The “De-Facto Continuation” Doctrine in Prison Health Care: Daniels v. Moores (2d Cir. 2025)

1. Introduction

Daniels v. Moores is a consolidated prison-conditions appeal arising from the United States Court of Appeals for the Second Circuit. Plaintiffs—New York State prisoners suffering from chronic pain—sued the Department of Correction and Community Supervision (DOCCS) officials under 42 U.S.C. § 1983, alleging that prison doctors had categorically denied them effective pain medication pursuant to DOCCS’s former “Medications with Abuse Potential” (MWAP) Policy. Although DOCCS rescinded that policy in 2021 and replaced it with Policy 1.24A (which ostensibly restored professional discretion to frontline providers), plaintiffs contended that the original, rigid practice continued “on the ground.” After a four-day bench trial, the district court (Preska, J.) permanently enjoined Chief Medical Officer Dr. Carol Moores to enforce Policy 1.24A, and awarded classwide relief and attorneys’ fees. Dr. Moores appealed, challenging mootness, class certification, the injunction’s scope under the Prison Litigation Reform Act (PLRA), and the fee award.

The Second Circuit affirmed in full, delivering three major takeaways:

1. De-Facto Continuation Doctrine: Rescinding an official policy does not moot a constitutional claim where the prohibited practice persists in substance.
2. Systemic Deliberate Indifference: A prison system’s reflexive denial of prescribed medications, without individualized assessment, can satisfy both the objective and subjective prongs of an Eighth Amendment claim.
3. PLRA-Compliant Systemic Relief: Courts may order structural remedies—including training, monitoring, and coding systems—so long as they are narrowly tailored to cure ongoing violations.

2. Summary of the Judgment

The Court of Appeals (Jacobs, Calabresi & Nathan, JJ.) held:

• Mootness: DOCCS’s formal rescission of the MWAP Policy did not moot the case because evidence showed a de-facto continuation of the same unconstitutional practice.
• Permanent Injunction: Each factor—irreparable harm, inadequacy of legal remedies, balance of hardships, and public interest—supported equitable relief, and the district court acted within its discretion.
• PLRA Compliance: The injunctive terms (enforcement of Policy 1.24A, chronic-pain coding, individualized reassessments, and staff training) were “narrowly drawn,” “necessary,” and the “least intrusive” means to correct the violation.
• Class Certification: The injunctive class satisfied Rule 23(a) and 23(b)(2); at least 800 inmates formed a sufficiently numerous, common, typical, and adequately represented group.
• Attorneys’ Fees: Plaintiffs were “prevailing parties” under 42 U.S.C. § 1988(b) because the injunction materially altered the parties’ legal relationship; the district court justifiably refused to reduce the lodestar for plaintiffs’ unsuccessful damages-class bid.

3. Analysis

3.1 Precedents Cited and Their Influence

• American Freedom Defense Initiative v. MTA
• Provided the test for voluntary cessation: courts look past formal rescission to determine whether challenged conduct “has, in fact, ceased.”
• Chance v. Armstrong
• Defined objective seriousness in Eighth Amendment medical claims—pain, deterioration, or inability to perform normal activities.
• Smith v. Carpenter
• Articulated the dual objective/subjective deliberate-indifference framework.
• Johnson v. Wright
• Recognized Eighth Amendment liability when prison officials reflexively apply a blanket policy despite physician recommendations.
• Handberry v. Thompson
• Explained that PLRA permits relief exceeding the bare constitutional floor if necessary and narrowly tailored to end violations.
• Monsanto Co. v. Geertson Seed Farms & eBay Inc. v. MercExchange
• Supplied the four-factor test for injunctive relief.
• Wal-Mart v. Dukes & Sykes v. Harris
• Delineated Rule 23(a)/(b)(2) standards for class commonality and injunctive suitability.

3.2 Legal Reasoning of the Court

1. Voluntary Cessation and Mootness
   The Court looked beyond DOCCS’s paperwork. Testimony and medical files showed that chronic-pain inmates continued to lose access to effective medication without individualized review. That finding, reviewed for clear error, precluded mootness and justified injunctive relief.
2. Eighth Amendment Violation
   • Objective prong: severe pain, loss of mobility, and deterioration established “serious medical need.”
   • Subjective prong: providers knowingly denied or discontinued medications based on a blanket, non-medical policy—classic deliberate indifference.
3. Permanency Factors (eBay/Monsanto)
   Irreparable harm flowed from ongoing pain; legal remedies inadequate; burden on DOCCS minimal compared with constitutional injury; public interest strongly favors constitutional compliance.
4. PLRA Constraints
   The Court endorsed remedial measures tightly linked to the violation: identify chronic-pain inmates, mandate individualized assessment, and train personnel. Importantly, the relief enforced defendants’ own replacement policy, minimizing intrusiveness.
5. Rule 23(b)(2) Class
   Systemic denial of pain treatment affected all chronic-pain prisoners; injunctive relief would operate uniformly. Ascertainability was satisfied by objective prison medical records (chronic-pain codes, neuropathy diagnoses).
6. Fee Award
   A permanent injunction makes plaintiffs prevailing parties. Because the damages claims rested on the same nucleus of facts, time spent thereon was compensable.

3.3 Impact on Future Litigation and Correctional Health Care

Although issued as a “summary order” (non-precedential under 2d Cir. Rule 32.1.1), Daniels v. Moores is poised to carry persuasive weight:

• Voluntary Cessation Standard Clarified: Defendants cannot moot litigation by re-branding policies while leaving entrenched practices intact. Courts may probe implementation realities.
• Medical Autonomy for Prison Physicians: Administrative policies that pre-empt individualized professional judgment invite Eighth Amendment scrutiny.
• Blueprint for Systemic PLRA Relief: The decision illustrates how to craft injunctive terms—coding, audits, training—that pass the PLRA’s narrow tailoring test.
• Class Actions in Prisoner Health Cases: Reinforces that health-care denial claims often lend themselves to (b)(2) certification despite individualized medical needs, so long as a common policy drives the harm.
• Attorneys’ Fees Incentive: Confirms robust fee recovery even when some prongs (e.g., damages class) fail, encouraging public-interest counsel to pursue comprehensive systemic challenges.

4. Complex Concepts Simplified

• Deliberate Indifference: More than negligence. Prison officials must know of and disregard a substantial risk—akin to criminal recklessness.
• Voluntary Cessation Doctrine: A defendant claiming mootness must show the challenged conduct is unlikely to recur. Formal policy change alone is insufficient if real-world practices persist.
• PLRA Need-Narrowness-Intrusiveness Test: Injunctions in prison cases must (1) address an actual federal right violation (need), (2) go no further than necessary (narrow), and (3) avoid unnecessary interference with prison operations (least intrusive).
• Rule 23(a) Requirements: Numerosity, commonality, typicality, adequacy—memory trick “NCTA.” For injunctive classes, ascertainability is usually satisfied when membership derives from objective criteria.
• Prevailing Party: A litigant who wins a court-ordered, material change in legal relations (e.g., an injunction) can recover reasonable fees.

5. Conclusion

Daniels v. Moores crystallizes a practical doctrine: when a policy is formally scrapped but functionally survives, constitutional claims live on. By refusing to let form trump substance, the Second Circuit preserved meaningful judicial oversight over prison medical care, endorsed structural—yet PLRA-compliant—remedies, and reaffirmed the centrality of individualized medical judgment behind bars. Going forward, correctional agencies face clear notice: cosmetic policy changes will not insulate systemic misconduct, and courts remain empowered to order targeted reforms that restore constitutional norms.

© 2024-2025. This commentary is for educational purposes and does not constitute legal advice.