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Hatten-Gonzales v. Earnest

United States District Court, D. New Mexico

August 21, 2018

DEBRA HATTEN-GONZALES, et al., Plaintiffs,
v.
BRENT EARNEST, Secretary of the New Mexico Human Services Department, Defendant.

          SOVEREIGN HAGER Sovereign Hager Maria Griego New Mexico Center on Law and Poverty Daniel Yohalem Attorney at Law Jane B. Yohalem Attorney at Law Attorneys for Plaintiffs

          CHRISTOPHER P. COLLINS New Mexico Human Services Department Attorney for Defendant

          SECOND REVISED MODIFIED SETTLEMENT AGREEMENT AND ORDER

         The parties were ordered to revise the settlement agreement in the matter of Debra Hatten Gonzales, et al. v. the Secretary of the NM Human Services Department. The terms of this Agreement (or “Consent Decree” or “Decree”) are prospective in nature but do not preclude a future Secretary of the NM Human Services Department (“HSD”) from requesting modifications. A Plaintiff class consisting of all present and future applicants for these programs was certified by an Order filed July 19, 1989, adopted herein by this reference.

         The applicants claim that HSD violates their federally-guaranteed right to receive a prompt eligibility decision and, if eligible, benefits, by: (1) failing to inform applicants adequately of eligibility factors which must be verified, the alternate methods by which verification can be accomplished and the availability of HSD assistance in obtaining verification which is not readily available; (2) imposing inconsistent and excessive verification requirements which discourage applicants from completing the application process or result in the unlawful denial of benefits; (3) delaying the issuance of eligibility decisions and benefits beyond federal time standards; (4) failing to screen food stamp applicants routinely and adequately for emergency assistance and provide timely expedited benefits; and (5) failing to provide applicants with adequate written notice of eligibility decisions. The Class Action Complaints for Declaratory and Injunctive Relief filed March 31, 1988 and July 1, 1988, and Sections 2(a), 3, 4 and 5 of the Pre-Trial Order, filed September 27, 1989, are adopted herein by this reference.

         Defendant, Secretary of the New Mexico Human Services Department, has denied the applicants' claims because HSD asserts that its application processing practices comply with relevant federal law and regulations, including, among other federal requirements: 1) processing applications within federal standards, 2) informing applicants of eligibility factors which must be verified, and 3) properly notifying applicants of eligibility decisions.

         If this revised Agreement is approved by the Court, notice will be provided to members of the plaintiff class by posting a copy of this Agreement in the public reception area of each ISD filed office, together with a notice, in English and Spanish, advising all applicants of the settlement of this suit, the name, address and telephone number of counsel for the class, and their right to advise class counsel of any perceived violations of this Agreement. The Agreement and notices will remain posted throughout the pendency of this action.

         The parties agree to make good faith efforts to resolve any differences that may arise in the course of rendering this Agreement operational. If the parties cannot resolve their differences after such negotiations, either party may seek a ruling from the Court.

         This Agreement is binding on the parties, their successors and agents. Once all the terms of this Agreement have been met, as defined in Section I (I), below, HSD shall be found in compliance with the Agreement and the case will be dismissed as provided herein. The Court shall have continuing jurisdiction over this matter to resolve disputes and enforce the terms of this Agreement.

         An applicant's right to raise claims and defenses individually based on issues resolved herein but not yet fully implemented is specifically reserved and not impaired by this Agreement.

         I. DEFINITIONS

         These definitions shall apply to the following terms used in this revised Agreement:

         A. The “application process” begins when an application for SNAP or Medicaid assistance is submitted to HSD and ends when a notice of eligibility decision and, if eligible, benefits, are deposited in the mail or available through electronic transfer. The application process includes providing relevant written information to applicant, screening an application, holding an application interview, verifying eligibility factors, responding to applicant requests for assistance, extensions of time, and mailing an eligibility decision, and if eligible, benefits.

         B. “Applicant” means a person applying for Medicaid or SNAP assistance, a household or an authorized representative.

         C. "Timely Denial" means, as to initial applications for SNAP benefits, an eligibility determination by a case worker or eligibility system to deny the initial application and to cause a notice to be generated on or before the 30th day after the application was received by the agency, unless the 30th day falls on a weekend or holiday. For Medicaid, the standard is 45 days or 90 days for disability determinations. If the 30th or 45th day falls on a weekend or holiday, the denial of SNAP and Medicaid benefits shall be timely if the SNAP or Medicaid application is denied on or before the next business day after the weekend or holiday.

         D. “Timely Application Approval" means 1) as to applications eligible for expedited processing, that SNAP benefits are issued to the household no later than the 7th calendar day following the date on which the household filed the application; and 2) as to applications subject to 30 day processing, that SNAP benefits are issued to the household no later than the 30th day following the date on which the household filed the application. For Medicaid applications subject to 45 day processing, the Medicaid benefits are available to the household by the 45th day following the date on which the household submitted the application.

         E. "Timely Recertification Application Approval" means 1) as to households that have filed a timely recertification application pursuant to 7 C.F.R. § 273 .14 (c), that SNAP benefits are issued not later than 30 calendar days after the date the household received its last allotment or no later than the household's normal issuance cycle in the month following the end of its current certification period as provided in 7 C.F.R. §§ 273. 14 (d)(1) and (2); and 2) as to households that have filed a recertification application after the 15th day of the last month of the certification period, but before the end of the certification period, that SNAP benefits are issued not later than 30 calendar days after the application was submitted. For Medicaid, a renewal application is timely approved if Medicaid benefits are available to the household and a notice of approval is issued by the last day of the last month of the current 12 month certification period.

         F. “Recertification Application Denial" means 1) a denial or termination of SNAP or Medicaid benefits at the end of a household's certification period that is a result of an eligibility determination to deny or terminate benefits; or 2) the automatic closure of a household's case at the end of the certification period.

         G. "Timely Recertification Application Denial" means 1) as to timely filed recertification applications, an eligibility determination to deny and mail notice of such denial on or before the last day of the household's current certification period; or 2) as to recertification applications filed after the 15th of the last month of the certification period, but before the end of the certification period, an eligibility determination to deny and mail notice of denial by the 30th day following the date the application was submitted, or in the cases where the 30th day falls on a weekend or holiday, the next business day following the 30th day. For Medicaid, a renewal application is timely denied if an eligibility determination to deny has been made and notice of such denial is mailed on or before the last day of the household's current certification period.

         H. “Systemic or Programmatic Barrier” means a policy or prevalent practice implemented at one or more of the Income Support Division offices that results in the failure to comply with federal law in the SNAP and/or Medicaid program and is not due to an isolated event or action.

         I. For the purpose of this Agreement, full implementation and full compliance means the department has met the requirements identified in this agreement. Each section identifies the method for measuring compliance.

         II. PROMPTNESS OF ELIGIBILITY DETERMINATIONS AND BENEFITS

         A. Federal laws and regulations establish application-processing timelines. Compliance with the federal application processing time standards in the SNAP and Medicaid programs is required, and HSD strives to be 100% compliant with those standards. The parties recognize, however, that unforeseen circumstances and human error by applicants and workers may result in less than 100% compliance in any given month. Therefore, for purposes of this agreement, the measurement of timeliness is set forth in the next subsection.

         B. The parties agree that the requirements of the Decree for timely processing, as defined in paragraph 1 of this Section, will be satisfied if Defendant meets a 96% “monthly” processing standard statewide for a period of six consecutive months, with no individual offices falling below 94% for two consecutive months.

         C. The monthly timely processing standard shall apply to each of the ...


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