Bryson v. NHDHHS, et al.

2006 DNH 113
CourtDistrict Court, D. New Hampshire
DecidedSeptember 29, 2006
Docket99-CV-558-SM
StatusPublished

This text of 2006 DNH 113 (Bryson v. NHDHHS, et al.) is published on Counsel Stack Legal Research, covering District Court, D. New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bryson v. NHDHHS, et al., 2006 DNH 113 (D.N.H. 2006).

Opinion

Bryson v . NHDHHS, et a l . 99-CV-558-SM 09/29/06 UNITED STATES DISTRICT COURT

DISTRICT OF NEW HAMPSHIRE

BONNIE BRYSON and CLAIRE SHEPARDSON, on behalf of themselves and all others similarly situated, Plaintiffs Civil N o . 99-cv-558-SM v. CLASS ACTION Opinion N o . 2006 DNH 113 JOHN STEPHEN, in his capacity as Commissioner of the State of New Hampshire Department of Health and Human Services; and MATTHEW E R T A S , in his capacity as Director of the State of New Hampshire Bureau of Developmental Services, Defendants

O R D E R

As noted by Judge Kozinski, exploring the relationship

between Medicaid and the integration mandates of the Americans

with Disabilities Act (“ADA”) and Section 504 of the

Rehabilitation Act (“RA”) requires navigating in murky waters.

ARC of Washington State, Inc. v . Braddock, 427 F.3d 615, 617 (9th

Cir. 2005). Here, the plaintiff class, consisting of persons who

have acquired brain disorders (“ABDs”) and who qualify for home

and community-based care services (“HCBC”) under New Hampshire’s

Medicaid ABD waiver program1, contend that the State’s

1 The plaintiff class, as certified, consists of individuals with acquired brain disorders who are currently institutionalized in nursing homes, psychiatric hospitals, administration of that program operates to discriminate against

them based upon disability. Specifically, plaintiffs complain

that the State is depriving them of rights to community

integration mandated by Title II of the Americans with

Disabilities Act, 42 U.S.C. § 12132, and its implementing

regulations, as well as Section 504 of the Rehabilitation Act of

1973, 29 U.S.C. § 7 9 4 , and its implementing regulations. They

seek declaratory and injunctive relief under 42 U.S.C. § 1983,

requiring the State to modify its Medicaid program to accommodate

their participation in the ABD waiver program, by increasing the

cap on the number of persons admitted to the program to the point

that the waiting list is eliminated.

Most of the issues originally presented in this case have

been resolved earlier by this court, by the court of appeals, see

Bryson v . Shumway, 308 F.3d 79 (1st Cir. 2002), or by agreement

of the parties. The remaining issues — those raised in Counts 3

and 4 of the complaint as described above — were tried to the

court. Simultaneously with this order, the court has ruled on

the parties’ numerous requests for findings of fact and rulings

general hospitals, rehabilitation facilities, or other settings, who are able to be discharged into a less restrictive community setting, or they are individuals who are in the community but who, in the absence of home and community-based services, are likely to be placed in a nursing home, psychiatric facility, rehabilitation facility or other institution.

2 of law, but, generally, the pertinent facts are largely

undisputed. The basic point of contention is whether plaintiffs

are entitled to declaratory and injunctive relief forcing the

State to obtain enough additional ABD waiver program slots to

afford all members of the class prompt placement into that

program. Under the circumstances presented in this case, they

are not.

Discussion

New Hampshire, like every other state, participates in the

federal Medicaid program, “an optional plan under which the

federal government, through the states, partially funds medical

assistance to needy individuals.” Bryson, 308 F.3d at 81-2

(citations omitted). “Medicaid is a payment scheme, not a scheme

for state-provided medical assistance, as through state-owned

hospitals,” and involves the provision of “financial assistance

rather than . . . actual medical services.” Bruggeman v .

Blagojevich, 324 F.3d 906, 910 (7th Cir. 2003).

Under the Medicaid program, states may apply for certain

waivers. If approved, such waivers permit the states to operate

model programs in which home and community-based care services,

not otherwise authorized, may be provided free of some of the

3 usual requirements (like statewide availability of services, and

availability of such services to all persons equally).

The Medicaid waiver programs are “designed to allow states

to experiment with methods of care, or to provide care on a

targeted basis, without adhering to the strict mandates of the

Medicaid system.” Bryson, 324 F.3d at 8 2 . Those programs, as the

court of appeals previously noted, are in theory expenditure-

neutral. That is to say, “the average estimated per capita

expenditure under the waiver plans must not be more than the

average estimated expenditure absent the waiver program.” Id.

(citation omitted). But, “[i]n practice, the waiver programs may

be costly to the states, because even though the individuals

served by the waiver plan are no longer being served by nursing

homes or other [institutional] care facilities, other patients

may take those nursing home spots.” Id. at 82-83. And, “[m]any

patients not currently being served under Medicaid may also apply

for the waiver program.” Id. at 82 (citation omitted). “The

states thus have a financial incentive to keep their waiver

programs small, or at least, to begin with small programs and

grow them incrementally.” Id.

In 1993, New Hampshire applied for, and obtained, federal

approval of an ABD waiver program, authorizing it to provide home

4 and community-based services to persons with acquired brain

disorders. The ABD waiver program offers a community-based

alternative to institutional care for persons with ABDs. That

program has been renewed periodically and continues through the

present time. Since its inception, New Hampshire’s ABD waiver

program has grown steadily. Initially, the State funded 15

places in the ABD waiver program and now funds 132 places.

Demand for home and community-based ABD services, however, has

always exceeded the number of available places in the waiver

program. But as the number of program places has steadily

expanded, the number of persons on the waiting list has remained

fairly constant. In the first year, 25 people were on the

waiting list and, recently, in 2005, approximately 24 people were

awaiting placement in the program.

The State does not intentionally leave waiver program slots

unfilled. Rather, as existing slots become open, and new slots

are added, people on the waiting list are “earmarked” for those

slots, following which placement planning commences. There i s ,

of course, some delay between a spot becoming available and it

being filled by someone on the waiting list. But, those delays

generally are due to ordinary and necessary administrative

requirements, like planning, obtaining, and organizing services

and service-providers for the person moving off the waiting list

5 and into a community placement. New Hampshire’s ABD waiver

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Related

Sanchez v. Johnson
416 F.3d 1051 (Ninth Circuit, 2005)
Arc of Washington State Inc. v. Braddock
427 F.3d 615 (Ninth Circuit, 2005)
Woodruff v. Dimario
164 F. Supp. 2d 1 (District of Columbia, 2001)

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