Maniilaq Association v. Burwell

170 F. Supp. 3d 243, 2016 WL 1118256, 2016 U.S. Dist. LEXIS 36605
CourtDistrict Court, District of Columbia
DecidedMarch 22, 2016
DocketCivil Action No. 2015-0152
StatusPublished
Cited by6 cases

This text of 170 F. Supp. 3d 243 (Maniilaq Association v. Burwell) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Maniilaq Association v. Burwell, 170 F. Supp. 3d 243, 2016 WL 1118256, 2016 U.S. Dist. LEXIS 36605 (D.D.C. 2016).

Opinion

MEMORANDUM OPINION

JOHN D. BATES, United States District Judge

For more than twenty years, the Secretary of Health and Human Services has allocated $30,921 a year in federal funds toward renting health clinic space in the Native American village of Kivalina, Alaska. Maniilaq Association, a regional health corporation that now owns and operates the clinic in Kivalina, believes that amount is insufficient to assure adequate healthcare in that community. In an attempt to remedy the Kivalina clinic’s chronic underfunding, Maniilaq submitted a lease proposal based on section 105(i) of the Indian Self-Determination and Education Assistance Act. That section, Maniilaq argues, requires the Secretary to rent its Kivalina clinic space and pay it compensation, based on the clinic’s operating costs, of $249,842 a year. But the Secretary declined Manii-laq’s proposal, arguing that it must pay Maniilaq no more than the $30,921 it has provided previously. Maniilaq sued, and cross-motions for summary judgment are now pending before the Court. 1 The Court will grant summary judgment for Manii-laq, and direct the parties to enter into discussions regarding Maniilaq’s Kivalina lease proposal consistent with this opinion.

BACKGROUND

Under Title V of the Indian Self-Determination and Education Assistance Act (the Act), qualifying tribes or inter-tribal consortia may enter self-governance compacts to administer health services ordinarily provided by the Department of Health and Human Services (the Secretary). In 1994, the Alaska Native Tribal Health Consortium and the Secretary entered the Alaska Tribal Health Compact (the Compact). See Ex. A to Pl.’s Mem. [ECF No. 10-2] (Compact). Maniilaq Association, a non-profit association that provides health care services to twelve member tribes, is one co-signer of the Compact. Each compacting tribe or inter-tribal consortium must also enter into a written funding agreement with the Secretary. See 25 U.S.C. § 458aaa-4(a); see also 25 U.S.C. § 458aaa(b) (definition of Indian tribe). These funding agreements should identify the programs to be administered by the tribe, see id. § 458aaa-4(d)(l), and “authorize the Indian tribe to plan, conduct, consolidate, administer, and receive full tribal share funding” for the included programs, see id. § 458aaa-4(b)(l).

The statute dictates the minimum amount of tribal funding. “The Secretary shall provide funds under a funding agreement ... in an amount equal to the amount that the Indian tribe would have been entitled to receive under self-determination contracts under [Title I of the Act].” Id. § 458aaa-7(c); see also Compact Art. II, § 3 (“Subject only to the appropriation of funds by the Congress of the United States and in accordance with [25 U.S.C. § 458aaa-7], the Secretary shall provide the total amounts specified in the Funding Agreements.”). Title I, in turn, requires the Secretary to provide “not ... less than” the amount that she “would have otherwise provided for the operation of the programs” administered by the tribal organization; contract support costs; and, in the first year of a contract, start-up *245 costs. 2 Id. § 450j-l(a) (often referred to as section 106(a) of the Act). “At the option of an Indian tribe, a funding agreement may provide for a stable base budget specifying the recurring funds (including, for purposes of this provision, funds available under [section 106(a) ]” to be transferred to the compacting tribal organization. Id. § 458aaa-4(g).

In fiscal year 2011, for example, Manii-laq Association received approximately $41. 5 million under its funding agreement with the Secretary. See Ex. B to Pl.’s Mem. [ECF No. 10-3] (Funding Agreement) at 11-12. That amount was the sum of several component parts: recurring base funding, see id. at 11, 13-14; non-recurring funding, distributed from available funds at the beginning of each fiscal year, see id. at 11 & n.2; and tribal shares of available IHS headquarters and Alaska-area office funds, allocated among the Alaska tribes using methodologies “adopted in a caucus open to all Alaska Tribes and tribal organizations,” see id. at 11-12 & nn.3^4. Under the Compact, Maniilaq reserves the right to “reallocate or redirect” its funds among compacted programs “in any manner ... which [it] deems to be in the best interest” of its communities. Compact, Art. Ill, § 5. The Community Health Aide (CHAP) and Village Built Clinic (VBC) programs are the compacted programs relevant to this case.

The CHAP funds the training of health aides and practitioners who provide acute, chronic, and preventative health care in remote village locations. The VBC program was created to lease clinic space for use by the CHAP practitioners, and has its origins in congressional appropriations bills that appropriated earmarked funds for that purpose. But Congress has not earmarked funds for VBC leases since 1989, so in the decades since, the Secretary has allocated lease funding out of its Hospitals and Clinics Budget Line Item. See Pl.’s Mem. at 7-8. Most frequently, the Secretary leases clinic space owned by the villages themselves, see Ex. K to Pl.’s Mem. [ECF No. 10-12] at 1, and calculates the applicable lease amount pursuant to a 1991 circular, see Ex. J to PL’s Mem. [ECF No. 10-11] at 1. The circular’s formula makes the lease amount a function of a number of factors, including village population, clinic patient encounters, the price of fuel, the size of the clinic, and the available budget. See id. at 3-4. The Secretary considers the resulting leases to be “full service,” meaning they are intended to compensate the lessor for “rental of the space, -utilities, and all maintenance and operational costs associated with the clinic.” Id. at 4. But because the lease amount is not based explicitly on the fair market value of the clinic or on the real costs associated with running it, the lease amount often proves inadequate. According to a 2007 report by the Alaska Native Health Board, “lease funding [then] cov-erted] only approximately 55% of the current operating costs.” Ex. K to Pl.’s Mem., Executive Summary. That funding shortfall is the impetus behind this ease.

Since 1996, Maniilaq has compacted to administer the VBC program — in other words, to secure clinic space in its constituent villages for the CHAP practitioners. Rather than lease the clinic space directly, Maniilaq obtained it through a buyback-withhold agreement with the Secretary, who leased clinic space on Maniilaq’s behalf, then withheld the lease amount from the funding that Maniilaq received under the Compact. See Ex. B to Pl.’s Mem. at App. E, ¶ 2.2.2. In February 2012, Manii-laq sought to change this arrangement. By that time, it owned clinic space in all but one of its constituent villages. And as a result, it had assumed the burden of the VBC leases’ “chronic underfunding,” cov *246 ering clinic costs by diverting funds from other programs when necessary.

Maniilaq proposed a two-step remedy in a memorandum to the Secretary. See Ex. C to Pl.’s Mem. [ECF No.

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
170 F. Supp. 3d 243, 2016 WL 1118256, 2016 U.S. Dist. LEXIS 36605, Counsel Stack Legal Research, https://law.counselstack.com/opinion/maniilaq-association-v-burwell-dcd-2016.