Steward ex rel. Minor v. Abbott
Steward ex rel. Minor v. Abbott
Opinion of the Court
ORDER
Before the Court are Defendants’ motions (docket nos. 242, 244) seeking the dismissal of- Plaintiffs’ and Intervener’s claims against them. The Court has reviewed these motions, together with the arguments raised by the parties in their memoranda, responses, and replies (docket nos. 255, 260, 264, 274, 278), the record in this case, and the applicable law, and concludes, for the reasons set forth below, that Defendants’ motions to dismiss should be DENIED.
BACKGROUND
Plaintiffs are twelve individuals who allege that they suffer from intellectual or developmental disabilities and related conditions (IDD), and two organizations, The Arc of Texas, Inc., and the 'Coalition of Texans with Disabilities, Inc. Defendants are the State of Texas, and, in their official capacities, Governor Greg Abbott, Texas Health and Human Services Commission
Defendants have moved to dismiss the United States (docket no. 242), arguing that the United States lacks standing to assert claims under Title II of the. ADA and the Rehabilitation Act. Defendants have also moved to dismiss Plaintiffs’ claims, arguing that all Plaintiffs lack standing as to all of their claims, and that, as to every count of the complaint, all Plaintiffs have failed to state a claim upon which relief can be granted.
LEGAL STANDARDS AND ANALYSIS
A. Texas’s Motion to Dismiss the Claims of the United States
In its motion to dismiss the claims in intervention of the United States, Texas argues that, because Congress has not authorized the Attorney General to sue under Title II of the ADA, the enforcement provision of the Rehabilitation Act, or Title VI of the Civil Rights Act, the United States lacks standing to sue and should be dismissed from the case. Docket no. 242 at 1.-2.
To the extent that Texas’s argument for dismissal goes to Article III standing, it fails because the United State’s, as an intervenor who seeks no relief beyond that sought by the Plaintiffs in this case, need not possess Article III standing to proceed. It is the law of this circuit that “Article III does not require intervenors to independently possess standing where the intervention is into a subsisting and continuing Article III case or controversy and the ultimate relief sought by the intervenors is also being sought by at least one subsisting party with standing to do so.” Ruiz v. Estelle, 161 F.3d 814, 829-30 (5th Cir. 1998); Newby v. Enron Corp., 443 F.3d 416, 422 (5th Cir. 2006); League of United Latin Am. Citizens, Dist. 19 v. City of Boerne, 659 F.3d 421, 428 (5th Cir. 2011).
The United States’ complaint in intervention seeks injunctive relief and declaratory relief that is substantially the same ultimate relief sought by the "original Plaintiffs in this case. Cf. docket nos. 1 at 54-56, 53-1 at 18, 137 at 17, 173 at 84-86; see also Ruiz, 161 F.3d at 833 (where the intervening plaintiffs “seek the same ultimate relief’ as the original plaintiffs, but advance a different legal theory, the intervening plaintiffs’ complaint “creates no jurisdictional obstacle for the court”); see also McConnell v. Fed. Election Comm’n, 540 U.S. 93, 233, 124 S.Ct. 619, 157 L.Ed.2d 491 (2003) (“The National Right to Life plaintiffs argue that the District Court’s grant of intervention to the inter-venor-defendants ... must be reversed because the intervenor-defendants lack Article III standing. It is clear, however, that the Federal Election Commission (FEC) has standing, and therefore we need not address the standing of the intervenor-defendants, whose position here is identical to the FEC’s.”), overruled on other grounds by Citizens United v. Fed. Election Comm’n, 558 U.S. 310, 130 S.Ct. 876, 175 L.Ed.2d 753 (2010).
To the extent that Texas’s argument for dismissing the claims of the United States goes to doctrines of “prudential” or statutory standing, it fails for similar í’easons. A government agency’s capacity to intervene — and to raise claims that are within the scope of the original plaintiffs complaint — is not limited to the agency’s capacity to institute an independent action on its own behalf. In re Estelle, 516 F.2d 480, 485 (5th Cir. 1975) (“the intervenor-by-permission does not even have to be a person who would have been a proper party at the beginning of the suit[.]”) (separate opinion of Turtle, J.); Halderman v. Pennhurst State Sch. & Hosp., 612 F.2d 84, 92 (3d Cir. 1979) (“we need not decide whether absent the [original] action the United States could independently have sued. ... Congress has made the decision that someone could seek the injunctive relief in question. Intervention presented no danger that the federal executive would be initiating a lawsuit that Congress somehow never intended.”) rev’d on other grounds, 451 U.S. 1, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981).
