Opinion ID: 2082423
Heading Depth: 1
Heading Rank: 8

Heading: New York State Constitution, Article XVII

Text: Plaintiffs contend that section 122 violates article XVII, § 1 of the State Constitution, which provides: The aid, care and support of the needy are public concerns and shall be provided by the state and by such of its subdivisions, and in such manner and by such means, as the legislature may from time to time determine (NY Const, art XVII, § 1 [emphasis added]). As this provision demonstrates, care for the needy is not a matter of legislative grace; it is a constitutional mandate ( Tucker v Toia, 43 NY2d 1, 7; see also, Lovelace v Gross, 80 NY2d 419, 424; Jiggetts v Grinker, 75 NY2d 411, 416). Of course, New York is not required to meet every legitimate need of every needy person ( see, Matter of Bernstein v Toia, 43 NY2d 437, 448-449). Rather, the Legislature may determine who is needy and allocate the public dollar accordingly. This Court, however, has interpreted article XVII, § 1 as prohibiting the Legislature from refusing to aid those whom it has classified as needy ( Tucker v Toia, 43 NY2d, at 8, supra ). In Tucker, the State required minors to obtain final orders of disposition in support proceedings against their parents before they could become eligible for home relief. We found this requirement so onerous as to constitute a practical deprivation of benefits. Needy minors, we recognized, may not know the whereabouts of their parents, or even if their parents are located in this State. In some cases, it could take a minor as long as a year to obtain a disposition in an often futile support proceeding. While waiting, needy minors were effectively denied home relief. Because the requirement imposed an overly burdensome eligibility condition on recipientsone unrelated to needwe held that the requirement contravened the letter and spirit of section 1 of article XVII ( see, 43 NY2d, at 9, supra ). The State argues that the allocation scheme here does not contravene Tucker. It contends that the Constitution affords it discretion to set levels of benefits for the needy and, in the exercise of that discretion, it has provided plaintiffs full safety net assistance and emergency medical treatment. We agree that article XVII, § 1 affords the State wide discretion in defining who is needy and in setting benefit levels. Indeed, in Matter of Barie v Lavine (40 NY2d 565, 566), this Court upheld a regulation that required welfare recipients to participate in a work referral program and denied them benefits for 30 days if they failed to comply. Plaintiffs argue that section 122 does not merely set levels of benefits for the needy, but deprives them of all otherwise available ongoing medical carea species of aid distinct from safety net assistance and emergency medical treatment. They contend that ongoing medical care covers a full spectrum of ailments, whereas emergency medical treatment becomes necessary when their medical conditions reach crisis or catastrophic levels. Plaintiffs and amici point out that diabetics, for example, often require daily insulin doses and blood glucose monitoring in order to stay alive, and that with such care they can lead healthy, productive lives. They are, however, denied this coverage. Treatment is unavailable until the condition reaches emergency proportions, involving insulin shock, renal failure and possibly amputation. Similarly, asthmatics receive no coverage for inhalers and medications to control their conditions. They receive no medical care until they experience severe attacks that can lead to suffocation and death. Contrasting it with emergency treatment, the Supreme Court has characterized ongoing medical care as a basic necessity of life ( see, Memorial Hosp. v Maricopa County, 415 US 250, 259-261). To allow a serious illness to go untreated until it requires emergency hospitalization is to subject the sufferer to the danger of a substantial and irrevocable deterioration in his health ( id. at 261). In this context, plaintiffs and amici argue that when such patients are treated in emergency settings, the hospitals are not permitted to release them without a discharge plan for necessary continuing health care services, citing Public Health Law § 2803 (1) (g). Because they cannot be readily discharged, many remain in hospital facilities. Those who are discharged experience a cycle of emergency, recovery, stabilization, deterioration and the onset of another emergency. All of this, plaintiffs and amici contend, could be avoided through ongoing medical treatment. In Barie the work incentive requirement was an appropriate mechanism for identifying need. Here, however, the concept of need plays no part in the operation of section 122. Indeed, the statute suffers from an infirmity comparable to the one in Tucker and cannot be justified on the basis of a distinction between qualified aliens and PRUCOLs on the one hand, and citizens on the other. We conclude that section 122 violates the letter and spirit of article XVII, § 1 by imposing on plaintiffs an overly burdensome eligibility condition having nothing to do with need, depriving them of an entire category of otherwise available basic necessity benefits. [12]