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Mark J. Gattuso, Sr., et al v. New Jersey Department of Human Services

July 25, 2012

MARK J. GATTUSO, SR., ET AL., PLAINTIFFS,
v.
NEW JERSEY DEPARTMENT OF HUMAN SERVICES, ET AL., DEFENDANTS.



The opinion of the court was delivered by: Hon. Jerome B. Simandle

OPINION

SIMANDLE, Chief Judge:

I. INTRODUCTION

This case is before the Court on the motion of Defendants New Jersey Department of Human Services ("DHS") and Division of Disability Services ("DDS")*fn1 to dismiss the action for lack of subject matter jurisdiction, pursuant to Fed. R. Civ. P. 12(b)(1) or, in the alternative, for failure to state a claim upon which relief can be granted, pursuant to Fed. R. Civ. P. 12(b)(6). Plaintiffs in this matter are Mark J. Gattuso, Sr. and Margaret C. Gattuso, who bring claims on behalf of their non-competent adult child Joseph C. Gattuso, and on their own behalf for alleged violations of the laws and Constitution of the United States, specifically, Title II of the Americans with Disabilities Act ("ADA"), codified at 42 U.S.C. §§ 12131-12134.

Plaintiffs allege that the state of New Jersey is discriminating against them and their son, on the basis of age and disability, by failing to provide more resources and services than it already is to permit Joseph to be cared for at home rather than institutionalized in a long-term care facility; Plaintiffs further allege that their due process rights are violated by the state's benefits denial procedures. Defendants argue that the Complaint must be dismissed because this Court lacks subject matter jurisdiction to hear Plaintiffs' claims because the State Defendants retain state sovereign immunity to suit under the Eleventh Amendment to the United States Constitution, or in the alternative, because Plaintiffs fail to state a claim to relief.

The principal issues to be decided in this Opinion are (1) whether Congress has validly abrogated New Jersey's sovereign immunity as to Plaintiffs' claims, and (2) whether Plaintiffs adequately state a claim for relief that can be granted. As explained below, because the Court concludes that Congress has not abrogated the State's sovereign immunity as to Plaintiffs' claims, and because the Court concludes that Plaintiffs do not otherwise state a claim to relief that the Court can grant, the Court must dismiss Plaintiffs' Complaint.

II. BACKGROUND

Because Plaintiffs are proceeding without the benefit of a lawyer and drafted their Complaint on their own, the Court is mindful that it should construe Plaintiffs' pleadings liberally in their favor. See Haines v. Kerner, 404 U.S. 519, 520-21 (1972). For the purposes of deciding Defendants' motion, the Court will consider only facts alleged in the Complaint and matters of public record.*fn2

Plaintiffs' dependent adult child, Joseph Gattuso, suffers from a rare disease (not identified in the pleadings) that requires specialized care and nearly constant monitoring by a caregiver. Compl. at 2. He is 26 years old, and the Court infers from the Complaint that Plaintiffs receive funding and services through the New Jersey Community Resources for People with Disabilities ("CRPD") Waiver program to support Joseph's care at home so that he need not be institutionalized in a nursing home or other long-term care facility. Id. Plaintiffs allege that they are his primary caregivers (id. at 1), but also allege that some of the funding they receive from the CRPD waiver services pays for in-home nursing support to assist them in the care they provide. Id. at 1-2. Plaintiffs themselves also suffer from some significant physical disabilities (they allege that they are "totally disabled"). Id. at 4.

The CRPD Waiver program is a New Jersey entitlement program authorized under and funded in part through the Medicaid provisions of the federal Social Security Act, 42 U.S.C. § 1396n. The CRPD Waiver program provides funding and services to Medicaid beneficiaries to enable them to live in a home or community-based facility rather than in a long-term care facility. See N.J. Admin. Code § 10:60-6.1. "The purpose of these programs is to help eligible beneficiaries remain in the community, or return to the community, rather than be cared for in a nursing facility or hospital setting." Id. at § 10:60-6.1(a). The CRPD Waiver program "serves a limited number of beneficiaries [in New Jersey] who meet the medical and financial eligibility requirements."

Id. at § 10:60-6.1(b). To be eligible for CRPD Waiver funding, a beneficiary must be in need of "nursing facility level of care criteria," among other income-based eligibility requirements.

Id. at § 10:60-6.2. The CRPD Waiver provides for several services including in-home nursing care and case management, but "[t]he total cost of all services provided through the Community Resources for People with Disabilities (CRPD) Waiver program must be less than the cost of care in an appropriate institution."

Id. at § 10:60-6.3(d).

Plaintiffs claim that the benefits provided under this program are insufficient in ways that are discriminatory, and that the process whereby determinations of benefits are made deprives them of the due process of law. Specifically, Plaintiffs Complaint seeks relief through four counts.

Count one claims that the funding recipients of the CRPD Waiver funding receive is insufficient for beneficiaries to pay for adequate in-home nursing care because of the CRPD monthly cost cap allowance. Compl. at 1. The Court infers from this allegation that Plaintiffs themselves are impacted by this monthly cost cap, though Plaintiffs do no so specifically allege. The Court also infers that the CRPD Waiver cost cap to which the Plaintiffs refer is the requirement that "[t]he total cost of all services provided through the Community Resources for People with Disabilities (CRPD) Waiver program must be less than the cost of care in an appropriate institution." N.J. Admin. Code § 10:60-6.3(d). Plaintiffs allege that this monthly cost cap violates the Medicaid Act, 42 U.S.C. § 1396a(a)(30)(A), regarding reimbursement rates for the enlistment of qualified personnel such as skilled nurses. Compl. at 1. Plaintiffs do not allege any facts about the dollar amount at which their monthly costs are capped by Defendants.

Plaintiffs further allege that this monthly cost cap allowance threatens that beneficiaries (again, the Court infers that Plaintiffs include Joseph in this category) who would otherwise be better served in home or community placement may be institutionalized in order to receive adequate care. Plaintiffs further conclude that the Defendant state agencies permit or impose this funding limitation as a form of discrimination against the most disabled individuals in the state. Plaintiffs allege that this limitation on CRPD Waiver funding is a violation of Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132.

Count two of the Complaint claims that Defendants are discriminating against Joseph on the basis of his age because the monthly cost cap of the CRPD Wavier program was first ...


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