“[T]he whole thrust of the amendment [adding Fed. R. Civ. P. 24(b)(2)] is in the direction of allowing intervention liberally to governmental agencies and officers seeking to speak for the public interest.” 7C Charles Alan Wright et al., Fed. Prac. & Proc. Civ. § 1912 (3d ed. 1998) (discussing Sec. & Exch. Comm’n v. U.S. Realty & Imp. Co., 310 U.S. 434, 460, 60 S.Ct. 1044, 84 L.Ed. 1293 (1940)); Fed. R. Civ. P. 24 advisory committee’s note to 1946 amendment (same) (discussing Realty). As noted above, this is not a case in which the relief sought by the United States exceeds the scope of relief sought by the original Plaintiffs. This is, however, a case in which the original Plaintiffs’ claims, and the defenses asserted by the State of Texas and the other Defendants, arise from a statutory and regulatory regime that the Attorney General has been charged by Congress with administering.
B. Texas’s Motion to Dismiss Plaintiffs’ Second Amended Complaint
The Court now turns to Defendants’ Motion to Dismiss Plaintiffs’ Second Amended Complaint (docket no. 244). In their opposition to the motion to dismiss, Plaintiffs noté that they are no longer pursuing their Medicaid Act “comparability” claims or their claims against the Governor. Docket no. 264 at 4 n.2, The Court finds Defendants’ arguments for dismissal of Plaintiffs’ claims to be without merit, and concludes that Defendants’ Motion to Dismiss Plaintiffs’ Second Amended Complaint (docket no. 244) should be DENIED for the reasons set forth below.
1. Standing
First, Defendants move for dismissal under Fed. R. Civ. P. 12(b)(1), arguing the Court lacks subject matter jurisdiction because both the organizational and the individual plaintiffs have failed to establish standing.
Defendants precede their standing arguments with a threshold argument: that the Court, in assessing Plaintiffs’ standing, should “ignore” the declarations (docket nos. 264-1 to 264-7) that Plaintiffs submitted in opposition to Defendants’ motion to dismiss because the declarations were made out, “under the penalty of perjury[,]” to be “true and correct to the best of [the declarants’] knowledge.” See docket no. 270 at 3, Defendants support this argument" with the holding of the Fifth Circuit in Nissho-Iwai Am. Corp. v. Kline, 845 F.2d 1300, 1306 (5th Cir. 1988), but their argument misconstrues the relevant holding. In that ease, the court discussed the sufficiency of summary judgment affidavits and, alternatively, declarations that are admissible as summary judgment evidence under 28 U.S.C. § 1746. In that case, a purported affidavit, defective because un-sworn, was also ineffective as a declaration under Section 1746 because it did not contain language substantially similar to the operative language of that statute; i.e,, it was riot declared “under penalty of perjury” to be “true and correct.” Kline, 845 F.2d at 1306; 28 U.S.C. § 1746. The declarations in this case, which Defendants urge the Court to “ignore,” do contain the operative language of Section 1746, and no authority relied upon by Defendants supports their position that the qualifying phrase “to the best of my knowledge” in
Defendants also argue, as an initial matter, that Plaintiffs’ complaint should be dismissed for lack of standing because the remedy it seeks is “overly broad” in violar tion of the standards discussed in Lewis v. Casey, 518 U.S. 343, 360, 116 S.Ct. 2174, 135 L.Ed.2d 606 (1996) and “unenforceable” in violation of Fed. R. Civ. P. 65(d). Like Defendants’ argument for excluding Plaintiffs’ declarations, this argument rests upon Defendants’ misconstruction of the relevant law. Both Lewis and Rule 65(d) address the enforceability of a remedy, not the sufficiency of a pleading. They stand for the propositions that a remedy is defective, based upon Article III concerns, to the extent that it exceeds the scope of the injury established by a plaintiff, Lewis, 518 U.S. at 357-58, 116 S.Ct. 2174, and that injunctive relief is ineffective to the extent that it does not describe “in reasonable detail ... the acts restrained or required.” Fed. R. Civ. P. 65(d)(1)(C). No authority cited by Defendants support their position that a complaint may be dismissed for lack of subject matter jurisdiction if the prayer for relief in the complaint would be unenforceable if adopted verbatim as a court order. Any challenge to the relief that may be granted by this Court must wait until the Court has actually granted whatever relief, if any, that it finds appropriate.
Individual Plaintiffs: The “irreducible constitutional minimum of standing” requires that (1) the plaintiff have suffered an actual or imminent injury in fact that is concrete and particularized; (2) the injury complained of must be fairly traceable to the challenged action of the defendant, rather than resulting from the independent action of a third party not before the court; and (3) it must be likely that the injury will be redressed by a favorable decision. Lujan v. Defs. of Wildlife, 504
Defendants raise two arguments to challenge the standing of the individual Plaintiffs in this case. First, Defendants argue that the individual Plaintiffs can no longer allege any injury in fact because “all of the Individual Plaintiffs who have IDD and who have expressed a desire to live in the community and receive their services through the HCS waiver program have been provided an HCS slot and are living in the community.”
