Margaret Dowling and Vernon Cox, on Behalf of Themselves and the Medicaid Class and In-Home Supportive Class v. Gray Davis, Controller of the State of California and Thomas W. Hayes, Treasurer of the State of California Kenneth Kizer, Director of Department of Health Services, State of California Linda McMahon Director of Department of Social Services, State of California and Department of Social Services, State of California, Margaret Dowling, and Service Employees International Union, Local 434, Afl-Cio, Intervenors-Appellants v. Gray Davis, Controller of the State of California and Thomas W. Hayes, Treasurer of the State of California Kenneth Kizer, Director of Department of Health Services, State of California Linda McMahon Director of Department of Social Services, State of California and Department of Social Services, State of California

19 F.3d 445, 94 Cal. Daily Op. Serv. 1917, 94 Daily Journal DAR 3548, 1994 U.S. App. LEXIS 4892
CourtCourt of Appeals for the Ninth Circuit
DecidedMarch 18, 1994
Docket92-16393
StatusPublished

This text of 19 F.3d 445 (Margaret Dowling and Vernon Cox, on Behalf of Themselves and the Medicaid Class and In-Home Supportive Class v. Gray Davis, Controller of the State of California and Thomas W. Hayes, Treasurer of the State of California Kenneth Kizer, Director of Department of Health Services, State of California Linda McMahon Director of Department of Social Services, State of California and Department of Social Services, State of California, Margaret Dowling, and Service Employees International Union, Local 434, Afl-Cio, Intervenors-Appellants v. Gray Davis, Controller of the State of California and Thomas W. Hayes, Treasurer of the State of California Kenneth Kizer, Director of Department of Health Services, State of California Linda McMahon Director of Department of Social Services, State of California and Department of Social Services, State of California) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Margaret Dowling and Vernon Cox, on Behalf of Themselves and the Medicaid Class and In-Home Supportive Class v. Gray Davis, Controller of the State of California and Thomas W. Hayes, Treasurer of the State of California Kenneth Kizer, Director of Department of Health Services, State of California Linda McMahon Director of Department of Social Services, State of California and Department of Social Services, State of California, Margaret Dowling, and Service Employees International Union, Local 434, Afl-Cio, Intervenors-Appellants v. Gray Davis, Controller of the State of California and Thomas W. Hayes, Treasurer of the State of California Kenneth Kizer, Director of Department of Health Services, State of California Linda McMahon Director of Department of Social Services, State of California and Department of Social Services, State of California, 19 F.3d 445, 94 Cal. Daily Op. Serv. 1917, 94 Daily Journal DAR 3548, 1994 U.S. App. LEXIS 4892 (9th Cir. 1994).

Opinion

19 F.3d 445

62 USLW 2639, 44 Soc.Sec.Rep.Ser. 60,
Medicare&Medicaid Guide P 42,171

Margaret DOWLING and Vernon Cox, on behalf of themselves and
the Medicaid Class and In-Home Supportive Class,
Plaintiffs-Appellants,
v.
Gray DAVIS, Controller of the State of California; and
Thomas W. Hayes, Treasurer of the State of California;
Kenneth Kizer, Director of Department of Health Services,
State of California; Linda McMahon, Director of Department
of Social Services, State of California; and Department of
Social Services, State of California, Defendants-Appellees.
Margaret DOWLING, et al., Plaintiffs,
and
Service Employees International Union, Local 434, AFL-CIO,
et al., Intervenors-Appellants,
v.
Gray DAVIS, Controller of the State of California; and
Thomas W. Hayes, Treasurer of the State of California;
Kenneth Kizer, Director of Department of Health Services,
State of California; Linda McMahon, Director of Department
of Social Services, State of California; and Department of
Social Services, State of California, Defendants-Appellees.

Nos. 92-16393, 92-16439.

United States Court of Appeals,
Ninth Circuit.

Argued and Submitted Dec. 15, 1993.
Decided March 18, 1994.

Grace A. Galligher, Coalition of California Welfare Rights Organization, Sacramento, CA, Lynn S. Carman, Corte Madera, CA, for plaintiffs-appellants.

Richard G. McCracken, Davis Cowell and Bowe, San Francisco, CA, Craig Becker, University of California at Los Angeles Law School, Los Angeles, CA, for intervenors-appellants.

Larry G. Raskin, Deputy Atty. Gen., Sacramento, CA, for defendants-appellees.

Appeal from the United States District Court for the Eastern District of California.

Before: WALLACE, Chief Judge, GARTH,* and WIGGINS, Circuit Judges.

