Mental Hygiene Legal Service v. Delaney

Citation38 N.Y.3d 1076,191 N.E.3d 1113,171 N.Y.S.3d 842
Decision Date21 April 2022
Docket Number28
Parties In the Matter of MENTAL HYGIENE LEGAL SERVICE, Third Judicial Department, on Behalf of Oliviah CC., an Infant, Appellant, v. Kerry DELANEY, Acting Commissioner, New York State Office for People with Developmental Disabilities, et al., Respondents.
CourtNew York Court of Appeals

38 N.Y.3d 1076
191 N.E.3d 1113
171 N.Y.S.3d 842

In the Matter of MENTAL HYGIENE LEGAL SERVICE, Third Judicial Department, on Behalf of Oliviah CC., an Infant, Appellant,
Kerry DELANEY, Acting Commissioner, New York State Office for People with Developmental Disabilities, et al., Respondents.

No. 28

Court of Appeals of New York.

April 21, 2022

Sheila E. Shea, Mental Hygiene Legal Service, Third Judicial Department, Albany (Shannon Stockwell of counsel), for appellant.

Letitia James, Attorney General, Albany (Laura Etlinger, Barbara D. Underwood and Andrea Oser of counsel), for Kerry Delaney and another, respondents.

Stafford, Owens, Piller, Murnane, Kelleher & Trombley, PLLC, Plattsburgh (Brendan P. Owens of counsel), for Champlain Valley Physicians Hospital, respondent.

Disability and Aging Justice Clinic, CUNY School of Law, Long Island City (Natalie M. Chin of counsel), for Autistic Self Advocacy Network and others, amici curiae.

The Arc New York, Latham (Kathryn E. Jerian of counsel), for The Arc New York, amicus curiae.

171 N.Y.S.3d 843
191 N.E.3d 1114



38 N.Y.3d 1077

The appeal should be dismissed without costs, upon the ground that the issues presented are moot.

The subject child, a 16-year-old with developmental disabilities, was admitted into the emergency room of respondent Champlain Valley Physicians Hospital (hospital) after an incident at school during which she became unmanageable. When the hospital determined that the child did not require in-patient psychiatric or medical care and sought to discharge the child, her mother declined to take her home based on concerns for the safety of the child's sibling. The child's school district sought to remedy the situation by placing the child in a residential school, but no such school could accommodate her at that time. Respondent New York State Office for People with Developmental Disabilities (OPWDD)—which facilitates the provision of various services to children with developmental disabilities pursuant to a Medicaid waiver program—tried to find the child a temporary, residential placement at a suitable facility, but none had appropriate accommodations for children. OPWDD then increased the funds allocated to the child, who had previously been determined eligible to receive in-home services under the Medicaid waiver program, so that her mother

38 N.Y.3d 1078

could hire additional in-home services, but no qualified local providers were immediately available. During the several weeks that a placement or provider for in-home services was sought, the child remained in the emergency room.

Petitioner Mental Hygiene Legal Services, on behalf of the child, commenced this combined CPLR articles 70 and 78 special proceeding and declaratory judgment action against the hospital, OPWDD, and respondent New York State Department of Health (DOH). Specifically, petitioner sought the child's immediate discharge from the emergency room; a "safe discharge plan upon her release;" a determination that "it is arbitrary and capricious for OPWDD and DOH to fail to provide community habilitation and respite services" to the child; a declaration that the child's "confinement in a segregated, isolated emergency room" violated her statutory rights; to enjoin respondents from "segregat[ing]" the child in the emergency room and to require that the child be afforded community habilitation and respite services "with reasonable promptness" under the Medicaid Act to "enable her to be discharged from the emergency room;" and to seal the records of this proceeding. In essence, the petition alleged that OPWDD's service model and programs for children were inadequate.

At a scheduled hearing on the matter, the parties advised Supreme Court that the child had been discharged from the emergency room to a suitable placement at a residential school. Petitioner declined Supreme Court's offer to adjourn the matter until longer-term placement was secured. Instead, petitioner sought entry of a final order dismissing the proceeding, indicating a desire to appeal expeditiously from the court's ruling.

During the pendency of petitioner's appeal to the Appellate Division, the child was unconditionally placed in the residential school.