Article III limits federal-court jurisdiction to “cases” and “controversies[,]” a limitation which the Supreme Court has interpreted to “demand that ‘an actual controversy ... be - extant at all stages of review, not merely at the time the complaint is filed.’” Campbell-Ewald Co. v. Gomez, — U.S. -, 136 S.Ct. 663, 669, 193 L.Ed.2d 571 (2016), as revised (Feb. 9, 2016) (quoting Arizonans for Official English v. Arizona, 520 U.S. 43, 67, 117 S.Ct. 1055, 137 L.Ed.2d 170 (1997)). In general, if intervening circumstances deprive the plaintiff of a “personal stake, in the outcome of the lawsuit,” the action must be dismissed as-moot, Lewis v. Cont’l Bank Corp., 494 U.S. 472, 478, 110 S.Ct. 1249, 108 L.Ed.2d 400 (1990), but “[a] case becomes moot ... ‘only when it is impossible for a court to grant any effectual relief whatever to the prevailing party.’ ” Campbell-Ewald Co. v. Gomez, - U.S. -, 136 S.Ct. 663, 669, 193 L.Ed.2d 571 (2016) (quoting Knox v. Serv. Employees Int’l Union, Local 1000, 567 U.S. 298, 132 S.Ct. 2277, 2287, 183 L.Ed.2d 281 (2012)). As Plaintiffs, pointed out-r-and Defendants have failed to address or even acknowledge — the “relation-back doctrine” provides that “a suit brought as a class action should not be dismissed for mootness upon tender to the named plaintiffs of their personal claims, at least when ... there is pending before the- district court a timely filed and diligently pursued motion for class certification.” Murray v. Fid. Nat. Fin., Inc., 594 F.3d 419, 421 (5th Cir. 2010); Zeidman v. J. Ray McDermott & Co., 651 F.2d 1030, 1049-51 (5th Cir. Unit A July 1981) (discussing the origins of the rela
As to Defendants’ second argument, that the complaint should be dismissed for lack of standing because Plaintiffs have not identified the “inadequacy that produced the injury in fact[,]” Lewis, 518 U.S. at 357, 116 S.Ct. 2174, this argument fails both because it is premature and because Plaintiffs have, in fact, identified the inadequacies that they allege have caused their injuries,
The individual Plaintiffs have made an adequate showing of injury to preclude a Rule 12(b)( 1) dismissal of their claims.
Organizational Plaintiffs: Defendants also dispute the standing of the two organizational Plaintiffs in this case, the Arc of Texas, Inc. and the Coalition of Texans with Disabilities, Inc. An organizational plaintiff may have Article III standing either in its own right, “if it meets the same standing test that applies to individuals[,]” Assoc. of Cmty. Orgs. For Reform Now v. Fowler, 178 F.3d 350, 356 (5th Cir. 1999), or associational standing on behalf of its members, if “(a) its members
Organizations that seek to establish standing in their own right may satisfy the injury-in-fact requirement by showing a diversion of their resources, but “[n]ot every diversion of resources to counteract the defendant’s conduct ... establishes an injury in fact.” N.A.A.C.P. v. City of Kyle, Tex., 626 F.3d 233, 238 (5th Cir. 2010). For instance, expenditures of an organization’s resources do not satisfy the injury-in-fact requirement when the organization “ha[s] no legally-protected interest in not expending [its] resources on behalf of individuals for whom [it] advocates, at least where the only resources ‘lost’ are the legal costs of the particular advocacy lawsuit.” Ass’n for Retarded Citizens of Dallas v. Dallas Cty. Mental Health & Mental Retardation Ctr. Bd. of Trustees, 19 F.3d 241, 244 (5th Cir. 1994); Spann v. Colonial Vill., Inc., 899 F.2d 24, 27 (D.C.Cir. 1990) (“[a]n organization cannot ... manufacture the injury necessary to maintain a suit from its expenditure of resources on that very suit.”); Louisiana ACORN Fair Hous. v. LeBlanc, 211 F.3d 298, 305 (5th Cir. 2000) (same).
The organizational Plaintiffs in this case, however, have followed the Fifth Circuit’s “formula for establishing standing”
Additionally, the organizational Plaintiffs have met the injury-in-fact requirement for associational standing by producing evidence showing that their members are among those injured by the discrimination that they allege. See docket nos. 70-1 at 2, 70-2 at 2-3. The organizational Plaintiffs have also established a community of interest between the groups and the injured members by showing that the missions of the organizational plaintiffs — in their words, “advocating for services and supports that enable people with IDD to live safely and productively in integrated community settings, as opposed to being isolated in an institution” — are relevant to their relief they seek in this litigation. Humane Soc. of the U.S. v. Hodel, 840 F.2d 45, 56 (D.C.Cir. 1988); Int'l Union, United Auto., Aerospace & Agr. Implement Workers of Am. v. Brock, 477 U.S. 274, 290, 106 S.Ct. 2523, 91 L.Ed.2d 228 (1986); Christy McCarthy, et al., No. A-03-CA-231-SS, slip op. at 6-8, available at docket no. 244-3 at 6-8. Finally, participation of the members whose injury con
Accordingly, the Court rejects Defendants’ arguments and concludes that both the Arc of Texas and the Coalition of Texans with Disabilities have established Article III standing to proceed as organizational Plaintiffs in this case.
