Case: Koskinas v. Cuomo

Plaintiffs, homeless and mentally ill persons who had been discharged from state mental hospitals, filed two complaints in New York County's Supreme Court of the State of New York. (In that state, the "Supreme Court" is a trial court.) Represented by private counsel from a large New York City law firm, plaintiffs alleged that state and municipal officials and agencies, the defendants, had failed to comply with their obligation under state law (Mental Hygene Law § 29.15 (f) and (g)) to provide proper written service plans to patients discharged from mental hospitals. Plaintiffs sought declaratory relief and an injunction mandating compliance. One complaint was instituted against the New York City Health and Hospitals Corporation ("HHC") and other municipal defendants, while the other named as defendants the state's governor and Office of Mental Health ("OMH").

In March 1988, considering the cases together, the trial judge, Justice Edward H. Lehner, denied the plaintiffs' request that the defendants produce 200-300 written service plans as a representative sample of what defendants prepared for persons discharged from mental hospitals. Heard v. Cuomo, 526 N.Y.S.2d 760 (1988). The denial, however, was reversed on appeal in a memorandum decision that approved of disclosure, but with redactions of patient-identifying information and limits on access to, and use of, the service plan sample. The appellate court also declined to certify the cases as a class action, noting that any relief granted to plaintiffs would adequately flow to and protect others similarly situated. Heard v. Cuomo, 531 N.Y.S.2d 253 (App. Div. 1988).

After joint trial of the two cases, Justice Lehner issued a written decision on February 26, 1991. The court held that HHC had not fulfilled its obligation to provide dischargees from psychiatric hospitals operated by HHC with access to appropriate housing, and that this "failure is one of the root causes of the homeless crisis" in New York City. The court found that the Mental Hygiene Law requires HHC to ensure residences were adequate and appropriate because HHC was subject to licensure by the State Office of Mental Health, and the statute mandated that licensees had a responsibility to provide written discharge plans and that municipalities were to cooperate with licensees "in the preparation and implementation of comprehensive written services plans." The court further held that the state defendants were not in violation of their obligations under the Mental Hygiene Law. The court found that New York City did not have sufficient residences for all dischargees, and that the State was providing funding for additional placements though they were not enough placements to account for all dischargees. The court held that in light of the insufficient available housing to enable HHC to immediately fully comply, its judgment would provide for implementation over a period of time. The court invited the parties' suggestions as to the appropriate time period for compliance. Heard v. Cuomo, 567 N.Y.S.2d 594 (1991). In January 1992, the Appellate Division affirmed and granted leave for the municipal defendants to appeal to the state's Court of Appeals. Heard v. Cuomo, 578 N.Y.S.2d 417 (App. Div. 1992).

In an opinion written by Judge Bellacosa, the Court of Appeals affirmed the order of the Appellate Division and held that, in the context of this case, Mental Hygiene Law § 29.15 imposed these duties on HHC: (1) to prescribe and assist in locating adequate and appropriate housing for about-to-be-discharged mentally ill patients; (2) to discharge them in accordance with the individualized, written, patient service plans which include recommended housing; and (3) to coordinate the effectuation of those efforts among responsible entities. The court took care to note that neither the statute nor the affirmed judgment imposed upon HHC the explicit duty to build, create, supply or fund such housing, saying that arguments to the contrary were an "overreading" of the decisions plaintiffs had won. Heard v. Cuomo, 610 N.E.2d 348 (N.Y. 1993).

According to the Urban Justice website, the rights established in this case to proper discharge planning became known, in New York, as "Koskinas" rights, taking the name of the lead plaintiff in one of the two complaints that resulted in the Court of Appeals decision.

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