The U.S. Court of Appeals for the 2nd Circuit in Manhattan ruled on June 9 that New York City and New York state may be ordered to comply with federal, state, and local law to ensure that persons with HIV/AIDS can access benefits to which they are entitled, such as Medicaid. The ruling upheld a Dec. 11, 2001, injunction issued by U.S. District Court Judge Sterling Johnson Jr. against city and state officials. Attorneys from Housing Works, an AIDS services group, and the HIV Law Project were among those representing six plaintiffs with AIDS.

The plaintiffs were Medicaid-eligible people with low or no incomes and no private insurance who were dependent on government stipends for food and rent.

The appeals court reaffirmed that the Division of AIDS Services and Income Support (DASIS) -- now known as the HIV/AIDS Service Administration (HASA) -- within the city's Human Resource Administration (HRA) frequently failed to meet its own deadlines for providing services, and that the agency was so understaffed that caseworkers could not provide the services envisioned by the authorizing ordinance.

The primary appeals issue was whether such a failure was a violation of federal law -- Section 504 of the Vocational Rehabilitation Act and Title II of the Americans With Disabilities Act -- by the city and state. Mayor Michael Bloomberg's administration argued that HRA overall was so dysfunctional that people with HIV were no worse off than other, non-disabled applicants for city benefits. Plaintiffs should have to prove that DASIS failings have a "disparate impact" on HIV-infected benefits applications, the city argued.

The appeals court rejected that argument and also rejected the state's arguments that it should be let off the hook because administration of benefits is a local function. The court noted that, under federal law, the state retains supervisory responsibility for the administration of these benefits, many of which are paid for with federal funds that pass through state agencies on their way to the city. Thus, it was appropriate to name both state and local officials in the injunction, and to place the mandate of the court on both levels of government to see that benefits are properly distributed to those who are eligible to receive them.

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