<strong><em>2025 NY Slip Op 00805</em></strong></p>
<p class="key-principle">Regulations limiting admission to adult homes for individuals with serious mental illness, based on the proportion of residents with such illnesses, do not facially discriminate under the Fair Housing Act (FHA) because they do not deny or make housing unavailable; rather, they reflect a professional judgment on the appropriate settings for providing mental health services.</p>
<p><strong>Summary</strong></p>
<p>Oceanview Home for Adults challenged New York State Department of Health (DOH) regulations limiting admissions to adult homes for residents with serious mental illness. The regulations, aimed at large facilities with a high proportion of residents with serious mental illness, were challenged under the Fair Housing Act (FHA) as discriminatory. The Court of Appeals held that the regulations do not facially discriminate because they do not deny or make housing unavailable but, instead, reflect a professional judgment on the appropriate settings for providing mental health services, in line with the state's aim to integrate individuals with disabilities. The court focused on the clinical nature of the regulations, finding no evidence of discrimination based on stereotypes or prejudice.</p>
<p><strong>Facts</strong></p>
<p>New York State licenses adult homes to provide care. Following the “Olmstead” decision mandating integration for those with disabilities, the DOH implemented regulations. These regulations, at issue, prevented adult homes with over 80 beds where more than 25% of residents had a serious mental illness from admitting additional residents with such illness. Oceanview Home for Adults sued, claiming these regulations violated the FHA. The regulations stemmed from clinical advisories and were supported by a settlement agreement in a separate federal case, aiming to increase supported housing and improve care for the mentally ill.</p>
<p><strong>Procedural History</strong></p>
<p>The trial court ruled in favor of Oceanview, finding the regulations violated the FHA. The Appellate Division reversed, upholding the regulations. The Appellate Division found they were adopted to implement the Olmstead mandate and were narrowly tailored. Oceanview then appealed to the Court of Appeals, where the decision of the Appellate Division was affirmed.</p>
<p><strong>Issue(s)</strong></p>
<p>1. Whether the DOH regulations limiting admissions to adult homes for individuals with serious mental illness constitute facial discrimination under the FHA by denying or making housing unavailable based on disability.</p>
<p><strong>Holding</strong></p>
<p>1. No, because the regulations do not deny or make housing unavailable within the meaning of the FHA. Rather, they reflect a professional judgment on the appropriate settings for providing mental health services.</p>
<p><strong>Court's Reasoning</strong></p>
<p>The court emphasized that the regulations address the type of institutional setting, not whether housing is denied or unavailable. The court cited clinical advisories and DOH's judgment that large adult homes are not clinically appropriate for people with serious mental illness. The court found the regulations reflect a “reasonable modification[] to the State's provision of services” intended to eliminate discrimination. The court noted this clinical determination is not unusual, referencing other regulations that limit admission to all adult homes based on medical needs, and observed that the regulations did not stem from stereotypes or prejudice against those with mental illness.</p>
<p><strong>Practical Implications</strong></p>
<p>This decision reinforces the deference given to state agencies in regulating services for individuals with disabilities, particularly when based on professional medical judgment. The case suggests that similar regulations, aimed at improving the quality of care and integration, are likely to be upheld against FHA challenges. It implies that regulations impacting the type of settings, and not just the availability of housing, are less likely to trigger FHA violations. Attorneys and advocates should consider the nature and intent behind regulations, looking at whether they reflect discriminatory intent or, instead, a considered clinical judgment. They should also distinguish cases where there is a clear denial of housing versus those impacting the type of care and services provided.</p>