Justia Health Law Opinion Summaries

In two separate cases, mothers petitioned the Juvenile Court to involuntarily commit their children for inpatient care due to substance use disorders under Massachusetts General Laws c. 123, § 35. E.S. was committed for ninety days, and J.P. for thirty days, following hearings where family members and court clinicians testified about the juveniles' substance use and behaviors.In the case of E.S., the Bristol County Juvenile Court judge found clear and convincing evidence of a substance use disorder, citing E.S.'s history of alcohol and marijuana use, recent positive tests for fentanyl, and concerning behaviors such as stumbling and passing out. The judge also found a likelihood of serious harm due to the imminent risk posed by E.S.'s substance use and the lack of immediate outpatient care options. E.S.'s commitment was affirmed on appeal.For J.P., the Essex County Juvenile Court judge ordered commitment based on testimony about J.P.'s daily marijuana use, behavioral changes, and a single incident of driving under the influence. However, the court clinician did not find J.P. to be a danger to himself or others. On appeal, the Supreme Judicial Court found the evidence insufficient to support a likelihood of serious harm, noting the lack of clear evidence of imminent risk. J.P.'s commitment order was reversed.The Supreme Judicial Court of Massachusetts held that a finding of a substance use disorder under § 35 must be supported by clinical evidence to comply with substantive due process. The court affirmed E.S.'s commitment but reversed and vacated J.P.'s commitment, remanding the case for entry of an order consistent with its opinion. View "In the Matter of J.P." on Justia Law

The juvenile in this case was on probation after being adjudicated as a youthful offender for breaking and entering a vehicle with intent to commit a felony. While on probation, he began experiencing severe mental health issues, including hallucinations and delusions, which led him to obtain a firearm illegally. His mother called the police, and he was found in possession of a loaded firearm without a license. This led to new criminal charges and a notice of probation violation for not obeying state laws.The Juvenile Court judge found that the juvenile violated his probation by possessing the firearm and revoked his probation, sentencing him to incarceration. The judge ruled that the defense of lack of criminal responsibility was not available in probation violation hearings but considered the juvenile's mental illness in determining the disposition. The juvenile appealed, arguing that due process requires allowing the defense of lack of criminal responsibility in probation violation hearings.The Supreme Judicial Court of Massachusetts reviewed the case and held that the affirmative defense of lack of criminal responsibility is not required in probation violation hearings. The court reasoned that the primary inquiry in such hearings is whether the probationer violated a condition of probation, not whether the probationer is criminally responsible. However, the court acknowledged that evidence of mental illness is relevant to determining whether a violation was willful and in deciding the appropriate disposition. The court affirmed the lower court's decision, finding no error in the judge's ruling or abuse of discretion in revoking the juvenile's probation and imposing a sentence of incarceration. View "Commonwealth v. Z." on Justia Law

The case involves a dispute over the eligibility of a married individual, Costa Tingos, for Medicaid long-term care benefits. Costa and his wife, Mary, had been married for over 50 years, but had kept their finances largely separate due to Costa's history of gambling and financial mismanagement. When Costa moved into a nursing home, he applied for Medicaid benefits. However, Mary refused to provide information about her income and assets, which was necessary to determine Costa's eligibility. Costa argued that Mary's refusal to cooperate should not affect his eligibility.The case was initially heard by the Massachusetts Medicaid program, MassHealth, which denied Costa's application. Costa appealed to the MassHealth board of hearings, which also denied his appeal. Costa then sought judicial review in the Superior Court, which vacated the board's decision and remanded the case back to the board. After two more rounds of hearings and appeals, the Superior Court affirmed the board's decision to deny Costa's application.The Supreme Judicial Court of Massachusetts affirmed the decision of the Superior Court. The court held that the board's interpretation of the phrase "refuses to cooperate" in the relevant regulation was reasonable. The court found that Mary's refusal to disclose her financial information did not constitute a refusal to cooperate within the meaning of the regulation, given the couple's long history of cooperation in other aspects of their marriage. The court also rejected Costa's argument that the board's decision was arbitrary and capricious. View "Freiner v. Secretary of the Executive Office of Health and Human Services" on Justia Law

