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Case Name Clinton L. v. Cansler PB-NC-0004
Docket / Court 1:10-cv-00123 ( M.D. N.C. )
State/Territory North Carolina
Case Type(s) Disability Rights-Pub. Accom.
Public Benefits / Government Services
Special Collection Olmstead Cases
Attorney Organization NDRN/Protection & Advocacy Organizations
Case Summary
The Plaintiffs are individuals with dual diagnoses of intellectual disabilities and mental illness who receive 24-hour in-home care through North Carolina Medicaid, administered in their county by Piedmont Behavioral Healthcare (PBH) (the local management entity). The Plaintiffs receive care ... read more >
The Plaintiffs are individuals with dual diagnoses of intellectual disabilities and mental illness who receive 24-hour in-home care through North Carolina Medicaid, administered in their county by Piedmont Behavioral Healthcare (PBH) (the local management entity). The Plaintiffs receive care through the state-funded "Supervised Living" service and the North Carolina "Innovations Waiver." In early 2010, PBH announced that it was reducing reimbursement rates for service providers. On February 11, 2010, Plaintiffs filed this lawsuit in the U.S. District Court for the Middle District of North Carolina against the Secretary of the Department of Health and Human Services of North Carolina and PBH, challenging these rate reductions and alleging that the reductions violated the Americans with Disabilities Act (ADA). According to the complaint, the rate reduction would ultimately reduce the services that allow the Plaintiffs to live in the community and receive community-based treatment. Without the option of community-based treatment, the Plaintiffs faced the risk of being institutionalized. The Plaintiffs argued that this risk of unnecessary institutionalization amounted to a violation of both the ADA (under the Supreme Court ruling in Olmstead v. L.C., which held that the unjustified institutionalization of individuals with disabilities is a form of discrimination under the ADA) and Section 504 of the Rehabilitation Act of 1973.

The Plaintiffs filed a motion for preliminary injunction, and the United States filed a statement of interest in support of this motion. On May 12, 2010, the court (Judge James A. Beaty) denied the motion in part (with respect to enjoining the rate reductions or otherwise setting specific reimbursement rates) but granted it in limited part, ordering the Defendants to ensure that all plaintiffs were provided with community-based care throughout the course of this litigation.

The case proceeded to the discovery phase. The Defendants filed a motion to dismiss on August 16, 2010, arguing that the Plaintiffs lacked standing, that the case was not ripe for litigation, and that the Plaintiffs had failed to state a claim because there is no federal right to be served in a single-serve placement or by a particular provider. Ultimately, the court denied this motion in June 2011, and also denied the Plaintiffs' request to appoint a special master to oversee the allocation of services to the Plaintiffs. After several more months of discovery, the Defendants filed a motion for summary judgment in January 2012, claiming that although there had been some service changes, each plaintiff lives in the community and faces no risk of institutionalization due to the current reimbursement rates. On October 31, 2012, the court denied the motion for summary judgment, finding that issues of fact remained as to the risk of institutionalization that the Plaintiffs currently face.

At the end of discovery, the Plaintiffs filed their third amended complaint. While the original complaint alleged claims on behalf of a putative class, the final amended complaint alleged claims on behalf of six individual plaintiffs. The amended complaint also added a claim for one named plaintiff under ADA regulation 28 C.F.R. §35, alleging that the Defendants had violated the regulation by failing to take into account this plaintiff’s deafness and failing to provide appropriate auxiliary aids and services.

On July 24, 2013, the case was reassigned to Judge N.C. Tilley, Jr. The case proceeded to a 39-day trial beginning on September 10, 2013. On August 28, 2014, the Court ruled in favor of the Defendants, finding that the Plaintiffs could not carry the burden of proof as to any of their claims. The court held that no plaintiff was able to show that (1) he or she was at a “serious risk of institutionalization” and that (2) the Defendants’ reimbursement rate reduction was “substantially related” to that serious risk of institutionalization. With respect to the ADA regulation claim, the court held that the Plaintiffs could not show that there was a discrepancy in the quality of care. The Court explained that this claim focused almost entirely on the discrepancy in American Sign Language (ASL) abilities between the patient and his staff as opposed to other deaf-oriented accommodations. Because the facility provided ASL training to the staff and they were able to sign basic communication as this particular patient needed, the Court found that there was insufficient evidence that discrepancies between the plaintiff’s ASL ability and staff’s resulted in unequal quality of care. 2014 WL 4274251.

