The opinion of the court was delivered by: MICHAEL A. TELESCA
Plaintiff, Anna W.,* filed this action under 42 U.S.C. § 1983 on June 15, 1992, seeking declaratory and injunctive relief with respect to several regulations promulgated by the New York State Department of Social Services ("DSS"). These regulations (18 N.Y.C.R.R. §§ 360-1.4(k) and 360.4-7(a)(1)) set forth the circumstances under which a home owned by an individual applying for or receiving Medicaid may be considered as an available resource for the purpose of determining eligibility for benefits. Plaintiff contends that these regulations violate 42 U.S.C. § 1396(r)(2)(A) because they create a more restrictive resource standard than that used in the Supplemental Security Income ("SSI") program.
The facts of this action are not in dispute. The plaintiff, Anna W., has been receiving periodic inpatient treatment for bi-polar or manic-depressive disorder at the Rochester Psychiatric Center ("RPC") since 1958. In 1985, she was admitted to RPC as an inpatient. At that time, her doctors considered that her prognosis for recovery was poor, and believed that she would most likely need inpatient hospitalization for the rest of her life. She was not permanently admitted to RPC, however, and had the status of "temporary inpatient" at RPC. She remained an inpatient until 1991, when her condition improved to the point that she could be placed in shared, unsupervised housing, returning to RPC for one full day and night per week for continuing treatment. During the 7 1/2 years that plaintiff was an inpatient, she was occasionally placed in structured residential settings outside RPC.
Plaintiff owns a home with an approximate value of $ 60,000, where her son has lived from 1987 to the present. She has returned to this home relatively frequently during the years that she was an patient at RPC, although she has not resided there since 1985.
Plaintiff began receiving New York State Medical Assistance ("Medicaid") benefits in the summer of 1986, when she turned sixty-five. In April 1988, DSS notified the plaintiff that her benefits would be discontinued because her home counted as an excess resource and thus disqualified her from eligibility. She successfully challenged the original notice on the ground that she was given improper notice. After receiving proper notice of discontinuance, Plaintiff requested and was granted a fair hearing on the issue of the homestead exemption on January 7, 1992. Plaintiff testified at the hearing that she wanted to return to her home and that she intended to live at her home permanently when she fully recovered.
On February 12, 1992, the Commissioner's Designee issued an order affirming DSS, holding that plaintiff's "permanent absent status" from her home allowed DSS to count it as a resource. He noted that "since appellant is not residing in her property it has not regained its status as a homestead." He stated, however, that Plaintiff "testified that she is living one day at a time and would eventually like to return to the house, but did not know when she would be able to do this." Despite prevailing at this hearing, DSS has not discontinued plaintiff's benefits, although the decision of the Commissioner's designee entitles them to do so.
Ms. W.'s condition has since improved and she was discharged from the RPC in July, 1992. She has not returned to her home, but resides instead in an apartment with others in order to be close to treatment.
Plaintiff moves for summary judgment, claiming that the actions and regulations of the State DSS violate the federal Medicaid statute by determining her home to be a non-exempt resource despite her intent to return, and thus requiring her to sell her home to maintain her eligibility for Medicaid.
Plaintiff seeks to bring this action as a class action seeking declaratory and injunctive relief on behalf of class members similarly situated. Although plaintiff filed an amended complaint styling this action as a class action, no motion for certification as a class action was brought by the plaintiff. The proposed class of plaintiffs, however, is the class of persons adversely affected by the application of the regulations at issue in this case.