Mitchell v. Cmty. Mental Health of Cent. Mich., Case Number 16-11605
| Court | United States District Courts. 6th Circuit. United States District Court (Eastern District of Michigan) |
| Writing for the Court | Honorable David M. Lawson |
| Parties | THOMAS MITCHELL, through his Guardian, JOHN MITCHELL Plaintiffs, v. COMMUNITY MENTAL HEALTH OF CENTRAL MICHIGAN, MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, NICK LYON, and GOVERNOR RICK SNYDER, Defendants. JACOB HARTSHORNE, through his Guardians, NANCY and THOMAS HARTCHORNE, Plaintiffs, v. COMMUNITY MENTAL HEALTH OF CENTRAL MICHIGAN, MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, NICK LYON, and GOVERNOR RICK SNYDER, Defendants. |
| Decision Date | 22 March 2017 |
| Docket Number | Case Number 16-11605,Case Number 16-11607 |
THOMAS MITCHELL, through his Guardian, JOHN MITCHELL Plaintiffs,
v.
COMMUNITY MENTAL HEALTH OF CENTRAL MICHIGAN, MICHIGAN DEPARTMENT OF HEALTH
AND HUMAN SERVICES, NICK LYON, and GOVERNOR RICK SNYDER, Defendants.
JACOB HARTSHORNE, through his Guardians, NANCY and THOMAS HARTCHORNE, Plaintiffs,
v.
COMMUNITY MENTAL HEALTH OF CENTRAL MICHIGAN, MICHIGAN DEPARTMENT OF HEALTH
AND HUMAN SERVICES, NICK LYON, and GOVERNOR RICK SNYDER, Defendants.
Case Number 16-11605
Case Number 16-11607
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION
March 22, 2017
Honorable David M. Lawson
Magistrate Judge Patricia T. Morris
OPINION AND ORDER DENYING MOTIONS FOR PRELIMINARY INJUNCTION AND MOTIONS TO DISMISS
These two lawsuits were filed on behalf of two developmentally disabled individuals, Thomas Mitchell and Jacob Hartshorne, who had been receiving in-home Community Living Support (CLS) services through the Michigan Department of Health and Human Services (HHS),
Page 2
administered by a local contract provider, defendant Community Mental Health of Central Michigan (CMHCM). Although the plaintiffs had been receiving 24-hour care, CMHCM reduced the level of covered services furnished to them by eliminating payment for supervisory care while they slept. The change, says CMHCM, was provoked by an internal audit by a newly-employed "Utilization Manager" that disclosed that CMHCM was authorized to furnish CLS services only for face-to-face time with the client and could not be used during periods when the client was asleep. That new interpretation resulted in the service reduction, despite no changes in the law or the plaintiffs' medical status.
The plaintiffs allege in their complaints that the manner in which CMHCM reduced CLS services violated their right to procedural due process in violation of the Fourteenth Amendment, and it amounts to discrimination under the Americans with Disabilities Act and the Rehabilitation Act. Both plaintiffs filed motions for a preliminary injunction, and the defendants filed motions to dismiss. The two cases were consolidated before this Court for adjudication of the motions.
After the motions were argued, the Mitchells sought relief again in an administrative appeal, this time successfully, at least for their claim going forward. The Administrative Tribunal ordered CMHCM to provide Medicaid-covered CLS services to Thomas Mitchell, even when he is sleeping. The Mitchells' motion for a preliminary injunction, therefore, is moot, as it seeks only prospective relief.
The Hartshornes have not sought any additional relief from the state. However, there is no requirement that the plaintiffs must exhaust administrative remedies before baring their claims under 42 U.S.C. § 1983 for violation of their rights to procedural due process or for violations of the ADA or the Rehabilitation Act. Because they have stated viable claims under those statutes, the Court will
Page 3
deny the motions to dismiss. The Hartshornes have alleged in their motion for a preliminary injunction that they will suffer irreparable harm if the supervisory care during sleep hours is eliminated. However, that care continues, albeit at the plaintiff's expense, and, judging from the Mitchells' experience, it appears that the care could be restored if they pursued their administrative remedies. Therefore, the Court will deny the motion for preliminary injunction because they have not demonstrated irreparable harm adequately.
These cases were filed in the Northern Division of this Court and were subsequently reassigned to judges in the Southern Division for docket management. At the time of the reassignment, each case had two motions to dismiss and a preliminary injunction motion pending and fully briefed. Because the issues in the pending motions were substantially similar, it was decided that Hartshorne v. Community Mental Health of Central Michigan, Case No. 16-11607, would be reassigned temporarily to the undersigned for the purpose of hearing and deciding motions filed by the parties under Rule 12(b) and Rule 65 of the Federal Rules of Civil Procedure.
