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County of Nassau v. Leavitt

March 1, 2007

COUNTY OF NASSAU, NEW YORK, COUNTY OF SUFFOLK, NEW YORK, FEDERATION EMPLOYMENT AND GUIDANCE SERVICES, INC., LONG ISLAND MINORITY AIDS COALITION, INC., THURSDAY'S CHILD, INC., TRACI BOWMAN, MIRIAM SPAIER, JEROME KNIGHT, AND DONNA UYSAL, PLAINTIFFS,
v.
MICHAEL O. LEAVITT, IN HIS OFFICIAL CAPACITY AS SECRETARY OF HEALTH AND HUMAN SERVICES OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, ELIZABETH M. DUKE, IN HER OFFICIAL CAPACITY AS ADMINISTRATOR FOR THE HEALTH RESOURCES AND SERVICES ADMINISTRATION OF THE UNITED STATES, DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, DEFENDANTS.



The opinion of the court was delivered by: Seybert, District Judge

ORDER

INTRODUCTION

Before this Court is Plaintiffs' motion for a temporary restraining order ("TRO") and preliminary injunction ("PI"). On February 28, 2007, at a hearing, this Court DENIED Plaintiffs' motion for the TRO. The parties consented to treating the denial of the TRO as a denial of the PI for purposes of appealing immediately to the Second Circuit.

BACKGROUND

This case involves funding for medical and support services for HIV and AIDS patients in Nassau and Suffolk Counties ("Nassau-Suffolk") in Long Island, New York. The funding is provided through a federal statute known as the Ryan White HIV/AIDS Treatment Modernization Act of 2006 ("Act"). All of the Plaintiffs had received funding under previous versions of the Act (collectively referred to as the "Ryan White Legislation"). However, Congress amended the Act on December 19, 2006, and revised the way in which areas received funding through the Act. (Complaint ("Compl.") ¶ 1.)

Congress enacted the Ryan White Legislation to provide emergency relief funding to localities disproportionately affected by the HIV epidemic. (Id. at ¶ 17.) The funds were to assist localities in providing development, organization, coordination, and operation of effective and cost-efficient systems for delivery of essential services to individuals living with HIV and AIDS. (Id.) Nassau-Suffolk was one of these localities that received this emergency funding. For fiscal year 2006, Nassau-Suffolk received $6,148,307 in funding. (Id. at ¶ 28.)

In 2006, Congress amended the Act to distinguish between two types of localities to receive grants: (1) eligible metropolitan areas ("EMAs") and (2) transitional grant areas ("TGAs"). (Id. at ¶¶ 20-23.) A locality is an EMA if it reported 2000 or more AIDS cases during the last five years. A locality is a TGA if it had at least 1000 AIDS cases but less than 2000 AIDS cases reported during the last five years. See 42 U.S.C. §§ 300ff-11, 300ff-19.

On February 12, 2007, Defendant United States Department of Health and Human Services ("DHHS") informed Nassau County Executive Thomas R. Suozzi ("Suozzi") that Nassau-Suffolk no longer qualified as an EMA but would now be categorized as a TGA. (Compl. ¶¶ 33-34; Pls.' Mem. 7.) DHHS also informed Suozzi that the change in status "may result in [Nassau-Suffolk's] FY 2007 award being less than the FY 2006 award." (Pls.' Mem. 7.) DHHS did not provide any further information about the exact cut in funding that would result from the change in Nassau-Suffolk's status. (See id.) Plaintiffs allege, however, that $458,310,000 is available for 22 EMAs and only $145,690,000 is available for 34 TGAs. (Id. at 5.) Plaintiff claims that this indicates a funding reduction. (Id.)

Another issue in this case is certain restrictions on how localities spend Ryan White funding. The Act now requires 75% of grant funding to be used for core medical services and the remaining 25% of funding to be used for either support services or administrative expenses. (Compl. ¶ 38.) Despite this restriction on how to spend the funding, the Act provides a waiver for the cap under certain circumstances. A waiver may be granted if a locality does not have any waiting lists for AIDS drug assistance program services and core medical services are available to all individuals with HIV/AIDS. (Id. ¶ 39.)

Nassau-Suffolk allegedly has no waiting list for AIDS Drug Assistance Program services, and core medical services are already available to all individuals with HIV/AIDs in Nassau-Suffolk. (Id. ¶¶ 40-41.) However, Plaintiffs believe that waivers will not be provided during fiscal year 2007. (Id. ¶ 42.) During 2006, Nassau-Suffolk used in excess of 40% of their funding for support services, chiefly transportation, client advocacy, emergency financial assistance, housing assistance, and legal services. (Id. ¶ 43.)

On February 27, 2007, Plaintiffs commenced this action, by way of an order to show cause for a TRO and PI. Plaintiffs requested that this Court (1) enjoin Defendants from downgrading Nassau-Suffolk from an EMA to a TGA and (2) direct Defendants to waive the 25% cap on support services. The Court, however, addresses only the first part of Plaintiffs' requested relief: the change in Nassau-Suffolk's status from an EMA to a TGA. At the hearing, the parties agreed that Nassau County's waiver application would be decided in two weeks. (TRO Hr'g Tr. 25, Feb. 28, 2007).

DISCUSSION

I. Legal Standard

Granting PI relief is "an extraordinary and drastic remedy which should not be routinely granted." NextG Networks of N.Y., Inc. v. City of New York, 03-CV-9672, 2004 U.S. Dist. LEXIS 25063, at *12 (S.D.N.Y. Dec. 10, 2004). For this Court to issue a TRO or PI against "government action taken in the public interest pursuant to a statutory or regulatory scheme," the Plaintiffs must show "(i) irreparable harm absent the injunction and (ii) a likelihood of success on the merits." Freedom Holdings, Inc. v. Spitzer, 408 F.3d 112, 114 (2d Cir. 2005) (citations omitted). A plaintiff satisfies the irreparable harm requirement when it shows that absent a preliminary injunction, it "will suffer 'an injury that is ...


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