In this case, the plaintiff, Fallon Community Health Plan, Inc., adopted a policy requiring its employees to be vaccinated against COVID-19. The defendant, Shanika Jefferson, a home health aide employed by Fallon, sought a religious exemption from the vaccination requirement. Her request was denied, and her employment was terminated. Jefferson then applied for and was approved for unemployment benefits from the Department of Unemployment Assistance. However, Fallon contended that Jefferson was ineligible for the benefits and sought review of the decision. The board of review of the department, as well as a District Court judge, affirmed the decision.Fallon argued that Jefferson was disqualified from receiving unemployment benefits as per § 25 (e) (2) of General Laws c. 151A because she refused the COVID-19 vaccine in knowing violation of Fallon's reasonable policy and in wilful disregard of Fallon's interest in keeping its vulnerable patient population healthy. However, the Supreme Judicial Court disagreed with Fallon's contention. The court held that Jefferson did not engage in "deliberate misconduct", but rather made a good faith effort to comply with Fallon's policy by applying for a religious exemption. The court also found that Fallon failed to demonstrate that Jefferson should be disqualified on the basis of a "knowing violation" of that policy. The court considered the unique circumstances of the case, including Jefferson's sincere religious beliefs, which did not present her with a meaningful choice regarding vaccination. Therefore, the Supreme Judicial Court affirmed the decision of the lower courts, allowing Jefferson to receive unemployment benefits. View "Fallon Community Health Plan, Inc. v. Acting Director of the Department of Unemployment Assistance" on Justia Law

In the case concerning the estate of Frances R. Mason, the Supreme Judicial Court of Massachusetts ruled on two key issues. First, it considered whether the Massachusetts Medicaid program, MassHealth, could enforce a lien (known as a TEFRA lien) against a member's property after the member's death. The Court concluded that, under Massachusetts law, MassHealth can only enforce such a lien if the property is sold during the member's lifetime. Therefore, MassHealth could not enforce its lien against Mason's property, which was not sold until after her death. This ruling is a restriction on MassHealth's ability to recover Medicaid benefits paid.Second, the Court addressed the timing of MassHealth's claim for recovery of Medicaid benefits paid on Mason's behalf. The Court concluded that the three-year statute of repose of the Massachusetts Uniform Probate Code (MUPC) does not apply retroactively to bar MassHealth's claim against the estate of a member who died prior to the effective date of the MUPC. Accordingly, MassHealth's claim against Mason's estate, which was filed nearly nine years after her death, was not barred by the MUPC's three-year statute of repose.The facts of the case were as follows: Frances R. Mason was a recipient of Medicaid benefits from MassHealth. From January to August 2008, MassHealth paid for her care in a residential nursing facility. In May 2008, MassHealth imposed a TEFRA lien against Mason's home, as she was expected to be permanently institutionalized in the facility. Mason died in August 2008 without the property having been sold. MassHealth filed a claim to recover the Medicaid benefits paid for Mason's care in August 2018, after the executor of Mason's will had opened formal probate proceedings in June 2017.The disposition by the Court was to affirm the order of the Probate and Family Court judge insofar as it struck MassHealth's lien against Mason's home, and to reverse the order insofar as it dismissed MassHealth's claim against her estate. The case was remanded for further proceedings consistent with the Court's opinion. View "In re Estate of Mason" on Justia Law

In this case involving a facility that operated under the protection of a thirty-six-year-old consent decree the Supreme Judicial Court held that the trial judge did not abuse her discretion in concluding that the Department of Developmental Services failed to establish that the consent decree should be terminated based on the evidentiary record before the probate court.In question was the treatment and welfare of individuals who suffered from severe developmental and intellectual disabilities that caused them to engage in grievous self-harm and other life-threatening behaviors. The individuals lived in group homes under the care of Judge Rotenberg Educational Center, Inc. (JRC), a facility that employed the use of aversive interventions such as electric skin shock as part of its treatment approach. In the 1980s and 1990s State agencies disrupted JRC's operations, after which the consent decree was issued. Years later, the agencies bound by the decree moved for its termination, but the probate and family court denied the motion. The Supreme Judicial Court affirmed, holding that the Department's arguments against continued enforcement of the consent decree were unavailing. View "Judge Rotenberg Educational Center, Inc. v. Commissioner of Dep't of Developmental Services" on Justia Law

