Good magistrate decision on ADA/Olmstead, Medicaid/1983

A New York federal magistrate recommended against dismissing a suit claiming systematic, needless segregation of individuals with mental illness in nursing homes. Joseph S. v. Hogan, No. 06-1042 (E.D.N.Y. Apr. 21, 2008).

 The magistrate concluded that:

-- the plaintiffs stated claims under the Americans with Disabilities Act (ADA) and the Rehabilitation Act (RA), pursuant to Olmstead v. Zimring, 527 U.S. 581 (1999);
-- the Nursing Home Reform Act (NHRA) creates enforceable rights under 42 U.S.C. § 1983;
-- state protection and advocacy (P&A) agencies had associational standing;
-- nursing homes and hospitals were not necessary parties; and
-- some of the NHRA claims, but not the ADA or RA claims, were untimely.

The district court has not yet ruled on the report.

 

                The suit was brought by several individuals with mental illness along with Disability Advocates and MHLS, P&A agencies authorized by federal and state law respectively. They claimed New York was institutionalizing many with mental illness when they could and ought to receive care in the community. In concluding that the plaintiffs’ allegations were sufficient to state Olmstead claims, the magistrate specifically rejected the State’s argument that such claims require a determination by state officials that an individual’s needs could be met in a more integrated setting. The magistrate stated that although the Olmstead case involved determinations by state officials, this was not central to its holding. Moreover, he said it was “not clear whether Olmstead even requires a specific determination by any medical professional…or whether that just happened to be what occurred in Olmstead.”

 

                The magistrate next turned to the NRHA, 42 U.S.C. § 1396r – part of the Medicaid Act. The court discussed the requirements for a § 1983 cause of action under Blessing v. Freestone, 520 U.S. 329 (1997), Gonzaga Univ. v. Doe, 536 U.S. 273 (2002), and recent Court of Appeals cases. The magistrate said there was “no question” the plaintiffs were intended to benefit from NRHA, but found it a “close” question whether it created enforceable rights because it is “phrased in terms of the requirements that states must meet to maintain federal funding.”

 

                He concluded that NHRA satisfies Gonzaga because it concerns “whether each individual place in a nursing home actually requires nursing care, and if so, what additional services the individual requires.” Rather than being focus on system-wide policies and practices, NHRA repeatedly refers to decisions regarding “individuals” and requires reviews “in the case of each resident of a nursing facility who is mentally ill” (quoting § 1396r). (This accords with several court of appeals decisions holding statutory provisions using the term “individuals” enforceable under § 1983.) The legislative history also supported this view. The magistrate rejected the State’s argument that NRHA is unenforceable because it is a Spending Clause statute. There was no dispute that NRHA met the other factors set out in Blessing, and the magistrate noted precedent that its administrative remedies were not so comprehensive as to preclude a § 1983 action.

 

                The magistrate said that the P&A agencies had associational standing due to their statutory authority to represent the interests of those with mental illness, and because the declaratory and injunctive relief sought did not require individual participation. He also rejected the contention that the facilities housing those with mental illness were necessary parties, because the relief sought was directed at the State, and “there is no reason to believe [the facilities] would not cooperate” with implementation of any court order.

 

                Finally, the magistrate concluded that because the NHRA focuses only on admission to nursing homes and substantial changes in their condition there, some of the plaintiffs’ NHRA claims were time-barred, and were not subject to equitable tolling. By contrast, the ADA and RA claims alleged violations of continuing duties and were therefore timely.