Brill v. Wing

937 F. Supp. 170, 1996 U.S. Dist. LEXIS 11750, 1996 WL 465246
CourtDistrict Court, N.D. New York
DecidedAugust 13, 1996
DocketNos. 82-CV-1271, 79-CV-375
StatusPublished
Cited by1 cases

This text of 937 F. Supp. 170 (Brill v. Wing) is published on Counsel Stack Legal Research, covering District Court, N.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brill v. Wing, 937 F. Supp. 170, 1996 U.S. Dist. LEXIS 11750, 1996 WL 465246 (N.D.N.Y. 1996).

Opinion

MUNSON, Senior District Judge.

MEMORANDUM-DECISION AND ORDER

Presently before the court are eross-mo-tions concerning a consent decree entered into by the parties and “so ordered” on September 3,1985. Doe. 47 in 79-CV-375; Doc. 24 in 82-CV-1271.1 The consent decree resolved disputes that had arisen over New York State’s policy respecting the calculation of Medicaid benefits during the first six months an aged, blind, or disabled person is institutionalized in a medical or nursing facility, when such a person also has a noninsti-tutionalized spouse who is blind, aged, or disabled. Notice of Proposed Class Action Settlement, Ex. C att’d to Consent Decree, Doc. 24, at 1. It also addressed issues involving the notification of affected persons about spousal financial responsibility. Id. Plaintiffs now move to reopen the consent decree and for summary judgment. Pis.’ Notice Mot., Doc. 52. Defendant Commissioner of New York State Department of Social Services cross-moves for vacatur of the consent decree, or alternatively, in the event that the court grants plaintiffs’ motion, for an order joining the Secretary of the United States Department of Health and Human Services as a party defendant. Defs.’ Notice Mot., Doc. 55. Defendant Commissioner of New York City Human Resources Administration emphasizes that join-der of the Secretaiy is necessary to prevent subjecting any of the defendants to inconsistent obligations. Letter from David Drued-ing, Ass’t Corp. Counsel, Doc. 66. The following constitutes the court’s decision in this matter.

/. BACKGROUND

This action involves a class of plaintiffs consisting of all married couples residing in New York State, wherein one spouse is aged, blind, or disabled and has been or will be institutionalized in either: (1) a skilled nursing or intermediate care facility; (2) an acute [173]*173care facility for more than six months; (3) an acute care facility on alternate care status as provided in N.Y.Comp.Codes R. & Regs tit. 18, § 505.20; or (4) an acute care facility for less than six months, when medical documentation provides that the client is not expected to return home. Consent Decree, Doe. 24, at 2-3. Expressly included within this class is a subclass of all persons who were applicants for or recipients of Medicaid from or through the Ontario County Department of Social Services. Id. at 3.

The consent decree provided for conditional discontinuance of the eases. Its terms required the New York State Department of Social Services (“DSS”) to promulgate an administrative directive (ADM) which set forth new policies regarding the attribution of income between spouses. As explained in exhibits appended to the consent decree and intended for distribution to affected class members,

The settlement generally provides that the Department of Social Services (DSS) will not automatically consider the income and/or resources of the spouse of an institutionalized Medicaid applicant/recipient to be available after the calendar month following the month of institutionalization. In the past, the income and/or resources of an aged, blind or disabled spouse of an institutionalized aged, blind or disabled applicant/recipient may have been considered for the six calendar months following the month of institutionalization. The settlement does not change the right of DSS to sue the spouse in an appropriate court for contribution toward a recipient’s medical bills.

Notice of Proposed Class Action Settlement, Ex. C att’d to Consent Decree, Doe. 24, at 1-2.

This Notice is incorporated by reference into the consent decree. Consent Decree, Doc. 24, ¶ 14(b) at 11. The ADM also requires notification to applicants and noninstitution-alized spouses that Medicaid eligibility would not be affected by the community spouse’s failure or refusal to contribute to the cost of medical care. Id. ¶ 111(B) at 4.

Although the consent decree represents a comprehensive settlement of the consolidated actions, paragraph nineteen provides that:

In the separate event that the statutes or other laws of the United States or of the State of New York, or the regulations of the United States Secretary of Health and Human Services shall be amended, changed, repealed or, in the case of the regulations of such Secretary, reinterpreted so as to require [DSS], in its judgment, to change the policies or procedures set forth under the terms of this decree ... [plaintiffs may apply to the Court for such relief as they may deem appropriate concerning such change in the policies or procedures set forth under the terms of this decree, provided however, that the failure of plaintiffs to make such application shall be without prejudice to any subsequent action in this or any other Court by any person concerning such new policies or procedures.

Id. ¶ 19 at 15.

In 1989, after the execution of the consent decree, Congress passed and the President signed into law the Medicare Catastrophic Coverage Act (“the Act”), Pub.L. 100-360, 102 Stat. 683 (codified as amended in various sections of 26 and 42 U.S.C.). Under the Act, once an institutionalized spouse is determined eligible for medical assistance, federal and state Medicaid law govern the attribution of income to each spouse. 42 U.S.C. § 1396r-5; N.Y.Soe.Serv.Law § 366-c (McKinney 1992 & Supp.1996). The Act provides rules for determining how much of the institutionalized spouse’s income may be applied to the cost of his or her care in the institution, and how much may be contributed to the support of community spouse. 42 U.S.C. § 1396r-5(d).

In response to the new law, New York State passed Social Services Law § 366-c, promulgated amended regulations at N.Y.Comp.Codes R. & Regs. tit. 18, § 360-4.10, and prepared and issued new administrative directives. See Defs.’ Mem.Law, Doe. 57, at 3. Now plaintiffs return to this court, requesting that the court reopen the consent decree pursuant to paragraph nineteen and summarily enter a declaratory judgment that [174]*174several of DSS’s policies, as embodied in its amended regulations and administrative directives, violate federal law. In particular, plaintiffs challenge: (1) DSS’s practice and policy of requesting and allowing lawsuits for contributions from the income of a community spouse towards the costs of caring for the institutionalized spouse, Pis.’ Mem.Law, Doc. 53, at 9-17; and (2) the budgeting methodology employed by the state in attributing income among spouses, id. at 23-37. Plaintiffs further seek a permanent injunction directing DSS to cure all the practices and policies declared unlawful and directing that DSS inform all class members of the decision of the court and of the class members’ right to apply for corrective action consistent with any declaratory relief granted. Id. at 40.

The defendants oppose plaintiffs’ motion, and move to vacate the consent decree pursuant to Fed.R.Civ.P. 60(b).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Commissioner of the Department of Social Services v. Spellman
173 Misc. 2d 979 (New York Supreme Court, 1997)

Cite This Page — Counsel Stack

Bluebook (online)
937 F. Supp. 170, 1996 U.S. Dist. LEXIS 11750, 1996 WL 465246, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brill-v-wing-nynd-1996.