Doe v. Kidd

419 F. App'x 411
CourtCourt of Appeals for the Fourth Circuit
DecidedMarch 24, 2011
Docket10-1191
StatusUnpublished
Cited by6 cases

This text of 419 F. App'x 411 (Doe v. Kidd) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Doe v. Kidd, 419 F. App'x 411 (4th Cir. 2011).

Opinion

Reversed in part, affirmed in part, and remanded with instructions by unpublished opinion. Judge GREGORY wrote the opinion, in which Judge MOTZ and Judge KING joined.

Unpublished opinions are not binding precedent in this circuit.

GREGORY, Circuit Judge:

Sue Doe, the plaintiff-appellant, is a young woman with developmental disabilities, including epilepsy, mild mental retardation, and cerebral palsy. She filed this 42 U.S.C. § 1983 action against the South Carolina Department of Disabilities and Special Needs (“DDSN”), the South Carolina Department of Health and Human Services (“DHHS”), as well as Linda Kidd, Stan Butkus, Kathi Lacy and Robert Kerr, in their official capacities as state administrators (collectively, “Defendants”). The suit alleges that Defendants violated various sections of the Medicaid Act related to the provision of services. In an earlier appeal, Doe v. Kidd, 501 F.3d 348 (4th Cir.2007) (“Doe I ”), this Court affirmed in part, and reversed in part the district court’s grant of summary judgment for Defendants. Only one of Doe’s original claims survived that appeal, her allegation that Defendants had not complied with the *413 reasonable promptness provision of the Medicaid Act. Id. at 357.

On remand, the district court again granted summary judgment in favor of Defendants. Doe subsequently filed this timely appeal challenging (1) the dismissal of her reasonable promptness claim; (2) the denial of her motion to amend the complaint; and (3) the denial of her request for attorney’s fees. 1 Because we find that Defendants have violated Doe’s rights under the Medicaid Act as a matter of law, we reverse the district court and grant summary judgment in her favor. Accordingly, Doe may recover attorney’s fees. However, the district court properly denied her motion to amend.

I.

We review a grant of summary judgment de novo, and present all facts and reasonable inferences in the light most favorable to the nonmoving party. Varghese v. Honeywell Int’l, Inc., 424 F.3d 411, 416 (4th Cir.2005). The underlying material facts are not in dispute, and the extensive history of this case is laid out in further detail in our previous opinion. See generally Doe I, 501 F.3d at 351-53. DHHS is the South Carolina state agency responsible for administrating Medicaid programs. DDSN supervises the treatment and training of South Carolinians with mental retardation and related disabilities. Because South Carolina accepts Medicaid funding, these agencies are bound to comply with all related federal laws and regulations. Wilder v. Va. Hosp. Ass’n, 496 U.S. 498, 502, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990).

In July 2002, after unsuccessfully applying twice in the past, Doe filed a third application for DDSN services under the Medicaid waiver program pursuant to 42 U.S.C. § 1396n(c) (2000), whereby a state may waive the requirement that persons with mental retardation or related disabilities live in an institution in order to receive certain services. The waiver application process has three steps: first, DHHS needed to decide whether Doe was eligible for any Medicaid funding; next, DDSN was required to evaluate Doe to determine what services she was entitled to; and, finally, DDSN had to decide the most appropriate “level of care” for Doe as well as the least restrictive environment or care setting. These settings may include, listed in order of the least to the most restrictive placement: (1) a Supervised Living Program II (“SLP II”), an apartment where recipients of DDSN services reside together; (2) a Community Training Home I (“CTH I”), a private foster home where a services recipient resides with a family, one member of whom is a trained caregiver; or (3) a Community Training Home II (“CTH II”), a group home with live-in caregivers for four or fewer recipients. Appeals from DDSN decisions are taken to a DHHS hearing officer and thereafter may be appealed to a South Carolina administrative law judge.

In December 2002, without having made a final decision as to Doe’s eligibility for a waiver, DDSN placed Doe on the waiver *414 program’s non-critical waiting list. Doe appealed this decision to DHHS, and claimed that DDSN had failed to provide her with services within a reasonably prompt time frame as required by federal regulations. Pending that appeal, DDSN moved Doe to its critical waiting list in February 2003. Doe was advised that she met certain DDSN eligibility requirements in March 2003. She was then moved to the top of the critical waiting list.

At a March 2003 hearing on the appeal, a DHHS hearing officer dismissed the matter. He found that, by moving Doe to the top of the critical waiting list and determining that she was eligible for services, DDSN had resolved all of Doe’s claims in her favor. The hearing officer also found that DDSN had not provided Doe with services in a “reasonably prompt” period of time. However, because DDSN was then promising to provide Doe with services, the hearing officer found that he lacked the power to provide any other relief and the appeal was dismissed. Joint Appendix (“J.A.”) 887-89.

In April 2003, DDSN approved a “plan of care” that was developed for Doe pursuant to 42 C.F.R. § 441.301(b) (hereinafter the “2003 plan”). J.A. 616-44. The 2003 plan included a regime of personal care, psychological evaluations, and other services to be provided in-home at the residence of Doe’s mother. It also recommended that Doe “receive residential habilitation from a DDSN approved provider” within three months at a “setting located within the Columbia area to be chosen by her family.” J.A. 625.

In May 2003, in response to the declining mental health of Doe’s mother, Doe asked to terminate the in-home services and, per the 2003 plan, receive “residential habilitation services” in either a CTH I or CTH II. J.A. 920, 923. In June 2003, after failing to receive any residential habilitation services, Doe initiated this action, wherein she accused Defendants of violating the Medicaid Act. She sought injunc-tive relief from DDSN, the payment of medical expenses, and attorney’s fees.

In a letter dated June 26, 2003, DDSN authorized CTH I or SLP II services for Doe at a residential center (hereinafter the “authorization letter”). J.A. 942-44. According to the authorization letter, an assessment of Doe by DDSN revealed that her needs for “out-of-home placement/residential habilitation supervision, care and skills training” could be met at either of these two placements. J.A. 943. However, Doe rejected the DDSN chosen provider, the Babcock center, because she believed that the facility could not safely provide her with appropriate services.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Koss v. Norwood
305 F. Supp. 3d 897 (E.D. Illinois, 2018)
Koss v. Eagleson
N.D. Illinois, 2018
Sue Doe v. Linda Kidd
656 F. App'x 643 (Fourth Circuit, 2016)
JL ex rel. Thompson v. New Mexico Department of Health
165 F. Supp. 3d 1048 (D. New Mexico, 2016)
Doe v. South Carolina Department of Health & Human Services
727 S.E.2d 605 (Supreme Court of South Carolina, 2011)

Cite This Page — Counsel Stack

Bluebook (online)
419 F. App'x 411, Counsel Stack Legal Research, https://law.counselstack.com/opinion/doe-v-kidd-ca4-2011.