2. Failure to State a Claim
The Federal Rules of Civil Procedure require plaintiffs to include in their complaint “a short and plain statement of the claim showing that the pleader is entitled to relief[,]” and provide that a complaint may be dismissed for failure to state a claim upon which relief can be granted. Fed. R. Civ. P. 8(a)(2), 12(b)(6). In reviewing the sufficiency of a complaint upon a motion under Rule 12(b)(6), the Court must first identify the complaint’s factual allegations — which are assumed to be true for purposes of ruling on the 12(b)(6) motion — and distinguish them from any statements of legal conclusion, which are not entitled to the assumption of truth. Ashcroft v. Iqbal, 556 U.S. 662, 678, 680-81, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). Second, the Court must assess whether the assumed-as-true factual allegations set forth a plausible claim to relief. This is “a context-specific task that requires the reviewing court to draw on its judicial experience and common sense” to determine whether “the well-pleaded facts ... permit the court to infer more than the mere possibility of misconduct[.]” Id. at 679, 129 S.Ct. 1937.
ADA and Rehabilitation Act: The Americans with Disábilities Act was passed by Congress with the specific mandate of eliminating discrimination against individuals with disabilities. Title II of the ADA covers discrimination in the provision of public services. Melton v. Dallas Area Rapid Transit, 391 F.3d 669, 671 (5th Cir. 2004). To state a prima facie case under Title II of the ADA, a plaintiff must allege:
(1) that he is a qualified individual within the meaning of the ADA; (2) that he is being excluded from participation in, or being denied benefits of, services, programs, or activities for which the public entity is responsible, or is otherwise being discriminated against by the public entity; and (3) that such exclusion, denial of benefits, or discrimination is by reason of his disability.
Id. at 671-72. The Rehabilitation Act incorporates substantially identical elements. Id. at 676 n. 8. The Supreme Court has held that Title IPs prohibition on discrimination requires placement of persons with mental disabilities in community settings, rather than in institutions, in certain circumstances, such as:
when the State’s treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities.
Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 587, 119 S.Ct. 2176, 144 L.Ed.2d 540 (1999). Defendants point to a series of cases that follow Olmstead, in which
Defendants’ argument is undercut by the plain language of the ADA and Olmstead, that “[i]n the ADA, Congress ... referred expressly to ‘segregation’ of persons with disabilities as a ‘for[m] of discrimination,’ and to discrimination that persists in the area. of ‘institutionalization.’ ” Olmstead, 527 U.S. at 589 & n. 1, 119 S.Ct. 2176. Defendants’ argument is also contrary to the regulatory authority implementing Title II and the Rehabilitation Act, which prohibits discrimination in terms of the failure to maintain community-based services, methods of administration that screen qualified individuals from community-based services, and other manifestations of discrimination. See, e.g., 28 C.F.R. § 35.130(b)(8); (“A public entity shall not impose or apply eligibility criteria that screen out or tend to screen out an individual with a disability or any class of individuals with disabilities from fully and equally enjoying any service, program, or activity, unless such criteria can be shown to be necessary for the provision of the service, program, or activity being offered.”); 28 C.F.R. § 41.51(d) (recipients of federal funds must “administer programs and activities in the most integrated setting appropriate to the needs of qualified handicapped persons.”).
Segregation from community-based services is not cured by the fact that the community-based services exist; the existence of such services means nothing to individuals who are excluded from them. Plaintiffs have sufficiently alleged that they are qualified individuals within the meaning of Title II and the Rehabilitation Act, and, with the exception of Mr. Oat-man, Defendants do not appear to dispute Plaintiffs’ allegations on this point. Docket no. 173 at 2-3, 5-9, 36-76. Plaintiffs also allege that Defendants prohibit those with developmental disabilities who are residing in or at risk for placement in nursing care facilities from pursuing residential assistance services or community-based habili-tation services, except by lining up behind tens of thousands of other applicants on an overburdened Home and Community-Based Services waiting list — a hurdle which individuals with developmental disabilities residing in state-supported living centers and private intermediate care facilities, and individuals with physical disabilities who reside in nursing homes, need not clear to obtain similar services. Docket no. 173 at 18-19, 38, 40, 41-43, 45, 47-50, 52, 55, 57, 63, 66, 68-69, 71, 73-74, 76. Plaintiffs also allege that, because “Texas significantly and chronically undei-funds its service systemf,]” people with mental retardation or related conditions are not provided access to community-based services with reasonable promptness. Id. at 19-20. These allegations are sufficient to state claims of discrimination under Title II and the Rehabilitation Act, under the formula outlined in Olmstead.
