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MUSSINGTON v. ST. LUKE'S-ROOSEVELT HOSP. CTR.

June 11, 1993

YVONNE MUSSINGTON, individually and on behalf of her son, JONATHAN JACOBS; ROSEMARY JOHNSON, individually and on behalf of her children, EDWARD CUFFEE, JR., TONY JOHNSON, ROGER CUFFEE, SHAMAEKIA CUFFEE, JENNIFER CUFFEE, JESSICA CUFFEE, KEVIN CUFFEE, and VERONICA JOHNSON; CHURCH OF THE INTERCESSION; IGLESIA EPISCOPAL DE SANTA MARIA; RELIGIOUS COMMITTEE ON THE NEW YORK CITY HEALTH CRISIS, INC.; RIVERSIDE CHURCH OFFICE OF SOCIAL JUSTICE; ST. MARY'S EPISCOPAL CHURCH MANHATTAN; and UPPER MANHATTAN ANGLICAN/EPISCOPAL CLERGY ASSOCIATION, Plaintiffs,
v.
ST. LUKE'S-ROOSEVELT HOSPITAL CENTER; NEW YORK STATE DEPARTMENT OF HEALTH; and MARK R. CHASSIN, Commisioner of Health, in his official capacity, Defendants.


MARTIN, JR.


The opinion of the court was delivered by: JOHN S. MARTIN, JR.

JOHN S. MARTIN, JR., District Judge:

 Background

 Defendant St. Luke's-Roosevelt Hospital Center ("SLRHC") is a hospital which is actually comprised of two separate facilities: St Luke's, located in Manhattan at Amsterdam Avenue and 113th Street, and Roosevelt, located in Manhattan at Amsterdam Avenue and 59th Street. Originally completely distinct hospitals, the two merged in 1979 for financial reasons and now practically function as one hospital serving an area from West 34th Street to West 142nd Street in Manhattan.

 As a result of further financial difficulties, SLRHC has planned a number of long range changes, some of which involve consolidation of particular services at either one or the other facility. Changes in hospital services which require construction require the approval of the Commissioner of the Department of Health (both the Commissioner and the Department have been named as defendants and are collectively referred to herein as "DOH"), and such approval was given on March 4, 1987 and modified on July 11, 1990.

 Plaintiffs' complaint alleges that SLRHC plans and DOH approved SLRHC's intentions: (1) To consolidate its obstetric services ("OB"), which previously had a presence at both facilities, solely at Roosevelt; (2) Similarly to consolidate its neonatal intensive care unit ("NICU") at Roosevelt; (3) Similarly to consolidate its pediatric inpatient care services ("pediatrics") at Roosevelt; and (4) To reduce the number of general medical-surgical beds at St. Luke's by more than 200 beds.

 Plaintiffs consist of (1) low income African American and Latino adults and children living in the vicinity of St. Luke's, (2) churches located in the vicinity of St. Luke's and having congregation members living in the vicinity of St. Luke's, and (3) certain other organizations. Plaintiffs essentially allege that the shifting of services to the Roosevelt site will discriminate against Medicaid beneficiaries, African Americans and Latinos because it will be done with the intent of and will have the effect of reducing the number of persons in these categories who will utilize SLRHC. Plaintiffs seek a declaratory judgment that the above-mentioned changes will violate federal and state law because they discriminate against Medicaid patients and on the basis of race, basing claims on Title VI of the Civil Rights Act of 1964, 42 U.S.C. §§ 2000d et seq., and the Equal Protection clause of the United States Constitution by way of 42 U.S.C. § 1983, and they seek to enjoin such changes on the same grounds, basing these claims on the Hill-Burton Act, 42 U.S.C. §§ 291 et seq., and Title II of the Civil Rights Act of 1964, 42 U.S.C. §§ 2000a et seq. Analogous relief based on violations of state law is sought as well.

 Defendants now move to dismiss the complaint and for summary judgment.

 Discussion

 Defendants move to dismiss the complaint on the following grounds: (1) the claims are not a "case or controversy" because they are not ripe; (2) the plaintiffs lack standing to assert the claims; (3) the claims are barred by statutes of limitations; (4) the claims are barred by laches; (5) the complaint fails to allege the elements of the causes of action.

 Ripeness

 Defendants claim that aspects of this case are not justiciable because (1) There is no current plan to reduce the number of beds by 212; although there is an outstanding directive from the New York Commissioner of Health to do so, this instruction has apparently been deferred at least until 1995, and will be reviewed at that time; (2) As a result of community pressure, the OB and NICU services at St. Luke's will be continued, although the number of beds in OB will be reduced from 58 to 22 and in NICU from 16 to 14. Thus, argue defendants, plaintiffs' claim is only ripe as to the pediatric unit.

 Plaintiff responds that SLRHC has only bound itself to maintain these levels of service for two years, and thus the injury is still threatened, and that in any event the depletion in OB and NICU services itself presents a sufficient controversy.

 Jurisdiction of the federal courts is limited to actual cases and controversies. U.S. Const. art III; Allen v. Wright, 468 U.S. 737, 750, 82 L. Ed. 2d 556, 104 S. Ct. 3315 (1984). Under the doctrine of ripeness, a controversy must be sufficiently concrete before it may be brought to federal court. See Volvo N. Am. Corp. v. Men's Int'l Prof'l Tennis Council, 857 F.2d 55, 63 (2d Cir. 1988).

 This case is ripe as to the pediatrics, OB and NICU allegations, but not as to the allegations regarding the removal of the 212 medical-surgical beds. The significant planned reduction in OB services and wholesale elimination of pediatrics renders those issues ripe; while numerically the change in NICU seems minor, it still may be a sufficient ground for these claims. Plaintiffs' claims do not depend upon a total elimination of particular services, but rather on the reductions in those services, be they partial or complete.

 On the other hand, the elimination of the 212 beds will be based on a number of contingencies, and thus does not present a current controversy. The evidence submitted establishes that any decision to reduce the number of medical-surgical beds at St. Luke's has been delayed at least until 1995, at which time it will be wholly re-evaluated. There being no present plan to reduce the number of medical-surgical beds at St. Luke's, any claim based on such ...


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