to endure this fate for months on end as this case continues to creep through the court system,” said the April 16 appeal.

The cost of Tinslee’s care was not mentioned in previous court documents, but Cook Children’s said in the April 16 petition that the state, through a Medicaid agency, was threatening to inject itself into the case of Tinslee.

Tinslee’s medical care is paid for through a special program run by Texas Medicaid known as Texas STAR Kids, the hospital said in the brief. Texas hired a third party to administer the program and assess the fees to determine if the treatment should be covered.

The Texas director of Medicaid has begun to consider whether Texas should spend taxes on Tinslee’s care “when such care is medically unnecessary, well beyond the applicable standard of medical care, and cannot have an impact on Tinslee’s care. its underlying condition, ”according to the hospital.

Tinslee’s condition continues to deteriorate, the hospital said, and it asked in its petition that the 48th District Court expedite the court process to avoid further suffering. The hospital asked the court to set a trial date for July 26.

Legal battle

The legal fight around Tinslee began in October 2019 when Cook’s Children’s Ethics Committee unanimously voted to end Tinslee’s treatment. Under the Texas Advance Directives Act, the hospital has the legal right to terminate treatment of a patient if the care is deemed unnecessary.

However, Lewis fought back. She and her lawyer filed an injunction against the hospital in November 2019.

Since then, the case has been taken to court, with each party appealing if the decision was not in their favor. In January 2020, a judge ruled Tinslee could be removed from the respiratory system after an emotional hearing in Fort Worth 48th District Court. In July 2020, the Texas Second Appeals District in Fort Worth overturned that decision.

In October 2020, the Texas Supreme Court dismissed the hospital’s petition to remove Tinslee from life support, and in January, the Federal Supreme Court also dismissed the hospital’s plea.

The case is now sent back to the lower court for a final decision. If the 48th District Court rules in favor of Tinslee’s mother, the hospital cannot stop her treatment.

The ruling would have far-reaching ramifications, as it would essentially make the Texas Advance Directives Act unconstitutional. Lewis’s attorney argued the law was unconstitutional because it violated Tinslee’s right to life. Protect Texas’ Fragile Kids, the anti-abortion group Texas Alliance for Life and Attorney General Ken Paxton are among those who weighed in on Tinslee’s case and argued the statute was unconstitutional.

The hospital argues that groups and individuals have clung to Tinslee’s case and made her life “a public circus so that she can be the face of their fight to change the law of Texas.”

While physicians have the right to refuse care under common law, the Texas Advance Directives Act outlines a dispute resolution process and protects the hospital from legal ramifications. Cook Children’s lawyer Amy Warr argued in a previous hearing that doctors have the right to refuse to treat a patient if such care “causes suffering without medical benefit.”



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