511 F.Supp. 1073 (N.D.N.Y. 1981), 78-IV-145, Calkins v. Blum

Docket Nº:78-IV-145.
Citation:511 F.Supp. 1073
Party Name:Kenneth CALKINS, Yvonne Calkins, Gerald Makin, Helen Makin, Martin E. Toomey, Sr., and Mary Toomey, individually and on behalf of their minor children residing with them, and on behalf of all other persons similarly situated, Plaintiffs, and Alexander Kliss, Jane Kliss, David Hodeker, and Connie Hodeker, individually and on behalf of all other pers
Case Date:March 04, 1981
Court:United States District Courts, 2nd Circuit

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511 F.Supp. 1073 (N.D.N.Y. 1981)

Kenneth CALKINS, Yvonne Calkins, Gerald Makin, Helen Makin, Martin E. Toomey, Sr., and Mary Toomey, individually and on behalf of their minor children residing with them, and on behalf of all other persons similarly situated, Plaintiffs,

and

Alexander Kliss, Jane Kliss, David Hodeker, and Connie Hodeker, individually and on behalf of all other persons similarly situated, Curtis Williams, Addie Williams, Isahiah Floyd, and Louise Floyd, individually and on behalf of their minor children residing with them, and on behalf of all other persons similarly situated, Plaintiffs-Intervenors,

v.

Barbara B. BLUM, individually and as Commissioner of the New York State Department of Social Services, John L. Lascaris, individually and as Commissioner of the Onondaga County Department of Social Services, Sarah A. Curtis, individually and as Commissioner of the Steuben County Department of Social Services, W. Burton Richardson, individually and as Commissioner of the Monroe County Department of Social Services, Jerim Klapper, individually and as Commissioner of the Orleans County Department of Social Services, and Beverly Carbb, individually and as Commissioner of the Genesee County Department of Social Services, Defendants.

No. 78-IV-145.

United States District Court, D. New York

March 4, 1981

As Amended April 15, 1981.

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Onondaga Neighborhood Legal Services, Kliss & Hodeker, Syracuse, N. Y., for plaintiffs and plaintiff-intervenors; Maurie Heins, Syracuse, N. Y., of counsel.

Southern Tier Legal Services, Corning, N. Y., for plaintiffs; Martin A. Hotvet, Corning, N. Y., of counsel.

Greater Up-State Law Project, Rochester, N. Y., for plaintiffs and plaintiff-intervenors Kliss and Kodeker; Rene H. Reixach, Rochester, N. Y., of counsel.

Orleans Legal Aid Bureau, Inc., Albion, N. Y., for plaintiff-intervenors Williams; John Cebula, Albion, N. Y., of counsel.

Orleans Legal Aid Bureau, Inc., Batavia, N. Y., for plaintiff-intervenors Floyd Genesee Branch; Raymond Rodriguez, Batavia, N. Y., of counsel.

Robert Abrams, Atty. Gen., for State of New York, Syracuse, N. Y., for defendant Blum; Anne Meadvin, Asst. Atty. Gen., Syracuse, N. Y., of counsel.

Onondaga County Dept. of Social Services, Syracuse, N. Y., Attorney for Defendant Lascaris; John Barnaba, Syracuse, N. Y., of counsel.

Steuben County Dept. of Social Services, Bath, N. Y., for defendant Curtis; Wendy Lee Gould, Bath, N. Y., of counsel.

Monroe County Dept. of Social Services, Rochester, N. Y., for defendant Russo; James Robinson, Rochester, N. Y., of counsel.

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Thomas Young, Holley, N. Y., for defendant Klapper.

W. Douglas Call, Batavia, N. Y., for defendant Crabb.

MEMORANDUM DECISION AND ORDER

MUNSON, Chief Judge.

The named plaintiffs, plaintiff-intervenors, 1 and absent proposed class members are aged, blind, or disabled adults, their spouses, and any dependent children. All named plaintiffs have sought medical assistance (medicaid) as medically needy persons. In this action for declaratory, injunctive, and monetary relief, the plaintiffs 2 aver, inter alia, that the defendants, administrators of the medicaid program for the State of New York, have determined the medicaid eligibility of medically needy persons in a manner different from, and less generous than, the methods used to compute the medicaid eligibility of categorically needy persons. This disparate treatment, the plaintiffs alleged, has violated certain provisions of the Social Security Act, various regulations promulgated by the Department of Health and Human Services (HHS), 3 the Equal Protection Clause of the Fourteenth Amendment, the Supremacy Clause, and 42 U.S.C. s 1983.

Presently before the Court are motions by the plaintiffs for class certifications and for summary judgment, and by the defendants for dismissal of the complaint and for cross-summary judgment.

I.

A.

