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Court of Appeals Rules in Favor of Person with Disability

  • Synopsis: Published: 2011-02-24 - DHHS denied Jonathan critically needed habilitation services based upon a staff re-write of one of the State mental health plans - Rose Radford.

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NC Court of Appeals Rules in Favor of Disabled Man, Limits State's Power - NC Court of Appeals Decision in Favor of Petitioners vs. NC Department of Health & Human Services.

Ragsdale Liggett law firm announces a significant win for petitioner Jonathan McCrann, Jr., represented by Attorney James L. Conner II, in a case against the NC Department of Health and Human Services (DHHS). DHHS denied Jonathan critically needed habilitation services based upon a staff re-write of one of the State's mental health plans. These services had been provided for years and DHHS admitted in the litigation that Jonathan still needed them, qualified for them, and that cost was not an issue. The services were denied on a technical interpretation of one of the rewritten paragraphs in the Waiver. On January 18, 2011, the North Carolina Court of Appeals ruled in favor of McCrann on every point without dissent. The Court also ordered reimbursement for out-of-pocket costs during the 4-year long litigation.

The verdict is the culmination of a hard fought battle that began in 2006. After the DHHS informed the McCranns that the needed services would no longer be covered by the State's Medicaid-funded CAP program, (Community Alternatives Program for Persons with Mental Retardation and Other Developmental Disabilities), the McCranns filed a petition for a hearing at the Office of Administrative Hearings. Attorney Jim Conner won at trial when the Administrative Law Judge held in January 2008 that DHHS' denial of benefits was "arbitrary and capricious and erroneous as a matter of law." In 2009 Wake County Superior Court Senior Judge Donald Stephens upheld the ruling, adopting the ALJ's findings completely. When the State doggedly pursued the matter, Mr. Conner and his clients soundly defeated DHHS's last appeal as of right.

This ruling has significant implications. "The Court ruled correctly on what I believe is an incredibly important point of law," said Jim Conner. "State employees cannot make law by simply writing stuff down and getting some other bureaucrat in the federal Medicaid system to sign off on it. Technically, the Court held that the MR/DD/SAS Medicaid Waiver, written by a committee of State employees and approved by a federal official, is not law and was not enforceable against our client. To do so, they had to carefully and correctly limit the scope of an apparently contrary Supreme Court decision. This decision will fundamentally shake up the DHHS approach. They attempted to impose requirements and restrictions on citizens through waivers, memorandum, and other staff-generated documents that had not been through the legislature or the APA process for promulgating rules. The Court agreed that is wrong. The Court's decision will protect North Carolinians from bureaucratic overreaching."

Mike McCrann, a lawyer and Jonathan's father, says "we're doing this for all the truck drivers and waitresses out there who have disabled kids and who can't afford to fight back when the State pushes them around."

Ragsdale Liggett attorneys, Melissa Brumback, Ashley Campbell and Mary Hulett; paralegal Amy Cutler and legal assistant Lois Dills also did important work on this matter.



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