Massachusetts Association for Retarded Citizens, Inc. v. Edward J. King

668 F.2d 602, 1981 U.S. App. LEXIS 15038
CourtCourt of Appeals for the First Circuit
DecidedDecember 18, 1981
Docket81-1292, 81-1692
StatusPublished
Cited by22 cases

This text of 668 F.2d 602 (Massachusetts Association for Retarded Citizens, Inc. v. Edward J. King) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Massachusetts Association for Retarded Citizens, Inc. v. Edward J. King, 668 F.2d 602, 1981 U.S. App. LEXIS 15038 (1st Cir. 1981).

Opinion

BOWNES, Circuit Judge.

This case is a late offshoot of five consolidated class actions that challenged on constitutional and statutory grounds the conditions at five schools for the retarded in Massachusetts. The basic actions were settled by consent decrees, but subject to the continuing supervision of the district court. The preliminary injunction that is the focus of this case was precipitated by the passage by the Massachusetts Legislature of a charge-for-care statute, St.1980, c. 329, §§ 44-51, that was intended to increase federal Medicaid reimbursement for services provided to residents at the state schools. The statute accomplishes this by requiring that state school residents who are ineligible for Medicaid because of the amount of their assets become eligible by reducing their assets or putting them beyond their control or paying for their own care. Hitherto, most of plaintiffs, regardless of the amount of their assets, were not charged for care. Because the Commonwealth would receive directly from Medicaid an increase in revenue of approximately 18% for fiscal 1981 and 31% for fiscal 1982, its interest in implementing the charge-for-care statute is obvious.

The district court, on plaintiffs’ petition, issued a preliminary injunction prohibiting *604 defendants from implementing the charge-for-care statute pending a final resolution of plaintiffs’ claims on the merits. Defendants have appealed.

The underlying issue is whether the consent decrees entered in these cases prior to the enactment of the charge-for-care statute overrides the statute and requires defendants to provide care without charge to plaintiffs regardless of the amount of their assets. 1

A short history of the entire litigation and the charge-of-care statute is necessary for an understanding of the case before us. We borrow heavily from the district court’s unpublished opinion in reciting the factual background.

HISTORY OF THE LITIGATION

The first of this five actions was filed in 1972 on behalf of the mentally retarded clients ** at the Belchertown State school. A similar suit was brought two years later on behalf of clients at the Walter E. Fernald State School. In 1975, plaintiffs filed separate class action suits on behalf of clients at the Monson Development Center, the Wrentham State School and the Paul A. Dever School. Defendants in each of these suits are officials of the Commonwealth of Massachusetts responsible for 'the operation of the institutions for the retarded. 2 The five cases were consolidated by order of the district court.

The complaints alleged that conditions at the institutions were constitutionally and statutorily inadequate. The cases were settled prior to trial because the Governor and the Attorney General of the Commonwealth “made a judgment that the level of care did not reach [a] constitutional level of care,” and, as a result, concluded that “the case would be indefensible.” 3

Rather than engage in protracted litigation, the parties agreed to devote their resources and energy to the task of examining each institution in order to identify deficiencies and design practical and effective remedial programs. After hundreds of hours of difficult negotiations, the parties agreed to consent decrees that embodied the parties’ collective assessment of the needs of the clients at the five state schools and the appropriate means of meeting those needs. The consent decrees were approved and appropriately entered by the district court.

The parties also negotiated and agreed to a “Final Decree on Personnel at the Five State Schools for the Mentally Retarded” (Personnel Decree) under which defendants agreed to comply with the personnel standards for care and treatment set forth in Title XIX of the Social Security Act. The district court approved the Personnel Decree on August 2, 1978.

THE CHARGE-FOR-CARE STATUTE

Between 1970 and 1980, the Department of Mental Health (DMH) was statutorily prohibited from charging for the residential care of a person in a mental retardation facility who had reached the age of majority and had been in the care of the DMH for at least five years. Mass.Gen.Laws Ann. ch. 123, § 37 (prior to amendment). 4 Virtu *605 ally every member of the plaintiff class meets these criteria.

Most clients at the state schools are categorically eligible to receive Medicaid benefits by reason of their mental retardation. There are, however, financial eligibility requirements that preclude federal Medicaid assistance for clients with assets in excess of the allowable maximum. In most cases, this amount is $1,500. 5 According to defendants, a significant number of clients at the state schools are currently ineligible for Medicaid benefits because they hold assets in excess of this amount.

Under the joint federal/state Medicaid program, the Commonwealth receives federal reimbursement for approximately one-half the cost of services provided by the state schools. 6 Federal funds have become an important source of revenue for the state schools. In fiscal year 1981, over 95% of the state schools’ revenue (not including state appropriations) was derived from federal reimbursement for Medicaid expenses incurred by the 67% of the state school population then eligible for Medicaid. 7

In early 1980, the Executive Office of Human Services (EOHS) began exploring ways to increase the Commonwealth’s ability to obtain federal reimbursement for the cost of providing care to the mentally retarded clients at the state schools. As a means of achieving this goal, the EOHS participated in the drafting of the “charge-of-care statute,” which was enacted into law as St.1980, c. 329, §§ 44-51 (see Appendix for text of statute). These sections amend portions of Mass.Gen.Laws Ann. chs. 123 and 118E that pertain to charges for care for persons in state institutions for the mentally retarded. The amendments impose full charges for care on all clients of state institutions for the mentally retarded who, because they hold assets in excess of the maximum amount allowable under federal law, are ineligible for federal benefits under Title XVI or Title XIX of the Social Security Act (Medicaid).

Defendants estimate that there are 1603 clients who are potentially subject to charges for care under the statute. 8 The charge to be levied at each institution is to be determined by the state Rate Setting Commission. The rate will reflect both operating and capital costs. 9 According to defendants, the full cost of a client’s care in fiscal year 1981 was between $115.87 and $268.47 per day, or $41,134 to $95,307 per year. 10

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

Related

Ricci v. Okin
770 F. Supp. 2d 438 (D. Massachusetts, 2011)
Converse Inc. v. Reebok International Ltd.
328 F. Supp. 2d 166 (D. Massachusetts, 2004)
Gilday v. Dubois
First Circuit, 1997
Roberto Navarro-Ayala v. Rafael Hernandez-Colon
951 F.2d 1325 (First Circuit, 1991)
Palmigiano v. DiPrete
700 F. Supp. 1180 (D. Rhode Island, 1988)
Harold Williams v. William Lesiak
822 F.2d 1223 (First Circuit, 1987)
Ricci v. Callahan
646 F. Supp. 378 (D. Massachusetts, 1986)
Amf Incorporated v. Raymond L. Jewett
711 F.2d 1096 (First Circuit, 1983)
Elizabeth Lebeau v. Thomas Spirito, Etc.
703 F.2d 639 (First Circuit, 1983)
Brenda Dickenson v. Michael Petit
692 F.2d 177 (First Circuit, 1982)
Lynch v. King
550 F. Supp. 325 (D. Massachusetts, 1982)
David Brewster v. Michael S. Dukakis
687 F.2d 495 (First Circuit, 1982)

Cite This Page — Counsel Stack

Bluebook (online)
668 F.2d 602, 1981 U.S. App. LEXIS 15038, Counsel Stack Legal Research, https://law.counselstack.com/opinion/massachusetts-association-for-retarded-citizens-inc-v-edward-j-king-ca1-1981.