In Alsyrawan v. Department of Human Services, (PA Commonwealth Ct., May 20, 2024), a Pennsylvania state appellate court held that Medicaid rules limiting reimbursement of family members providing in-home and companion services to a total of 60 hours per week did not violate a Muslim family's rights under Pennsylvania's Religious Freedom Protection Act. The Medicaid recipient was a non-verbal adult male with Down syndrome and several other disabilities who was being cared for by his mother and sister. According to the court:
... [The] family, including Petitioner, follows Islamic law set forth in the Quran, which forbids ... unrelated males and females from being alone together, and unrelated males from providing personal care involving nudity or exposed private areas.... Therefore, to protect Petitioner from sin, only Mother, Sister, or other closely related female relatives may be alone with Petitioner, and only a father, brother, uncle, or grandfather could provide his more intimate bathroom and shower care.... Mother added that the prohibition of unrelated males and females being alone together likewise prohibits her from being alone with an unrelated male caretaker while he is tending to Petitioner....
... Petitioner also asserts that the Department’s refusal to grant him an exception to the 40/60 Rule violates the RFPA, where he has shown by clear and convincing evidence that placement of an unrelated caregiver in his home would burden his and his family’s religious exercise, and the Department cannot show that its denial of an exception is the least burdensome way to serve a compelling interest....
... [S]substantial record evidence supports that Islamic law allows an unrelated, non-Islamic male aide to assist Petitioner outside Mother’s presence (i.e., either outside the home or when Mother leaves the home to attend to personal business), before and after which Mother could provide Petitioner’s necessary intimate personal care....
... Because Petitioner has not shown by clear and convincing evidence that the 40/60 Rule “[s]ignificantly constrains or inhibits conduct or expression mandated by [his] sincerely held religious beliefs[,]” “[s]ignificantly curtails [his] ability to express adherence to [his] faith[,]” “[d]en[ies] [him] reasonable opportunity to engage in activities . . . fundamental to [his] religion[,]” nor “[c]ompels conduct or expression which violates a specific tenet of [his] religious faith[,]” 71 P.S. § 2403, he has failed to meet his initial burden of proving that the application of the 40/60 Rule substantially burdens his free exercise of religion under the Free Exercise Clause or the RFPA.