GARTH, Circuit Judge:

The appellants, Margaret Dowling and Vernon Cox, individually and on behalf of two certified subclasses of plaintiffs--recipients and beneficiaries of California's Medicaid program, Medi-Cal (hereinafter "the Dowling Medicaid class"), and recipients and providers of In-Home Support Services (hereinafter "the Dowling IHSS class")--and intervenors Service Employees International Union, Local 434, AFL-CIO (hereinafter "Service Employees"), appeal the judgment of the district court denying their respective motions for summary judgment and granting summary judgment in favor of appellees, Gray Davis, Controller of the State of California, the California Department of Social Services, and various California officials (hereinafter "the State").2

The class action seeking declaratory judgment and injunctive relief against the State was initiated by Dowling, a paraplegic, and Cox, a quadriplegic, in July 1990, after the State of California delayed paying Medi-Cal and In-Home Support Services ("IHSS") claims, because of the failure of the California legislature to adopt a timely state budget. Before the legislators adopted a Budget Act in late July 1990, visiting District Court Judge Tanner certified the Medicaid and IHSS subclasses, and granted intervenor status to the Service Employees. The Service Employees had asserted a right of procedural due process on behalf of IHSS recipients and providers. Judge Tanner at that time issued a preliminary injunction requiring the State to pay Medi-Cal provider and IHSS claims during the budget lapse. The parties subsequently filed cross motions for summary judgment on the claims of the Medicaid and IHSS classes.

In granting the State's cross motion for summary judgment, the district court concluded: that the State did not violate the Medicaid Act, 42 U.S.C. Sec. 1396, by deferring payment of Medi-Cal claims during the 1990 California budget impasse; that the statute authorizing federal block grants, 42 U.S.C. Sec. 1397, does not confer upon IHSS recipients a right to uninterrupted benefits during a State budget lapse, and that IHSS recipients have neither a property right nor a right to advance notice when the IHSS program ceases to exist during a budget lapse.

We have jurisdiction under 28 U.S.C. Sec. 1291 to review the July 28, 1992 final order of the district court, and we affirm.

I.

We review de novo the district court's grant of summary judgment in favor of the State. Jones v. Union Pacific R.R. Co., 968 F.2d 937, 940 (9th Cir.1992). Viewing the evidence in the light most favorable to the nonmoving party, we must determine whether there are any genuine issues of material fact and whether the district court correctly applied the relevant substantive law. Federal Deposit Ins. Corp. v. O'Melveny & Meyers, 969 F.2d 744, 747 (9th Cir.1992), cert. granted, --- U.S. ----, 114 S.Ct. 543, 126 L.Ed.2d 445 (1993).

II.

California's Medi-Cal program is governed by the Medicaid Act, 42 U.S.C. Sec. 1396, and funded with federal matching funds. The State plan must "provide that it shall be in effect in all political subdivisions of the State and, if administered by them, be mandatory upon them." Id. Sec. 1396a(a)(1). The State plan also must

provide such methods and procedures relating to ... the payment for, care and services available under the plan ... as may be necessary ... to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area; * * *.

Id. Sec. 1396a(a)(30)(A).

Delayed payment is an inherent feature of the Medicaid statutory and regulatory framework. The State is required to pay 90% of "clean" Medicaid claims within 30 days and 99% of such claims within 90 days of receipt. See id. Sec. 1396a(a)(37); 42 C.F.R. Sec. 447.45(d)(2), (3) & (4). All other claims must be paid within 12 months of the date of receipt. Id.

Summary judgment in favor of the State was proper because, as the district court found, the Dowling Medicaid class presented no evidence showing that the California budget impasse had led to a violation of Sec. 1396a(a)(37). Given that the federal statute and applicable regulations impose explicit time requirements, the district court correctly declined to interpret other regulatory provisions to apply a stricter standard to the State's budgetary processes than that imposed by Sec. 1396a(a)(37).

Having concluded that the State had complied with all time constraints of Sec. 1396a(a)(37), the district court properly entered judgment vacating the preliminary injunction and granting summary judgment in favor of the State. Although the district court's July 28, 1992 order also denied Dowling's motion for summary judgment, it effectively grants all the relief sought by the Dowling Medicaid class.

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

Related

Allum v. Second Judicial District Court of Nevada
510 U.S. 988 (Supreme Court, 1993)
Dowling v. Davis
840 F. Supp. 731 (E.D. California, 1992)
Dowling v. Davis
19 F.3d 445 (Ninth Circuit, 1994)

Cite This Page — Counsel Stack

Bluebook (online)
19 F.3d 445, 94 Cal. Daily Op. Serv. 1917, 94 Daily Journal DAR 3548, 1994 U.S. App. LEXIS 4892, Counsel Stack Legal Research, https://law.counselstack.com/opinion/margaret-dowling-and-vernon-cox-on-behalf-of-themselves-and-the-medicaid-ca9-1994.