Missouri v. Bowen

813 F.2d 864
CourtCourt of Appeals for the Eighth Circuit
DecidedMarch 2, 1987
DocketNo. 86-1686
StatusPublished
Cited by12 cases

This text of 813 F.2d 864 (Missouri v. Bowen) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Missouri v. Bowen, 813 F.2d 864 (8th Cir. 1987).

Opinion

MAGILL, Circuit Judge.

The State of Missouri appeals from an order of the district court1 granting summary judgment in favor of the Secretary of the Department of Health and Human Services (“DHHS”).2 In granting the Secretary’s motion, the court thus denied Missouri’s claim that the DHHS’ noncompliance with its own regulations — failing to act within the 60-day time period in 45 C.F.R. § 95.511 on a cost allocation plan amendment submitted by Missouri — constituted approval of the amendment. Additionally, the court held that Missouri did not have to exhaust its administrative remedies as a precondition to the court’s hearing of the above claim. For the reasons discussed below, we affirm.

I. BACKGROUND.

A. Statutory and Regulatory Framework.

This case arises under Title IV-E of the Social Security Act, 42 U.S.C. § 670 et seq., which establishes a cooperative state-federal foster care and adoption assistance program for children. In order to participate in the program, the state must submit a plan to the DHHS which meets the criteria set forth in 42 U.S.C. § 671. Missouri, through its Department of Social Services, has participated in the program continuously since its inception.

Under Title IV-E, participating states become eligible to receive federal reimbursement for certain percentages of the program’s operational costs. 42 U.S.C. § 674. Federal payments are made quarterly and are based upon the DHHS’ estimate of the amount of federal financial participation to which the state is entitled. 42 U.S.C. § 674(d).

Because the various categorical assistance programs under the Social Security Act are interrelated, states participating in the Title IV-E program are required to make determinations of the amount of commonly incurred expenses that are attributable to each program in which there is federal participation. This process is known as the “allocation of costs.” Under regulations promulgated by the Secretary, the state must submit a proposed cost allocation plan 3 and any plan amendments to the DHHS’ Division of Cost Allocation (“DCA”). 45 C.F.R. §§ 95.507, 95.509.

After a.plan is submitted, the DCA is required to notify the state of its findings:

The Director, DCA, after consulting with the affected Operating Divisions, shall notify the State in writing of his/her findings. This notification will be made within 60 days after receipt of the proposed plan or amendment and shall either: (1) Advise the State that the plan or plan amendment is approved or disapproved, (2) advise the State of the changes required to make the plan or amendment acceptable, or (3) request the State to provide additional information needed to evaluate the proposed plan or amendment. If the DCA cannot make a determination within the 60-day period, it shall so advise the State.

45 C.F.R. § 95.511(a) (emphasis added).

While a proposed plan or plan amendment is pending, the state may file claims for federal financial participation (“FFP”) based on the pending plan, subject to retro[866]*866active adjustment if the approved plan differs from the proposed plan. 45 C.F.R. § 95.517(a).4

If a state is dissatisfied with the disposition of its plan, it may obtain administrative review on two levels. First, the state may appeal the DCA’s decision to the Regional Director of the DHHS. 45 C.F.R. Part 75. Second, the state may obtain review of the Regional Director’s decision by appealing to the DHHS’ Grant Appeals Board (“GAB”). 45 C.F.R. Part 16.

B. Factual Background.

The dispute in this case centers on a cost allocation plan amendment (the “Amendment”) submitted by Missouri to the DCA on September 25, 1984.5 The Amendment sought significant increases in the amount of federal financial participation in Missouri’s Title IV-E programs, and according to the Secretary, “radically altered the methods in allocating costs between the various state-administered Social Security Act programs.” 6

The Amendment sparked various communications between the parties over the next two months, wherein the DCA requested, and Missouri provided, additional information.7 Despite these oral communications, the DCA did not make a written response to the Amendment until December 20, 1984, 26 days after the 60-day deadline in 45 C.F.R. § 95.511 had expired. The letter was prompted by a December 12, 1984 letter from Missouri, wherein Missouri asserted that the DCA’s noncompliance with the regulation resulted in approval of the Amendment, and that it would begin to file claims under the Amendment, pursuant to 45 C.F.R. § 95.517.8

[867]*867In the December 20 letter, the DCA stated that Missouri could, as it said it would, file claims for federal financial participation pursuant to 45 C.F.R. § 95.517. Additionally, the DCA responded to Missouri’s “deemed approval” theory as follows:

Part 95.511(a) does not specify what happens if the DCA fails to advise the state that a determination will be made within the 60 day period. There were many verbal communications with several of your staff on this amendment. Even if your “assumed” approval is valid, any such approval is based on information provided by the state and is void if the information is found to be materially incomplete or inaccurate. The information provided by the state is incomplete. Please provide the following information and a revised amendment to reflect the following.

Letter from Merle Schmidt, Director of DCA, to Mr. Barnett A. Toan, Director of Missouri Department of Social Services (December 20, 1984).9 The DCA required Missouri to submit the revised amendment containing the requested information by January 23, 1985. However, the parties met in January, after which the DCA sent Missouri a letter suspending the due date and stating that the Amendment would continue to be reviewed as originally submitted.

The parties continued negotiations regarding the Amendment during the next several months.

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