Oscar Salazar v. DC

CourtCourt of Appeals for the D.C. Circuit
DecidedFebruary 8, 2011
Docket10-7031
StatusPublished

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Oscar Salazar v. DC, (D.C. Cir. 2011).

Opinion

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United States Court of Appeals FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued November 15, 2010 Decided February 8, 2011

No. 10-7031

OSCAR SALAZAR, BY HIS PARENTS AND NEXT FRIENDS, ADELA AND OSCAR SALAZAR, ET AL., APPELLEES

v.

DISTRICT OF COLUMBIA AND VINCENT C. GRAY, IN HIS OFFICIAL CAPACITY AS MAYOR OF THE DISTRICT OF COLUMBIA, APPELLANTS

Appeal from the United States District Court for the District of Columbia (No. 1:93-cv-00452)

Richard S. Love, Senior Assistant Attorney General, Office of the Attorney General for the District of Columbia, argued the cause for appellant. With him on the briefs were Peter J. Nickles, Attorney General, Todd S. Kim, Solicitor General, and Donna M. Murasky, Deputy Solicitor General. 2

Kathleen L. Millian argued the cause for appellees. With her on the brief were Bruce J. Terris and Zenia Sanchez Fuentes. Lynn E. Cunningham and Martha J. Perkins entered appearances.

Before: ROGERS and GRIFFITH, Circuit Judges, and EDWARDS, Senior Circuit Judge.

Opinion for the Court by Circuit Judge ROGERS.

ROGERS, Circuit Judge: The District of Columbia appeals the denial of a motion pursuant to Rule 60(b)(6) of the Federal Rules of Civil Procedure to vacate an order on dental services under a settlement agreement regarding medical services for children eligible for Medicaid. The district court ruled that the motion was untimely and, alternatively, that the challenge to its authority to order relief exceeding the federal standards underlying the settlement agreement lacked merit in view of its authority to enforce the agreement. On appeal, the District government contends that the district court erred in dismissing the motion as untimely, and abused its discretion by imposing requirements that exceed the parties’ settlement agreement.

The circumstances do not indicate that the motion to vacate was untimely. In the context of institutional reform litigation, which contemplates ongoing district court proceedings as occurred here, the parties continued to attempt to resolve their differences regarding compliance with the dental order, with the district court’s encouragement. On January 27, 2006, the court- appointed monitor filed a report indicating that goals set by the dental order were unrealistic and a new evaluation was warranted. The District government filed its motion to vacate four months later. Nonetheless, the district court could properly find that the District government failed to show the requisite extraordinary circumstances to warrant relief under Rule 3

60(b)(6). The legal argument that the district court exceeded its authority by requiring the District government to engage in activities to which the parties did not agree and that are not required by federal law could have been raised on appeal from the dental order; the District government noticed an appeal and then withdrew it. Accordingly, we affirm the denial of the Rule 60(b)(6) motion.

I.

This appeal arises in the context of a complex remedial order concerning medical services and assistance provided by the District of Columbia government pursuant to the Medicaid provisions of the Social Security Act, 42 U.S.C. §§ 1396a, 1396d (Chapter 19). On January 22, 1999, the settlement agreement between the plaintiff class (“appellees”) and the District government was approved and entered as an order by the district court. The Settlement Order provides in paragraph 36 that the District government “shall provide or arrange for the provision of early and periodic screening, diagnosis, and treatment (EPSDT) services when they are requested by or on behalf of children.” As relevant, appellees filed two motions to enforce the provisions relating to dental care.

First, on July 3, 2002, appellees moved to enforce Paragraph 36 in part because in 2001 only 30.65% of eligible children received dental services and only 20.55% received preventive dental services. By order entered seven months later, the district court found that the District government was in violation because its own reports showed that “the vast majority of children within the class covered by this litigation who should receive lead blood screening and dental services are not getting them.” Mem. Op. (Feb. 28, 2003) at 1. The District government was ordered to: (1) notify, at least annually, dental care providers of the Medicaid requirements; (2) require each 4

managed care organization to develop a corrective action plan; and (3) mail, by April 15, 2003, to all households in the District of Columbia with one or more Medicaid-eligible children a written notice describing the dental benefits. The district court also ordered the court-appointed monitor to prepare a report by May 15, 2003 evaluating the effectiveness of these efforts.

Second, after the monitor filed his report on June 17, 2003 recommending improved strategies for the broader provision of dental services, appellees again moved to enforce the Settlement Order on April 23, 2004. Six months later, in view of its conclusion the District government had violated Paragraph 36, the district court ordered various remedial measures to increase the rate at which children were receiving dental care. The District government was ordered to: (1) develop a dental periodicity schedule that complies with generally accepted dental standards; (2) develop a corrective action plan for ensuring that all Medicaid-eligible children receive dental services, including increased provider participation, provider training, and outreach; and (3) meet specific participation goals, ranging from 70% to 85%, depending on age, no later than September 30, 2007. Order of Oct. 18, 2004 (“the Dental Order”).

The District government noted an appeal from the Dental Order on November 16, 2004. On January 27, 2005, however, it moved to hold the appeal in abeyance pending its filing a motion in the district court to “dissolve” the Dental Order. Then, on March 15, 2006, the District government moved to dismiss the appeal, which motion was granted, see Order, No. 04-7200 (D.C. Cir. Mar. 15, 2006). The monitor had filed a report on January 27, 2006, pursuant to the district court’s order of September 14, 2005, outlining strategies to enhance access to dental care for Medicaid-eligible children and suggesting that evidence from the several states and the standard of 57% set by 5

the U.S. Department of Health and Human Services indicated that the Dental Order set unrealistic dental utilization rates and should be reevaluated.

Four months later, on May 26, 2006, the District government filed a motion to vacate the Dental Order on the ground that the district court had exceeded its authority. The District government argued: (1) the evidence did not support a finding it had violated the Settlement Order by failing to provide and arrange for appropriate dental services upon request; (2) the remedial relief was not tailored to cure a constitutional or federal law violation; (3) it was placed in the position of being an insurer of dental care under an inequitable strict liability standard; and (4) the relief “[v]astly [e]xceeds the [s]tandards set by the [f]ederal and [l]ocal [a]gencies [a]dministering” the Medicaid program for children’s medical care. Memorandum of Points and Authorities in Support of Defendants’ Motion to Vacate Order Granting Injunctive Relief Dated October 18, 2004 at 3–4, Salazar v.

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