Accordingly, dismissal of Plaintiffs’ Title II and Rehabilitation Act claims would be improper.
3. Section 1983 Claims
Defendants argue that Plaintiffs’,claims under the Medicaid Act and the . Nursing Home Reform Amendments Act should be
The Supreme Court has articulated a three-part test within which the Court evaluates whether Congress, in enacting the statutory provisions in question, intended to create rights enforceable by private parties:
(1) Congress must have intended that the provision in question benefit the private plaintiff; (2) the right assert-edly protected by the statute must not be so “vague and amorphous” that its enforcement would strain judicial competence; and (3) the statute must unambiguously impose a binding obligation on the states, with the asserted right couched in mandatory rather than precatory terms.
Id. (citing Blessing v. Freestone, 520 U.S. 329, 340-41, 117 S.Ct. 1353, 137 L.Ed.2d 569 (1997)); Gonzaga Univ. v. Doe, 536 U.S. 273, 280, 122 S.Ct. 2268, 153 L.Ed.2d 309 (2002). The Supreme Court has taken care to distinguish between the creation of “rights” that are enforceable through Section 1983, and “broader and vaguer ‘benefits’ or ‘interests,’ ” which are an insufficient basis for a private action under Section 1983. Equal Access for El Paso, Inc. v. Hawkins, 509 F.3d 697, 704 (5th Cir. 2007) (discussing Gonzaga). The character of a particular provision as a Spending Clause statute neither establishes nor forecloses the private enforceability of that statute. Cf. Wilder v. Virginia Hosp. Ass’n, 496 U.S. 498, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990) (“Boren Amendment” provision of Medicaid Act created private right in health care providers); Suter v. Artist M., 503 U.S. 347, 112 S.Ct. 1360, 118 L.Ed.2d 1 (1992) (statute that conditioned state’s receipt of federal adoption assistance funds on state’s formulation of “plan” to make “reasonable efforts” to keep children out of foster homes not privately actionable because it “impose[d] only a rather generalized duty on the State”); Gonzaga Univ., 536 U.S. at 280-82, 122 S.Ct. 2268 (summarizing prior cases, noting that “[o]ur more recent decisions, however, have rejected attempts to infer enforceable rights from Spending Clause statutes.”).
Plaintiffs’ Medicaid Act claims focus on two statutory provisions, 42 U.S.C. §§ 1396a(a)(8) and 1396n(c).
Section 1396a: Plaintiffs’ “Reasonable Promptness” claim alleges a violation of Section 1396a(a)(8), which requires that states furnish Medicaid benefits to eligible individuals with “reasonable promptness[.]” The Fifth Circuit has held that this requirement “creates a private cause of action enforceable under § 1983” under the standards set forth by the Su~
This argument is undercut by the representations that Defendants make in support of their mootness and standing arguments, where they asked the Court to dismiss Plaintiffs’ claims for lack of injury because the individual named Plaintiffs are already enrolled in the HCS waiver program, and because “[f]or the 2016-17 biennium, the Texas Legislature appropriated $84,541,298 to fund an additional 1,300 HCS slots for this target group[.]” Cf, Docket no. 244 at 2, 13, 24-25, 48-49.
Section 1396n: Section 1396n(c)(2), at subparagraphs (B)'and (C), imposes two related requirements on states that seek HCS waivers. First, subparagraph (B) requires that participating states provide an evaluation of the need for institutional care to individuals who may require it but who also may be eligible for community-based care under a waiver program. Second, sub-paragraph (C) requires that the state provide information about any feasible community-based alternatives available under the waiver to the individuals described in subparagraph (B). The Fifth Circuit has never directly considered the question of whether Section 1396n(c) creates rights enforceable by Medicaid recipients
Other courts have discussed the history of Section 1320a-2, and its bearing on the Blessing analysis for Medicaid Act statutes, explaining that the statute now codified at Section 1320a-2 was enacted to overturn an aspect of the Supreme Court’s decision in Suter v. Artist M., 503 U.S. 347, 112 S.Ct. 1360, 118 L.Ed.2d 1 (1992). Ball v. Rodgers, 492 F.3d 1094, 1111 (9th Cir. 2007); Planned Parenthood Arizona, Inc. v. Betlach, 899 F.Supp.2d 868, 878 (D.Ariz. 2012). In Suter, the Supreme Court held that a Social Security Act provision
The first stage of the inquiry outlined in Blessing and refined in Gonzaga goes to “whether or not Congress intended to confer individual rights upon a class of beneficiaries.” Gonzaga, 536 U.S. at 285, 122 S.Ct. 2268; Blessing, 520 U.S. at 340, 117 S.Ct. 1353. The Fifth Circuit has held that statutory language in a provision neighboring section 1396n(c) requiring that “[a] State Plan must provide for making medical assistance available ... to all individuals” who méet certain eligibility criteria is “precisely the sort of ‘rights-creating’ language identified in Gonzaga as critical to demonstrating a congressional intent to establish a new right.” S.D. ex rel. Dickson v. Hood, 391 F.3d 581, 603 (5th Cir. 2004) (“‘⅜ [is] difficult, if not impossible, as a linguistic matter, to distinguish the import of the relevant [Medicaid Act] language— ‘A State Plan must provide’ from the ‘No person shall’ language of Titles VI and IX’
Turning to the second and third Blessing factors, that right to evaluation and information is neither vague nor amorphous, and it is mandatory. See Wilder v. Virginia Hosp. Ass’n, 496 U.S. 498, 512, 514-15, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990) (statutory requirement that- state adopt “reasonable” and “adequate” reimbursement rates not too vague to create enforceable right; “[i]f the Secretary is entitled to reject a state plan upon concluding that a State’s assurances of compliance are unsatisfactory ... a State is on notice that it cannot adopt any rates it chooses and that the requirement that it make ‘findings’ is not a' mere formality.’ ”); see also Wright v. City of Roanoke Redevelopment & Hous. Auth., 479 U.S. 418, 431, 107 S.Ct. 766, 93 L.Ed.2d 781 (1987) (construing vagueness prong).