The Plaintiffs filed a motion to alter or amend the judgment (under Federal Rule of Civil Procedure 59(e)), arguing primarily that Fourth Circuit precedent ((Pashby v. Delia, 709 F.3d 307 (4th Cir. 2013)) only required plaintiffs to show a “significant” risk of institutionalization rather than a “serious” or “severe” one. On March 29, 2016, the Court denied the motion, reasoning that the court in Pashby did not intend to alter the existing standard espoused by the DOJ. The case is now closed.

Beth Kurtz - 02/06/2013
Sara Stearns - 05/11/2019


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Issues and Causes of Action
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Issues
Benefit Source
Medicaid
Content of Injunction
Preliminary relief granted
Defendant-type
Hospital/Health Department
Jurisdiction-wide
Disability
disability, unspecified
Hearing impairment
Integrated setting
Least restrictive environment
Mental impairment
Discrimination-basis
Disability (inc. reasonable accommodations)
General
Deinstitutionalization/decarceration
Public benefits (includes, e.g., in-state tuition, govt. jobs)
Medical/Mental Health
Intellectual disability/mental illness dual diagnosis
Intellectual/Developmental Disability
Mental Disability
Intellectual/developmental disability, unspecified
Mental Illness, Unspecified
Plaintiff Type
Private Plaintiff
Causes of Action Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12111 et seq.
Section 504 (Rehabilitation Act), 29 U.S.C. § 701
Defendant(s) NC Department of Health and Human Services
Piedmont Behavioral Healthcare (PBH)
Plaintiff Description Plaintiffs are individuals with developmental disabilities and mental illness. They receive 24-hour care through a Medicaid Supervised Living program.
Indexed Lawyer Organizations NDRN/Protection & Advocacy Organizations
Class action status sought Yes
Class action status granted No
Filed Pro Se No
Prevailing Party Defendant
Public Int. Lawyer Yes
Nature of Relief Preliminary injunction / Temp. restraining order
None
Source of Relief Litigation
None
Filing Year 2010
Case Closing Year 2014
Case Ongoing No
Additional Resources
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Docket(s)
1:10-cv-00123 (M.D. N.C.)
PB-NC-0004-9000.pdf | Detail
Date: 03/29/2016
Source: PACER [Public Access to Court Electronic Records]
General Documents
Complaint-Class Action [ECF# 1]
PB-NC-0004-0001.pdf | Detail
Date: 02/11/2010
Source: PACER [Public Access to Court Electronic Records]
Motion for Temporary Restraining Order and Preliminary Injunction [ECF# 4]
PB-NC-0004-0002.pdf | Detail
Date: 02/11/2010
Source: PACER [Public Access to Court Electronic Records]
Memorandum in Support of Plaintiffs' Motion for a Temporary Restraining Order and Preliminary Injuction [ECF# 5]
PB-NC-0004-0003.pdf | Detail
Date: 02/11/2010
Source: PACER [Public Access to Court Electronic Records]
Statement of Interest of the United States of America [ECF# 14]
PB-NC-0004-0004.pdf | Detail
Date: 02/16/2010
Source: PACER [Public Access to Court Electronic Records]
Renewed Motion for Preliminary Injuction [ECF# 22]
PB-NC-0004-0005.pdf | Detail
Date: 04/07/2010
Source: PACER [Public Access to Court Electronic Records]
Memorandum in Support of Plaintiffs' Renewed in Motion for Preliminary Injunction [ECF# 23]
PB-NC-0004-0006.pdf | Detail
Date: 04/07/2010
Source: PACER [Public Access to Court Electronic Records]
Order on Motion for Preliminary Injunction [ECF# 36] (M.D. N.C.)
PB-NC-0004-0007.pdf | Detail
Date: 05/12/2010
Source: PACER [Public Access to Court Electronic Records]