On appeal, petitioner did not dispute that habeas relief was no longer available, nor did it seek to challenge the adequacy of the subject child's ultimate discharge or placement—the primary relief sought in the petition. The Appellate Division affirmed,

191 N.E.3d 1115
171 N.Y.S.3d 844

determining that the matter was moot but applying the exception to the mootness doctrine to reach petitioner's arguments ( 176 A.D.3d 24, 30-31, 109 N.Y.S.3d 469 [3d Dept. 2019] ), which it rejected on the merits ( id. at 31-37, 109 N.Y.S.3d 469 ).

Petitioner does not contest that the matter is moot. Nevertheless, petitioner urges this Court to apply the exception to

38 N.Y.3d 1079

the mootness doctrine, as the Appellate Division did below, to reach the merits of its challenges to respondents’ compliance with or implementation of various statutes relating to the provision of services to children with disabilities. However, it is undisputed that, during the pendency of petitioner's appeal to this Court, OPWDD developed a new program, Crisis Services for Individuals with Intellectual and/or Developmental Disabilities ([CSIDD] 14 NYCRR 635-16.1 et seq. ), aimed at preventing persons with developmental disabilities from experiencing a crisis that may result in hospitalization and thereby reducing the likelihood of these issues recurring. At oral argument before this Court, counsel for OPWDD and DOH represented that the services provided by CSIDD are now available throughout the entirety of the State of New York, and particularly in the region where the child resided. Given the intervening material alterations of the service programs challenged in the petition, we decline to invoke the exception to the mootness doctrine under the unique circumstances of this case (see generally Matter of Hearst Corp. v. Clyne , 50 N.Y.2d 707, 714-715, 431 N.Y.S.2d 400, 409 N.E.2d 876 [1980] ). Because we dismiss on mootness grounds, we have no occasion to address the substance of the Appellate Division's order. Of course, should unfortunate extended hospitalizations give rise to new litigation, we take no position on any future challenges to the efficacy of OPWDD's current programs.

RIVERA, J. (dissenting).

Petitioner is a child with complex developmental disabilities who alleges that she was confined for weeks to an emergency room bed in a local general hospital because respondents approved, but failed to provide, necessary community habilitation and respite services, as required by state and federal law.1 These allegations are reminiscent of claims from the litigation of the 1970s when disabled people were institutionalized in settings that failed to meet their basic needs. Petitioner's counsel, Mental Hygiene Legal Service (MHLS), and the hospital where she was confined maintain that this was not an aberration, and that other similarly situated disabled children have languished in emergency rooms awaiting services. The courts below agreed with respondents that, although the child was confined to the emergency room during a lengthy waiting period for services approved by the State, the child

38 N.Y.3d 1080

cannot maintain a claim for relief under law. That cannot be true where petitioner challenges a gap in service resulting from the State's dependence on nonexistent service providers in her region, which in turn caused her lengthy confinement, notwithstanding that both state and federal law expressly require the State to ensure necessary medical services to all eligible persons with developmental disabilities in order to effectuate the legislative goal of minimizing the risk of institutionalization. Her assertions are sufficient at the pleading stage. Therefore, I would reverse and

171 N.Y.S.3d 845
191 N.E.3d 1116

remit so that the lower court may consider whether the State's delayed process for ensuring the provision of services is legally permissible.



To understand what led to the governmental actions challenged on this appeal requires some historical background on discrimination against persons with disabilities, especially those with developmental disabilities, the social movement and litigation to end institutionalization and segregation in state-run facilities, and legislation to protect the civil rights of the disabled and to fund appropriate services that further the goal of integration in community settings.


The Movement from Institutionalization to Deinstitutionalization and Community Integration

For decades throughout the United States, many thousands of people with intellectual and developmental disabilities were segregated from their communities in massive state-run institutions, more akin to warehouses, where they often suffered physical and mental abuse, neglect, and isolation from friends, family, and the broader society. In many instances, the "treatment" afforded to individuals in these institutions "was merely custodial, more concerned with achieving quiescence and control than in promoting recovery" (see Samuel R. Bagenstos, The Past and Future of Deinstitutionalization Litigation , 34 Cardozo L Rev 1, 24 [2012] ). The number of people with such disabilities confined to state-run institutions in the United States peaked at 194,650 in 1967 (see id. at 7-8 [2012], citing Deborah S. Metzel, Historical Social Geography , in Mental Retardation in America: A Historical Reader 420, 432 [Steven Noll & James W. Trent Jr. eds., 2004]).

38 N.Y.3d 1081

In response to the humanitarian crisis in these institutions, disability rights supporters pushed for deinstitutionalization. Advocates sought to move individuals with disabilities out of state-run institutions through litigation and to ensure that such individuals could receive services and resources necessary to thrive outside...

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