Co. of Colusa v. Douglas

CourtCalifornia Court of Appeal
DecidedJuly 11, 2014
DocketC073624M
StatusPublished

This text of Co. of Colusa v. Douglas (Co. of Colusa v. Douglas) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Co. of Colusa v. Douglas, (Cal. Ct. App. 2014).

Opinion

Filed 7/11/14 (unmodified opn. attached) CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA THIRD APPELLATE DISTRICT (Sacramento) ----

COUNTY OF COLUSA et al., C073624

Plaintiffs and Appellants, (Super. Ct. No. 34-2012-80001053-CU-WM-GDS) v. ORDER MODIFYING OPINION TOBY DOUGLAS, as Director, etc., et al., [NO CHANGE IN JUDGMENT] Defendants and Respondents.

THE COURT:

It is ordered that the opinion certified for publication and filed herein on July 9, 2014, be modified to clarify the Disposition as follows:

On page 17, delete the paragraph (which includes fn. 5) following the DISPOSITION in its entirety, and replace it with:

1 DISPOSITION

The judgment is reversed. The trial court is directed to grant the Counties’ petition for writ of mandate and complaint for declaratory and injunctive relief as follows: The DHCS 2009 Memorandum and the DMH 2010 Letter contravene section 14053.1 (which requires the State to pay for ancillary outpatient services for Medi-Cal eligible IMD patients within the federal IMD exclusion), and are therefore invalid; the State is enjoined from applying them. The Counties are awarded their costs on appeal.1 (Cal. Rules of Court, rule 8.278(a)(1), (2).) (CERTIFIED FOR PUBLICATION)

There is no change in judgment.

BY THE COURT:

BUTZ , Acting P. J.

DUARTE , J.

HOCH , J.

1 In light of our resolution, we do not reach the issue of whether the DHCS 2009 Memorandum and the DMH 2010 Letter are also invalid as underground regulations under the Administrative Procedures Act. We grant the Counties’ request for judicial notice, showing the State’s estimated cost for IMD ancillary services for fiscal years 2013-2014 and 2014-2015. We deny the State’s motion to augment or, in the alternative, request for judicial notice to consider an unpublished decision of the federal Health and Human Services Agency.

2 Filed 7/9/14 (unmodified version) CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA THIRD APPELLATE DISTRICT (Sacramento) ----

Plaintiffs and Appellants, (Super. Ct. No. 34-2012-80001053-CU-WM-GDS) v.

TOBY DOUGLAS, as Director, etc., et al.,

Defendants and Respondents.

APPEAL from a judgment of the Superior Court of Sacramento County, Timothy M. Frawley, Judge. Reversed. Remcho, Johansen & Purcell, Margaret R. Prinzing, Karen Getman and Harry A. Berezin for Plaintiffs and Appellants (all counties). Marcos A. Kropf, County Counsel (Colusa); Wendy B. Chaitin, County Counsel (Humboldt), and Karen Roebuck, Deputy County Counsel; Colleen J. Carlson, County Counsel (Kings), and Diane Walker, Deputy County Counsel; John F. Krattli, County Counsel (Los Angeles), and Stephanie Jo Farrell, Principal Deputy County Counsel; Brina A. Latkin, County Counsel (Mendocino); Charles J. McKee, County Counsel (Monterey), Stacy L. Saetta and Anne K. Brereton, Deputy County Counsel; Minh C. Tran, County Counsel (Napa), and Janice D. Killion, Deputy County Counsel; Nicholas S. Chrisos, County Counsel (Orange), and James C. Harman, Deputy County Counsel; Gerald O. Carden, County Counsel (Placer), and Valerie D. Flood, Deputy County Counsel; Pamela J. Walls, County Counsel (Riverside); John F. Whisenhunt, County