Title XIX of the Social Security Act of 1965, 42 U.S.C. ss 1396-1396k, has created a cooperative federal-state medical assistance (medicaid) program designed to enable each State, "as far as practicable under the conditions of each State, to furnish (1) medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals whose income and resources are insufficient to meet the costs of necessary medical services, ...." 42 U.S.C. s 1396(1). If a state chooses to participate in the medicaid program, it must submit to the Department of Health and Human Services (HHS), the administrator of the federal medicaid program, see 42 C.F.R. ss 435.1-. 1011, a medical assistance plan that comports with the requirements of the Social Security Act and of the regulations promulgated by HHS. 42 U.S.C. ss 1396, 1396a; 42 C.F.R. s 435.10.

With respect to these requirements, the federal program distinguishes two groups of medicaid recipients. Pursuant to 42 U.S.C. s 1396a(a)(10)(A), a participating State must provide medical assistance to the "categorically needy," those aged, blind, or disabled individuals, and families and children, whose levels of income and resources are low enough to qualify them for federal cash assistance under the Supplementary Security Income (SSI) program, 42 U.S.C. ss 1381-1383c, or under the Aid to Families with Dependent Children (AFDC) program, 42 U.S.C. ss 601-644. See 42 C.F.R. s 435.4 (amended 45 Fed.Reg. 24883, April 11, 1980). Pursuant to 42 U.S.C. s 1396a(a)(10)(C), a participating State may provide medicaid benefits to the "medically needy", those aged, blind, or disabled individuals, and families and children, whose levels of income and resources are too low to cover the costs of medical care, but too high to qualify them for cash grants under the SSI or AFDC programs. See 42 C.F.R. s 435.4. This class of medically needy may

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thus be divided into two subgroups: the SSI medically needy, those aged, blind, or disabled individuals in need of medical assistance who are ineligible for SSI, and the AFDC medically needy, those families and children in need of medical assistance who are ineligible for AFDC.

The State of New York is one state that participates in the cooperative medicaid program. See N.Y.Soc.Serv.Law ss 363-369. In this regard, the State of New York also operates under a state constitutional mandate to affirmatively aid the needy. N.Y.Const. Art. XVII, s 1. See Lee v. Smith, 43 N.Y.2d 453, 373 N.E.2d 247, 402 N.Y.S.2d 351 (1977); Tucker v. Toia, 43 N.Y.2d 1, 371 N.E.2d 449, 400 N.Y.S.2d 728 (1977). Under the New York medicaid scheme, which is administered by the departments of social services of the State, counties, and of the City of New York, the State furnishes medical assistance to both the categorically and medically needy. N.Y.Soc.Serv.Law ss 366(1)(a)(1), (2) & (5).

Since the commencement of this action, the State of New York has converted to a different medical assistance plan, effective August 29, 1980. Under the new "209b" plan, as set forth in 42 U.S.C. s 1396a(f), 4 the State, instead of HHS, determines SSI eligibility, and may apply to aged, blind, or disabled individuals medicaid eligibility criteria that are more restrictive than the criteria utilized under the SSI program. See 42 C.F.R. s 435.121 (amended 45 Fed.Reg. 24883, April 11, 1980). Thus, this opinion must address two separate time frames, the pre- and post-conversion periods.

B.

At dispute in this action are the budgeting procedures used by the defendants in ascertaining the eligibility for and amount of, medical assistance for the medically needy.

For purposes of clarity, the plaintiffs fall into four groups. The first group of plaintiffs is comprised of several aged, blind, or disabled, SSI medically needy persons: Kenneth Calkins, a blind resident of Onondaga County; Gerald Makin, a disabled resident of Steuben County; Mary Toomey, a disabled resident of Monroe County; Curtis and Addie Williams, disabled residents of Orleans County; Jane Kliss, a disabled resident of Monroe County; Isahiah and Louise Floyd, disabled residents of Genesee County; and Connie Hodeker, a disabled resident of Monroe County. The second group of plaintiffs represent the spouses of these aged, blind, or disabled, SSI medically needy persons, who join this action because they bear the financial responsibility for the medical and non-medical care of their medically needy spouses: Martin E. Toomey, Sr., a resident of Monroe County; Alexander Kliss, a resident of Monroe County; and David Hodeker, a resident of Monroe County. The third group of plaintiffs includes individuals who reside with SSI medically needy persons and who are AFDC medically needy by virtue of their children's deprivation of parental support, which stems from the disabilities of the parents: Yvonne Calkins, a resident of Onondaga County and a caretaker relative of two minor children; Curtis and Addie Williams, residents of Orleans County and caretaker relatives of three minor children; Isahiah and Louise Floyd, residents of Genesee County and caretaker relatives of one minor child; and Helen Makin, a resident of Steuben County and a caretaker relative of four minor children. The final group of plaintiffs consists of aged, blind, or disabled SSI medically needy persons who reside with AFDC medically needy persons, and who thus qualify as both SSI and AFDC medically needy:

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Kenneth Calkins, Gerald Makin, Curtis and Addie Williams, and Isahiah and Louise Floyd.

The defendants are administrators of the New York medicaid program. The defendant Blum, Commissioner of the New York State Department of Social Services, is the chief administrator of that Department, and is responsible for exercising general supervision over all local...

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