This class-action lawsuit was filed on April 23, 2012 in the United States District Court for the Southern District of New York. The plaintiffs were elderly and/or disabled recipients of Medicaid who received daily twenty-four-hour split-shift in-home care through the New York State Medicaid program. The suit was filed against the Commissioner of the New York State Department of Health and the Executive Deputy Commissioner of the New York State of Temporary and Disability Assistance (the "State Defendants"), and against the Administrator of the New York City Human Resources Administration/Department of Social Services (the "City Defendant"). Plaintiffs brought the action under the Medicaid Act, 42 U.S.C. § 1396 et seq. and its implementing regulations; Title II of the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12131 et seq. and its implementing regulations; Section 504 of the Rehabilitation Act of 1973 ("Section 504"), 29 U.S.C. § 794; and the Due Process Clause of the 14th Amendment and Supremacy Clause of the United States Constitution. Plaintiffs sought injunctive and declaratory relief.
The City Defendant had notified members of the putative class that their home care service hours would be reduced, even though their current level of care was physician-prescribed and there had been no changes to their medical conditions or treatment needs, on the basis that the plaintiffs did not meet the "total assistance" requirement of Medicaid regulations. Plaintiffs argued that this policy was arbitrary and irrational, and that because there was not change in the plaintiffs' conditions, these reductions violated the Due Process Clause of the 14th Amendment. Plaintiffs argued that the defendants had discriminated against plaintiffs on the basis of disability and that they had put the plaintiffs at risk of unnecessary institutionalization, contrary to the integration and anti-discrimination and mandates of the ADA and Section 504. Plaintiffs also alleged the defendants had violated the Medicaid Act by denying Medicaid recipients a level of equal in amount, scope, and duration to that provided to other Medicaid recipients with the same medical needs.
On June 12, 2012, the parties agreed to a joint stipulation in lieu of temporary restraining order proceedings before the court, wherein the defendants agreed not to reduce the hours of any additional patients, with very limited exceptions, while the plaintiffs' motion for a preliminary injunction was pending before the Court.
On June 28, 2012, the plaintiffs filed an amended complaint that removed references to preliminary relief. On August 29, 2012, the plaintiffs voluntarily dismissed all claims against the Executive Deputy Commissioner. The Commissioner of the New York State Department of Health remained in the case.
On September 4, 2012, the Court (Judge Shira A. Scheindlin) granted the plaintiffs' motion for a preliminary injunction in part, preventing the defendants from reducing any patients care while the case was pending or until further decisions, except in cases where there were changes to a patient's condition that made the service reduction medically appropriate, as certified by a physician who had personally examined the patient. The Court declined to reinstate twenty-four-hour split-shift care for all those patients whose level of care had been reduced between October 4, 2011 and the date of the injunction. Strouchler v. Shah, 891 F. Supp. 2d 504 (S.D.N.Y. 2012). The Court denied the Defendants' motion to modify this preliminary injunction on September 12, 2012.
On October 5, 2012, the Court (Judge Scheindlin) granted the plaintiffs' motion for class certification, with the Court amending the definition as: "[a]ll New York City Medicaid recipients of continuous personal care services who, at any time since January 1, 2011, have been threatened with unlawful reduction or discontinuance of these services or whose care has been unlawfully reduced or discontinued because the City Defendant has determined that they do not meet the medical criteria for these services." The Court explained that, because the preliminary injunction was in place, it was unnecessary to include the words "or will be." Strouchler v. Shah, 286 F.R.D. 244 (S.D.N.Y. 2012).
On October 15, 2012, the parties filed a joint stipulation, with the defendants' agreeing to reinstate the split-shift care of an individual member of the purported class whose service had been reduced to sleep-in care prior to the date of the preliminary injunction. On November 12, 2012, in the wake of the Hurricane Sandy disaster, the Court ordered the defendants to restore split-shift care to 16 individuals identified by the plaintiffs. This order was modified by an order dated November 16, 2012, which referred to a state-level directive ordering the restoration of split-shift care to certain individuals already being served by a "managed long-term care provider."
The parties then proceeded to the discovery phase of the litigation, while engaging in settlement negotiations.
Two years later, on May 27, 2014, the parties filed a settlement agreement, which was approved by Judge Scheindlin on September 12 of the same year. Under the terms of the settlement agreement, the State and City Defendants agreed that continuous personal care services of any Medicaid recipient thereof shall not be reduced or terminated for any of five reasons: "the recipient needs only 'some' assistance;" "the recipient's needs can be predicted or scheduled;" "the recipient's only medical needs are turning and positioning;" "there has been a change in the recipient's medical condition, unless [the State or City] Defendant submits to the recipient a notice that identifies the change and states why the prior services are no longer needed;" or "there has been a mistake in the previous assessment, unless the [local district or City Defendant] submits to the recipient a notice that identifies the mistake and states why the prior services are not needed." The agreement further stipulates that the State Defendant is to make best efforts to amend state law such that it is consistent with the agreement under the New York State Administrative Procedure Act. In exchange, the plaintiffs released the City and State Defendants from all claims. The case was closed on September 16, 2014.Alex Colbert-Taylor - 08/08/2013
Kevin Nomura - 04/12/2015