1 Counsel (Sacramento), and Rick J. Heyer, Deputy County Counsel; Rita L. Neal, County Counsel (San Luis Obispo), and David M. Stotland, Deputy County Counsel; John C. Beiers, County Counsel (San Mateo), John D. Nibbelin, Chief Deputy County Counsel, and Peter K. Finck, Deputy County Counsel; Orry P. Korb, County Counsel (Santa Clara), Danny Y. Chou, Assistant County Counsel, and Greta S. Hansen, Deputy County Counsel; Bruce D. Goldstein, County Counsel (Sonoma), and Phyllis C. Gallagher, Deputy County Counsel; John P. Doering, County Counsel (Stanislaus), William Dean Wright and Alice E. Mimms, Deputy County Counsel; Kathleen Bales-Lange, County Counsel (Tulare), and Julia C. Langley, Deputy County Counsel; Sarah Carrillo, County Counsel (Tuolumne), and Christopher J. Schmidt, Deputy County Counsel, for Plaintiffs and Appellants (individual counties). Cota Cole and Derek P. Cole for Plaintiff and Appellant Trinity County. Hooper, Lundy & Bookman and Mark E. Reagan for California Association of Health Facilities as Amicus Curiae on behalf of Plaintiffs and Appellants. Kamala D. Harris, Attorney General, Julie Weng-Gutierrez, Assistant Attorney General, Ismael A. Castro and Lisa A. Tillman, Deputy Attorneys General, for Defendants and Respondents.

We conclude that Welfare and Institutions Code section 14053.1—under which the State of California, rather than its counties, pays for ancillary outpatient services for Medi-Cal eligible patients ages 21 to 64 in an “institution for mental diseases” (IMD)— remains a valid law.2

In reaching this conclusion, we find that Welfare and Institutions Code section 14053.1’s presence in the California statutes is not the result of a legislative amendment to a repealed act, which is a legislative action proscribed under Government Code section 9609; and further find that Welfare and Institutions Code section 14053.3 (which requires the state to recover from counties payments for certain ancillary services, when Medi-Cal coverage is unavailable) did not shift funding from the state to the counties for ancillary outpatient services to Medi-Cal eligible IMD patients ages 21 to 64, and did not impliedly repeal section 14053.1. Accordingly, we shall reverse the judgment.

2 Undesignated statutory references are to the Welfare and Institutions Code.

2 FACTUAL AND PROCEDURAL BACKGROUND

We draw much of our background from the able summary of facts and procedure the trial court provided in its ruling. Medicaid, Medi-Cal, and Payment of Services for IMD Patients

Medicaid is a cooperative federal-state program under which the federal government and participating state governments share the costs of medical treatment for generally low-income individuals. (42 U.S.C. § 1396 et seq.) California’s Medicaid program is known as Medi-Cal. (§ 14000 et seq.)

IMD’s are hospitals, nursing facilities, and other institutions that primarily treat and care for patients with mental diseases. (42 U.S.C. § 1396d(i).) Nearly all individuals placed within IMD’s are gravely disabled by mental disease and unable to provide for themselves; most IMD patients qualify for Medi-Cal.

Under federal Medicaid law, the federal government does not pay for services to IMD patients between the ages of 21 and 65. (42 U.S.C. § 1396d(a)(xvii)(29)(B); Connecticut Dept. of Income Maintenance v. Heckler (1985) 471 U.S. 524, 525 [85 L.Ed.2d 577, 579].) The federal government deems long-term care in mental institutions a state responsibility; this policy is known as the “IMD exclusion” (hereafter, federal IMD exclusion). (Heckler, supra, 471 U.S. at p. 533, fn. 24 [85 L.Ed.2d at p. 584, fn. 24].) As to that exclusion, federal Medicaid law does not prohibit states from paying for IMD services as a “state-only” Medicaid benefit. Statutory Scheme Involving State Medi-Cal Funding of IMD Ancillary Services

In 1999, California (the State) added a state-only Medi-Cal benefit by enacting section 14053.1. That section provides that the State will pay for “ancillary outpatient services” for IMD patients ages 21 to 64 (i.e., the patients within the federal IMD exclusion).

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Bluebook (online)
Co. of Colusa v. Douglas, Counsel Stack Legal Research, https://law.counselstack.com/opinion/co-of-colusa-v-douglas-calctapp-2014.