The respective plaintiffs, Thomas Mitchell and Jacob Hartshorne, are two individuals suffering from various forms of developmental disabilities. They both were receiving in-home healthcare under Michigan's Medicaid CLS program until 2015 through defendant HHS. Defendant Rick Snyder, as governor, oversees all departments in Michigan, and defendant Nick Lyons is the director of HHS (collectively "State defendants"). The Medicaid services in the plaintiffs' region are administered by defendant CMHCM. The plaintiffs' services were reduced, omitting nighttime coverage while they are sleeping.
Page 4
After the plaintiffs' services were reduced, their guardians each filed requests for administrative hearings challenging the reductions. Mitchell had a full hearing and received a written decision by an Administrative Law Judge finding that the reduction of services was appropriate. Hartshorne withdrew his request the day before his hearing in order to pursue federal claims. The ALJ dismissed the action for failure to appear at the hearing.
The plaintiffs filed substantially similar three-count complaints alleging a violation of their right to procedural due process under the Fourteenth Amendment via 42 U.S.C. § 1983(Count 1); disability discrimination in violation of Title II of the ADA (Count 2); and violation of the Rehabilitation Act (Count 3).
Medicaid is a federal program that subsidizes state medical services furnished to, among others, "disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services." 42 U.S.C. § 1396-1. The plaintiffs in these related cases are adults with developmental disabilities who qualify for benefits under Medicaid. Under Medicaid, they are eligible for long-term institutional care. The Medicaid statute originally "reflected a congressional policy preference for treatment in the institution over treatment in the community." Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 601 (1999). Since 1981, however, "Medicaid has provided funding for state-run home and community-based care through a waiver program." Id. at 601(citing 42 U.S.C. § 1396n(c)). Through that program, Congress recognized that allowing individuals with disabilities to reside in a community setting can both save money and improve care. See Price v. Medicaid Dir., 838 F.3d 739, 742-43 (6th Cir. 2016). The plaintiffs' CLS services were authorized
Page 5
under a Medicaid waiver program. See Michigan's Medicaid Provider Manual at 102. They have chosen to live with their respective families in a community setting.
The State of Michigan, through HHS, provides mental health services to qualified individuals. Defendant CMHCM is under contract with HHS to provide Medicaid-covered services to people who reside in a specified service area. As part of the plaintiffs' Habilitation Supports Waiver Program, they received CLS services, which the plaintiffs allege included medically necessary supervisory care at night while the plaintiffs slept. Mitchell received the nighttime supervision for approximately seven months, and Hartshorne received the services for approximately five years. In the summer of 2015, the plaintiffs' CLS services were reduced by eliminating the nighttime supervisory care.
The plaintiffs contend that the reduction of services was erroneous because CLS services are intended to increase or maintain personal self-sufficiency, facilitating an individual's achievement of his goals of community inclusion and participation, independence or productivity. The defendants contend that they had misinterpreted their Medicaid Service Provider Manual, and that their actions amounted to a correction, as CLS is available only for face-to-face encounters, which excludes sleep time. They reason that the purpose of CLS is not to furnish supervision, but to assist in skill development. CLS cannot be provided when a client is asleep, they say, because there would be no training or learning component.
Plaintiff Thomas Mitchell is a 30-year-old Medicaid beneficiary with severe intellectual disabilities and a seizure disorder, who qualifies as a person with a developmental disability under Michigan Compiled Laws 330.1100a(25). Mitchell alleges that he moved from a licensed adult
Page 6
foster care home in August 2014 to his own apartment in the lower level of his father's Mount Pleasant, Michigan home. On March 6, 2015, Thomas's father met with CMHCM's case manager, Lorraine Crawford, who informed him that CMHCM would no longer pay for any CLS services while Thomas was asleep at night. The Mitchells allege that at no time did CMHCM send a termination notice of the CLS nighttime supervision to them, detailing the reasons for the change in coverage, as required by law.
The Mitchells' complaint does not make clear whether the notice was not provided at all or was merely deficient. It appears that CMHCM understood the plaintiffs' allegation to mean there was no notice whatsoever. Therefore, rather than responding to an allegedly deficient notice, CMHCM responded by attaching to its motion a March 6, 2015 Action Notice that it asserts Mitchell received at a meeting on that same day. CMHCM does not discuss the adequacy of the Action Notice.
The Action Notice, in part, says the following:
This is to notify you that CMH for Central Michigan has made the following decision(s) about the service(s) you have asked for or the service(s) you get from us. This does not mean that you will lose your Medicaid and will not affect other Medicaid services you are receiving, or may need in the future....
The Action we have take is:
The service(s) you requested will be Authorized per your revised Individual Plan of Service. H2015 - Comprehensive Community Support Services T2002 - Non-emergency Transportation; per diem T1016
To continue reading
Request your trial