Hawkins v. Cohen

• Decision Date: 09 August 2018
• Docket Number: NO. 5:17-CV-581-FL,5:17-CV-581-FL
• Court: U.S. District Court — Eastern District of North Carolina
• Parties: MARCIA ELENA QUINTEROS HAWKINS, ALICIA FRANKLIN, VANESSA LACHOWSKI, AND KYANNA SHIPP, on behalf of themselves and all others similarly situated, Plaintiffs, v. MANDY COHEN, in her official capacity as Secretary of the North Carolina Department of Health and Human Services, Defendant.

MARCIA ELENA QUINTEROS HAWKINS, ALICIA FRANKLIN,VANESSA LACHOWSKI, AND KYANNA SHIPP,on behalf of themselves and all others similarly situated, Plaintiffs, v. MANDY COHEN, in her official capacity as Secretary of the

North Carolina Department of Health and Human Services, Defendant.

NO. 5:17-CV-581-FL

UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF NORTH CAROLINA WESTERN DIVISION

August 9, 2018

ORDER

This matter is before the court on plaintiffs' motion to certify class (DE 17), defendant's motion to dismiss (DE 32), and plaintiffs' motion for preliminary injunction (DE 37). The motions have been fully briefed, and the issues raised are ripe for ruling. For the following reasons, each motion is granted in part and denied in part.

STATEMENT OF THE CASE

Plaintiffs commenced this putative class action on November 21, 2017, and filed corrected amended complaint on December 6, 2017, alleging violations by defendant of provisions of the federal Medicaid Act, 42 U.S.C. § 1396a; the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12132; section 1557 of the Affordable Care Act ("ACA"), 42 U.S.C. § 18116; and the Due Process Clause of the Fourteenth Amendment to the United States Constitution. As described in more detail herein, plaintiffs challenge policies and procedures of defendant that allegedly caused plaintiffs and others similarly situated to lose Medicaid benefits without sufficient notice, without adequate determination of eligibility for benefits, and without reasonable accommodation of disabilities and language barriers.

As relief, plaintiffs seek class certification, declaratory relief, and a preliminary and permanent injunction prohibiting defendant from continuing her unlawful policies and practices, and requiring defendant to reinstate Medicaid coverage to plaintiffs and all affected class members "until their Medicaid eligibility has been properly redetermined under all eligibility categories, under procedures that reasonably accommodate disabilities and limited English proficiency, and until adequate and timely notice of termination has been provided to them." (Compl. at 27-28).¹ Plaintiffs also seek an award of costs and reasonable attorney's fees.

In their motion to certify class, plaintiffs seek certification of an overarching class and three subclasses. In particular, plaintiffs propose a class defined as:

All individuals whose Medicaid coverage was, is, or will be interrupted or terminated, effective January 1, 2014 or later, by Defendant Secretary of the North Carolina Department of Health and Human Services [hereinafter "DHHS"], or any of her employees, contractors, agents, or assigns, without first making an individualized determination of ineligibility under all Medicaid eligibility categories.

Plaintiffs propose three subclasses as follows:

Subclass One: All individuals whose Medicaid coverage was, is, or will be terminated or interrupted, effective January 1, 2014 or later, by Defendant Secretary of DHHS, or any of her employees, contractors, agents, or assigns, without first making an individualized determination of ineligibility under all Medicaid eligibility categories and without first sending the beneficiary at least 10-day prior written notice of the termination of Medicaid that describes the specific reasons for thetermination, the specific regulation supporting the termination, and the right to a pre-termination hearing.

Subclass Two: All individuals for whom Medicaid coverage was, is, or will be terminated or interrupted, effective January 1, 2014 or later, by Defendant Secretary of DHHS, or any of her employees, contractors, agents, or assigns without first making an individualized determination of ineligibility under all Medicaid eligibility categories and without accommodating the beneficiary's disability during the eligibility redetermination process.

Subclass Three: All individuals for whom Medicaid coverage was, is, or will be terminated or interrupted, effective January 1, 2014 or later, by Defendant Secretary of DHHS, or any of her employees, contractors, agents, or assigns, without first making an individualized determination of ineligibility under all Medicaid eligibility categories and without communicating during the redetermination process in the beneficiary's primary language where the beneficiary has limited English proficiency.