Defendants' Motion to Dismiss [ECF# 44]
PB-NC-0004-0008.pdf | Detail
Date: 08/16/2010
Source: PACER [Public Access to Court Electronic Records]
Defendants' Memorandum of Law in Support of Motion to Dimiss [ECF# 45]
PB-NC-0004-0009.pdf | Detail
Date: 08/16/2010
Source: PACER [Public Access to Court Electronic Records]
Memorandum in Support of Plaintiff's Motion to Appoint a Special Master [ECF# 55]
PB-NC-0004-0011.pdf | Detail
Date: 03/15/2011
Source: PACER [Public Access to Court Electronic Records]
Plaintiff's Motion to Appoint a Special Master [ECF# 56]
PB-NC-0004-0010.pdf | Detail
Date: 03/15/2011
Source: PACER [Public Access to Court Electronic Records]
Order on Motion to Dismiss [ECF# 67] (M.D. N.C.)
PB-NC-0004-0016.pdf | Detail
Date: 06/15/2011
Source: PACER [Public Access to Court Electronic Records]
Defendant Coughlin's Motion for Summary Judgment [ECF# 86]
PB-NC-0004-0014.pdf | Detail
Date: 01/17/2012
Source: PACER [Public Access to Court Electronic Records]
Defendant Coughlin's Memorandum in Support of Motion For Summary of Motion for Summary Judgment [ECF# 87]
PB-NC-0004-0013.pdf | Detail
Date: 01/17/2012
Source: PACER [Public Access to Court Electronic Records]
Defendant Cansler's Motion for Summary Judgment [ECF# 88]
PB-NC-0004-0012.pdf | Detail
Date: 01/17/2012
Source: PACER [Public Access to Court Electronic Records]
Order and Opinion Denying Summary Judgment [ECF# 102] (2012 WL 5381488 / 2012 U.S.Dist.LEXIS 155827) (M.D. N.C.)
PB-NC-0004-0015.pdf | WESTLAW| LEXIS | Detail
Date: 10/31/2012
Source: PACER [Public Access to Court Electronic Records]
Plaintiffs' Third Amended Complaint [ECF# 139]
PB-NC-0004-0017.pdf | Detail
Date: 06/28/2013
Source: PACER [Public Access to Court Electronic Records]
Memorandum Opinion [ECF# 161] (2014 WL 4274251) (M.D. N.C.)
PB-NC-0004-0019.pdf | WESTLAW | Detail
Date: 08/28/2014
Source: PACER [Public Access to Court Electronic Records]
Memorandum Opinion [ECF# 168] (M.D. N.C.)
PB-NC-0004-0020.pdf | Detail
Date: 03/29/2016
Source: PACER [Public Access to Court Electronic Records]
show all people docs
Judges Beaty, James A. Jr. (M.D. N.C.) show/hide docs
PB-NC-0004-0007 | PB-NC-0004-0015 | PB-NC-0004-0016
Tilley, Norwood Carlton Jr. (M.D. N.C.) show/hide docs
PB-NC-0004-0019 | PB-NC-0004-0020
Plaintiff's Lawyers Bagenstos, Samuel R. (District of Columbia) show/hide docs
PB-NC-0004-0004
Beck, Gill P. (North Carolina) show/hide docs
PB-NC-0004-0004 | PB-NC-0004-9000
Bills, Jennifer L. (Massachusetts) show/hide docs
PB-NC-0004-0001 | PB-NC-0004-0002 | PB-NC-0004-0003 | PB-NC-0004-0005 | PB-NC-0004-0006 | PB-NC-0004-0010 | PB-NC-0004-0017
Holder, Eric H. Jr. (District of Columbia) show/hide docs
PB-NC-0004-0004
Perez, Thomas E. (District of Columbia) show/hide docs
PB-NC-0004-0004
Rittelmeyer, John R. (North Carolina) show/hide docs
PB-NC-0004-0001 | PB-NC-0004-0002 | PB-NC-0004-0003 | PB-NC-0004-0005 | PB-NC-0004-0006 | PB-NC-0004-0010 | PB-NC-0004-0011 | PB-NC-0004-0017 | PB-NC-0004-9000
Strickland, Andrew B. (North Carolina) show/hide docs
PB-NC-0004-0001 | PB-NC-0004-0002 | PB-NC-0004-0003 | PB-NC-0004-0005 | PB-NC-0004-0006 | PB-NC-0004-0010 | PB-NC-0004-0017
Defendant's Lawyers Corbett, Lisa G. (North Carolina) show/hide docs
PB-NC-0004-0008 | PB-NC-0004-0009 | PB-NC-0004-0012 | PB-NC-0004-9000
Hollowell, Wallace C. (North Carolina) show/hide docs
PB-NC-0004-0008 | PB-NC-0004-0009 | PB-NC-0004-9000
Martin, Stephen D. (North Carolina) show/hide docs
PB-NC-0004-0008 | PB-NC-0004-0009 | PB-NC-0004-0013 | PB-NC-0004-0014 | PB-NC-0004-9000

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