Plaintiffs’ complaint alleges violations of Section 1396n(c)’s rights to assessment and information about community-based alternatives to nursing facility care, and Plaintiffs allege that these violations contributed to, the unnecessary institutionalization in nursing facilities that they allege they suffered, as well as the deterioration to their health and autonomy that they allege flowed from their improper placement in nursing facilities. Docket no. 173 at 28-29, 38, 40, 42, 45, 47, 55, 57, 59, 61, 63, 66, 68, 71, 73, 76. Finally, Defendants also argue that Plaintiffs have failed to state a claim because the HCS waiver program is full, and Defendants are therefore no longer bound to meet Section 1396n’s requirements with respect to waiver services that are no longer “feasible” or “available[.]” Makin v. Hawaii, 114 F.Supp.2d 1017, 1027-28 (D.Haw. 1999). As above, this argument fails because, according to Defendants, the HCS waiver program has in fact been expanded to accommodate an additional capacity.
Section 1396r: Finally, Defendants challenge Plaintiffs’ claims under the Nursing Home Reform Amendments Act. (NHRA), alleging violations of 42 U.S.C. §§ 1396r(e)(7)(A).and (B).
The Fifth Circuit has not clearly addressed the question of whether the NHRA is enforceable, via Section 1983, by Medicaid recipients against states, although it has “assume[d], without deciding” that this is the case. Grant ex rel. Family Eldercare v. Gilbert, 324 F.3d 383, 387 n. 5 (5th Cir. 2003) (citing Rolland v. Romney, 318 F.3d 42, 51-56 (1st Cir. 2003)). The first and third circuits have found that the NHRA is enforceable by Medicaid recipients against the state. Grammer v. John J. Kane Reg’l Centers-Glen Hazel, 570 F.3d 520, 525 (3d Cir. 2009) (“The FNHRA are replete with rights-creating language.”); Rolland, 318 F.3d at 53 (“after clearly identifying those it seeks to protect, the [NHRA] goes on to endow them with particular rights, utilizing ‘rights-creating’ language.”). The second circuit, considering a related question, dismissed a Section 1983 NHRA claim brought by health care providers and commented that “[i]t is clear from the plain language of this provision that it was not intended] to benefit the putative plaintiffs] — here the health care providers_ Rather, the provision is obviously intended to benefit Medicaid beneficiaries.” Concourse Rehab. & Nursing Ctr. Inc. v. Whalen, 249 F.3d 136, 143-44 (2d Cir. 2001) (internal quotation marks omitted). Plaintiffs also note a handful of district courts that are in accord. Martin v. Voinovich, 840 F.Supp. 1175, 1200 (S.D.Ohio 1993); Joseph S. v. Hogan, 561 F.Supp.2d 280, 304 (E.D.N.Y. 2008); Tinder v. Lewis Cty. Nursing Home Dist, 207 F.Supp.2d 951, 955 (E.D.Mo. 2001).
This Court agrees with the persuasive authority from other jurisdictions finding that the NHRA creates rights, actionable through Section 1983, in Medicaid recipients. The NHRA provisions at issue in this case outline the “Preadmission Screening and Annual Resident Review” (“PASARR”) process” required by the statute to assess the level of care required by individuals with intellectual and developmental disabilities who are admitted to nursing facilities. Grant ex rel. Family Eldercare v. Gilbert, 324 F.3d 383, 385 (5th Cir. 2003). The statute uses mandatory language to impose an obligation upon the state mental health authority to provide these screenings to individuals, creating a right to individualized assessments of the need for institutional care, to be conducted before an individual is committed to receive care in an institutional setting. Section 1396r(e)(7)(A) and (B) outline the “State requirements for preadmission screening and resident review,” describing the circumstances under which states are required to administer that review, requiring the state to assess “whether or not the resident ... requires the level of services” provided in the institutional setting, requiring states to review their determination upon changes in the resident’s condition, and prohibiting the state from delegating its screening function to a nursing facility or affiliated entity. Section 1396r(b)(3)(F)(i) prohibits a nursing home from admitting any mentally ill resident
The authorities relied upon by Defendants are inapposite to this analysis. With two exceptions, all of them involve claims against private nursing home defendants, not state actors.