In support of their motion to certify class, plaintiffs rely upon declarations by plaintiffs and their current counsel, with exhibits attached thereto including: 1) DHHS fiscal reports and reports of pending recertifications by date and county; 2) letters from DHHS to county social services departments; 3) an August 4, 2017, email from counsel for defendant to counsel for plaintiffs regarding DHHS monthly reports; 4) a DHHS form DS-8110 titled "Your Benefits are Changing"; 5) a DHHS "Family and Children's Medicaid Manual MA-3420"; 6) a DHHS form DS-8110 sent to plaintiff Marcia Elena Quinteros Hawkins ("Hawkins"); and 7) tables regarding English proficiency and disability in certain populations.

Defendant filed a response to the complaint, on February 5, 2018, in the form of the instant motion to dismiss, which seeks dismissal of all claims for failure to state a claim upon which relief can be granted, as well as dismissal of claims against plaintiff Vanessa Lachowski ("Lachowski") for lack of standing. Defendant also filed a response in opposition to plaintiffs' motion to certify class.

Plaintiffs filed the instant motion for preliminary injunction on February 13, 2018. Plaintiffs seek preliminary injunction on the basis of a subset of claims in the complaint, and plaintiffs seek preliminary injunctive relief more narrowly than the preliminary and permanent injunctive relief sought in the complaint. In particular, plaintiffs move the court "to enjoin Defendant and her agents from terminating Medicaid benefits of the named plaintiffs and members of the proposed Plaintiff class without first determining ineligibility under all Medicaid categories, including Medicaid based on an alleged disability, and providing timely and adequate written notice and the opportunity for a pre-termination hearing." (Mot. (DE 37) at 1). Plaintiffs do not seek preliminary relief on the basis of their claims under the Americans with Disabilities Act or section 1557 of the Affordable Care Act, but reserve those allegations and claims for discovery and trial. Plaintiffs also reserve for trial their request to reinstate those who have been illegally terminated since January 2014.

In support of the instant motion for preliminary injunction, plaintiffs rely upon declarations by counsel and paralegals, with exhibits attached thereto including, in further supplement to materials already filed in support of class certification: 1) additional DHHS fiscal reports and reports of pending recertifications by date and county, 2) additional letters and reports from DHHS to county social services departments, 3) additional portions of DHHS Medicaid manuals and training materials, 4) reports issued by the Social Security Administration, 5) Mecklenburg county social services department correspondence and notices regarding plaintiffs as well as other individuals, including Leroy Rivers ("Rivers"), Johanna Espino Martinez, Alma Miranda Reyes ("Reyes"), and Dequavius Bowman. Plaintiffs also rely upon declarations by plaintiffs Hawkins and Lachowski, as well as Reyes, Rivers, Jerry Hedger, and Tarren Turrubates, who received notices from Mecklenburg county social services department.

In opposition to the preliminary injunction motion, defendant relies upon 1) an affidavit of Carolyn McClanahan ("McClanahan"), who serves as the associate director of DHHS Medicaid Eligibility Services, 2) excerpts of DHHS manuals, 3) a letter from DHHS to county social services departments, 4) Mecklenburg county social services department notices sent to plaintiffs Hawkins, Franklin, Lachowski, as well as another individual, Lakeisha R. O'Fair, mother of plaintiff Shipp.

Plaintiffs replied in support of their preliminary injunction motion on March 14, 2018, wherein they modify their request for preliminary injunctive relief. Plaintiffs now request the following preliminary injunction:

1) immediately cease automatic computer-generated terminations of Medicaid without first sending timely, adequate notice; 2) immediately cease terminations of Medicaid where the beneficiary has not been determined ineligible under all Medicaid categories, including categories based on disability if disability is alleged during the redetermination process upon inquiry by Defendant; 3) provide the right to a de novo pre-termination hearing, including on the issue of disability.

(Reply (DE 53) at 6). Plaintiffs filed a notice of suggestion of subsequently controlling authority on July 5, 2018.

STATEMENT OF FACTS

The facts alleged in the complaint may be summarized as follows.

A. Medicaid Administration in North Carolina

North Carolina has elected to participate in the Medicaid program, which entitles North Carolina to receive federal funds for Medicaid services provided to eligible beneficiaries, including families with dependent children and aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services. Defendant is the Secretary of DHHS, which administers the Medicaid program in North Carolina, and which directs policiesand procedures governing the processing of Medicaid eligibility determinations and redeterminations by all 100 county departments of social services ("DSS") in North Carolina.

According to the complaint, defendant has put in place a "computer system called NCFAST" that presently is programmed to cause automatic terminations of Medicaid benefits without notice to individuals who previously received Medicaid benefits. (Compl. ¶ 51). In particular, "[a]bsent timely action" by an individual county DSS upon periodic re-eligibility review or...