The Supreme Court reversed the order of the single justice of the appeals court reversing the denial of Plaintiffs' motion for a preliminary injunction and vacated the injunction, holding that the single justice abused her discretion in enjoining Defendants from enforcing their December 2021 amended COVID-19 vaccination policy.Plaintiffs - the Boston Firefighters Union, the Boston Police Superior Officers Federation, and others - filed a complaint challenging Defendants' unilateral amendment of the COVID-19 vaccination policy for all city of Boston employees, seeking declaratory and injunctive relief. The superior court denied Plaintiffs' motion for injunctive relief, but a single justice of the appeals court reversed and ordered the entry of a preliminary injunction. The Supreme Court reversed, holding that the single justice abused her discretion in issuing the preliminary injunction because the potential harm to the city resulting from the spread of COVID-19 clearly outweighed the economic harm to employees. View "Boston Firefighters Union, Local 718, Internat'l Ass'n of Fire Fighters, AFL-CIO v. City of Boston" on Justia Law

The Supreme Judicial Court remanded these consolidated cases seeking a judgment declaring the parties' respective rights to each of the remainder proceeds of two annuity contracts, holding that the cases were governed in all material respects by the Court's decision today in Dermody v. Executive office of Health & Human Servs., 491 Mass. __ (2023).In each of these cases, the Executive Office of Health and Human Services (Commonwealth) claimed entitlement to remainder proceeds of the two annuity contracts up to the amount of medical assistance paid on behalf of an institutionalized spouse, whose eligibility for Medicaid long-term care benefits was obtained through the purchase of an annuity during the relevant "look-back" period, as defined under 42 U.S.C. 1396p(c). The Supreme Judicial Court held that the Commonwealth was entitled to remainder proceeds from the annuities to the extent of benefits it paid on behalf of the institutionalized spouses in this case. View "Executive Office of Health & Human Services v. Mondor" on Justia Law

In this case where Plaintiffs sought a declaration that the Massachusetts Constitution protects a fundamental right to physician-assisted suicide, thereby immunizing the practice from criminal prosecution, the Supreme Judicial Court held that the proposed right, as defined by Plaintiffs, was not supported in the relevant provisions of the Constitution.Plaintiffs were a licensed physician who wished to provide physician-assisted suicide and a retired physician who had been diagnosed with an incurable cancer. Plaintiffs brought a civil action seeking declaratory and injunctive relief, arguing that terminally ill patients with six months or less to live have a constitutional right to receive a prescription for lethal medication in order to bring about death in a manner and time of their choosing. The trial court granted summary judgment for Defendants. The Supreme Judicial Court affirmed, holding (1) the Massachusetts Declaration of Rights does not protect physician-assisted suicide; and (2) the law of manslaughter prohibits physician-assisted suicide without offending constitutional protections. View "Kligler v. Attorney General" on Justia Law

In this case involving licenses to operate a retail marijuana dispensary the Supreme Judicial Court affirmed in part and reversed in part the judgment of the Land Court judge ordering the issuance of a special permit to Plaintiff and the issuance of a second injunction, holding that the second injunction exceeded the permissible scope of the judge's authority.After denying Plaintiff's application for a special permit license to operate a recreational marijuana establishment in the City of Taunton the City granted a special permit to a different applicant. Plaintiff filed a complaint challenging the denial of its special permit application. The Land Court judge found the City's denial of Plaintiff's special permit application was arbitrary and capricious and enjoined the City from conducting previously-scheduled licensing proceedings to consider applications from nonparties seeking licenses to operate medical marijuana dispensaries and from issuing any of the four licenses to the pending applicants. A single justice vacated the preliminary injunction. The Supreme Judicial Court vacated the portion of the judgment concerning the city council's licensing hearings and otherwise affirmed, holding that the injunction exceeded the scope of the judge's authority but that the judge did not err in determining that the City's denial was arbitrary and legally untenable. View "Bask, Inc. v. Municipal Council of Taunton" on Justia Law