Finally, Defendants argue that Plaintiffs have failed to state a cognizable NHRA claim. First, Defendants argue that the relevant provisions of Section 1396r impose no obligations upon the state, but only regulate nursing facilities. This argument fails in the face of the plain language of the statute, which outlines “State requirements for preadmission screening and resident review”; provides that “the State must have in effect a preadmission screening program” that meets the relevant requirements; and notes that the failure of the Secretary to develop pertinent minimum criteria “shall not relieve any State of its responsibility to have a pread-mission screening program under this subparagraph or to perform resident reviews[.]” 42 U.S.C. § 1396r(e)(7)(A). Second, Defendants argue that Plaintiffs’ “specialized services claim should be dismissed because the specialized services obligation imposed upon the states is lim
CONCLUSION
It is therefore ORDERED that the State of Texas’s Motion to Dismiss the Claims of the United States of America (docket no. 242) and Defendants’ Motion to Dismiss Plaintiffs’ Second Amended Complaint (docket no. 244) are DENIED.
In light of Plaintiffs’ representations that they are no longer pursuing their Medicaid Act “comparability” claims, or their claims against Governor Abbott, such claims are DISMISSED WITHOUT PREJUDICE.
IT IS SO ORDERED.
. Texas has acknowledged that Title II of the ADA and the Rehabilitation Act do authorize the Attorney General to sue. Docket no. 56 at 5, 10 (“the United States has an ‘interest’ in Title II of the ADA”; "both Title II and the Rehab Act allow for enforcement through the termination or refusal to grant federal funding, or by ‘any other means provided by law’... Courts interpret ‘any other means provided by law’ to authorize DOJ enforcement via federal court action.”) (citing 42 U.S.C. § 2000d-1).
. The Court will address Defendants’ argument about Plaintiffs’ standing to bring "freedom of choice” claims under 42 U.S.C. § 1396n(c)(2)(B) and (C) in the section discussing the existence of a private right of action under that statute.
. Defendants also argue that the Court should "doubly disregard" the declarations of Garth Corbett and Marisol McNair (docket nos. 264-6,264-7), because, in addition to including the phrase "to the best of my knowledge [,]" Corbett and McNair are, respectively, an attorney and legal assistant working on behalf of the Plaintiffs. Therefore, Defendants argue, these two declarations violate Texas Disciplinary Rule of Professional Conduct 3.08, This argument is without merit. See Tex. R.P.C. Rule 3.08(a)(2),-cmt.5.
. Specifically, Defendants claim that, of the twelve surviving individual Plaintiffs, seven (Linda Arizpe, Leonard Barefield, Patricia Ferrer, Richard Krause, Zackowitz Morgan, Eric Steward, and Vanisone Thongphanh) are now enrolled in the HCS waiver program, docket no. 244-2 at 2-3;. an eighth (Maria Hernandez) is being assessed by her physician for her ability to be safely served in the community, id. at 3; a ninth (Melvin Oatman) is not eligible for intellectual and developmental disability services, id. at 3-4; and the remaining three (Thomas Johnson, Johnny Kent, and Joseph Morrell) met with a service coordinator on July 28 and August 20, 2015, and, on both dates, informed her that they want to remain in the nursing facilities where they currently reside, Docket no. 244-1 at 2-4.
Plaintiffs dispute Defendants’ characterizations that Maria Hernandez is actively being transitioned into community care, docket no. 264 at 20-21; Defendants’ claims about Melvin Oatman’s eligibility for Home and Community-based Services, id. at 21-22; and the adequacy of the information Defendants have provided to Thomas 'Johnson, Johnny • Kent, and Joseph Morrell about community-based alternatives to their current, institutional, care. Id. at 18-20. Plaintiffs also argue that the individual Plaintiffs, who have been transitioned to community-based care remain “at risk for being referred/screened, or readmitted to a nursing facility,” Id. at 22.
. To be clear, the record supports no such assumption. It is far from clear that the relief Defendants have provided to some of the individual Plaintiffs is sufficient to vitiate the Article III standing of all of the individual Plaintiffs. At the very least, disputes remain between the parties as to the eligibility of some of the individual Plaintiffs for HCS waiver services, as well as the sufficiency of Defendants’ measures to provide information regarding community-based alternatives to individual Plaintiffs who, it is not disputed, still reside in nursing facilities. See Docket no. 264 at 18-23 (describing the current status of the individual Plaintiffs).
. Plaintiffs filed their initial motion seeking class certification (docket no. 13) on January 19, 2011, and subsequently updated the motion (docket nos. 94, 174) to correspond to their amended complaints (docket nos. 63, 173). (From September 27, 2011, to July 23, 2012, and from September 21, 2012, to September 30, 201S, the case was stayed (docket nos. 58, 107, 138, 179, 181, 220).) The first individual Plaintiffs who have transitioned to community-based care were offered Home and Community-based Services waiver slots on September 14, 2012, and did not actually enroll or begin receiving services until well thereafter. Docket no. 244-2 at 2.
. Cf. Lewis, 518 U.S. at 357, 116 S.Ct. 2174 (noting, in review of "whether [named plaintiffs'] injuries, and the other findings of the District Court, support the injunction ordered in this case” that "[t]he general allegations of the complaint in the present case may well have sufficed to claim injury by named plaintiffs, and hence standing to demand remediation, with respect to [injuries alleged by the named plaintiffs].... That point is irrelevant now, however, for we are beyond the pleading stage.”).
. See Cleburne Living Ctr., Inc. v. City of Cleburne, Texas, 726 F.2d 191, 203 & n. 16 (5th Cir. 1984), aff'd in part, vacated in part sub nom., City of Cleburne, Tex. v. Cleburne Living Ctr., 473 U.S. 432, 105 S.Ct 3249, 87 L.Ed.2d 313 (1985).
. Plaintiffs are no longer pursuing their “comparability” claim under 42 U.S.C. § 1396a(a)(10)(B). Docket no. 264 at 4 n.2.
. To the extent that Defendants may argue that putative class members are ineligible notwithstanding the program’s expansion because of the lengthy HCS waitlist, this argument is fatally undercut by Defendants’ representations that members of the putative class no longer need seek HCS waiver slots through the waitlist, "but may bypass the interest list and enroll in HCS directly from the [nursing facility] (or from the community if being diverted from a[ ] [nursing facility]).” Docket no. 244 at 2, 13, 48-49.
. The statutory provision at issue in Suter was enacted under the short title “Adoption Assistance and Child Welfare Act of 1980” and codified at 42 U.S.C. § 671(a)(15).
. Planned Parenthood Arizona, Inc., 899 F.Supp.2d at 878.
. Plaintiffs clarify in their opposition to Defendants’ motion to dismiss that they do not assert any independent claim under Section 1396r(b)(3)(F), but cite it merely “because §, 1396r(e)(7)(A)(i) cross references to that section in order to fully define and clarify the nature and extent of the preadmission screening program[J” Docket no. 264 at 81 n.64.
. Stewart v. Bernstein, 769 F.2d 1088, 1092 (5th Cir. 1985) (finding no cause of action implied under Medicaid Act against private nursing home and its administrator); Prince v. Dicker, 29 Fed.Appx. 52, 54 (2d Cir. 2002) (same); Schwerdtfeger v. Alden Long Grove Rehab. & Health Care Ctr., Inc., No. 13 C 8316, 2014 WL 1884471, at *5 (N.D.Ill. May 12, 2014) ("Here, [Defendant] is a private nursing facility, and thus, is not a state actor subject to Section 1983.”); Baum v. N. Dutchess Hosp., 764 F.Supp.2d 410, 425 (N.D.N.Y. 2011) (“FNHRA does not clearly and unambiguously authorize a private federal cause of action for nursing home residents against private nursing homes. FNHRA lacks the rights-creating language critical to reflecting Congress's intent to create a new federal right or individual entitlement that would be enforceable under § 1983.”); Duncan v. Johnson-Mathers Health Care, Inc., No. 5:09-CV-00417-KKC, 2010 WL 3000718, at *10 (E.D.Ky. July 28,2010) (dismissing Section 1396r claims against nursing home); Brogdon ex rel. Cline v. Nat'l Healthcare Corp., 103 F.Supp.2d 1322, 1332 (N.D.Ga. 2000) ("the Court finds little evidence of Congress’ intent to create a private cause of action that would entitle nursing home residents to sue nursing homes to enforce Medicare and Medicaid participation standards.”); Estate of Ayres ex rel. Strugnell v. Beaver, 48 F.Supp.2d 1335, 1339-40 (M.D.Fla. 1999) (remanding claims against private nursing home defendants to state court upon finding that no statutory private right of action — and thus no federal question jurisdiction — exists under the Medicare and Medicaid Acts); Nichols v. St. Luke Ctr. of Hyde Park, 800 F.Supp. 1564, 1567 (S.D.Ohio 1992) (finding that Medicaid Act creates no private right of action enforceable against private nursing home defendants).
Reference
- Full Case Name
- Eric STEWARD, by his next friend and Mother, Lillian Minor v. Greg ABBOTT, Governor of the State of Texas, Defendants The United States of America, Intervenor v. The State of Texas
- Cited By
- 7 cases
- Status
- Published