Reese v. Department of Health & Mental Hygiene

934 A.2d 1009, 177 Md. App. 102, 2007 Md. App. LEXIS 139
CourtCourt of Special Appeals of Maryland
DecidedNovember 2, 2007
Docket514 Sept. Term, 2006
StatusPublished
Cited by7 cases

This text of 934 A.2d 1009 (Reese v. Department of Health & Mental Hygiene) is published on Counsel Stack Legal Research, covering Court of Special Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reese v. Department of Health & Mental Hygiene, 934 A.2d 1009, 177 Md. App. 102, 2007 Md. App. LEXIS 139 (Md. Ct. App. 2007).

Opinion

HOLLANDER, Judge.

The State of Maryland has “long supported the reduction of inpatient psychiatric hospital beds in favor of community-based programs.” Williams v. Wasserman, 164 F.Supp.2d 591, 634 (D.Md.2001) (Blake, J.). Indeed, since the 1970’s, the State’s “deinstitutionalization” of patients diagnosed with mental illness and developmental disabilities “has been dramatic.” Id. In large measure, that change was prompted by advocates for the disabled, based on their view that disabled individuals are entitled to, and would prefer, community treatment in lieu of institutional care. But, as this case demonstrates, not every developmentally disabled person who needs professional care prefers placement in the community. In this appeal, the guardian of a mentally retarded adult complains because the State has declined to institutionalize her ward in a State-run facility for the mentally retarded.

In 2004, Mary L. Reese, appellant, and the late William Massa, 1 as guardians of Virginia Massa, sought to admit Ms. Massa, the mentally retarded daughter of Mr. Massa, to a State-operated intermediate care facility, known as a State residential center (“SRC”). As we shall see, in this case the application process implicated federal and State law.

By letter dated July 19, 2005, S. Anthony McCann, then the Secretary of the Maryland Department of Health and Mental Hygiene (the “Department”), appellee, denied the application, based on his determination that placement in the community was an appropriate, less restrictive alternative. The Department subsequently opposed appellant’s request for a hearing *108 at the Office of Administrative Hearings (“OAH”), at which appellant sought to present evidence as to Ms. Massa’s condition. The Department claimed that the denial of a request for admission to a SRC is not a contested case under the Administrative Procedure Act (“APA”), Md.Code (2004, 2006 Supp.), §§ 10-201 through 10-226 of the State Gov’t. Article (“S.G.”), and therefore there was no entitlement to such a hearing. OAH agreed with the Department and denied the request.

Thereafter, Ms. Reese appealed the OAH decision to the Department’s Board of Review (the “Board”), which upheld OAH by order dated December 12, 2005. She then filed a petition for judicial review in the Circuit Court for Montgomery County. On March 15, 2006, the court granted the Department’s motion to dismiss. This appeal followed.

Appellant presents three issues, which we quote:

1. Whether the State’s policy of preventing individuals with qualifying developmental disabilities from obtaining admission to State Residential Centers (“SRCs”) violates the freedom of choice requirement of the federal Medicaid statute and its implementing regulations.
2. Whether the State has failed to furnish Medicaid services it agreed to provide Ms. Massa with “reasonable promptness” in violation of federal Medicaid law.
3. Whether the State’s interpretation of Md.Code Ann. Health-Gen. Art. § § 7-503 and 7-504, which forecloses any review of the Secretary’s denial of SRC admission, violates Appellant’s due process rights.
For the reasons that follow, we shall vacate and remand.

I. STATUTORY & REGULATORY FRAMEWORK

To understand the facts and the issues, it is helpful to begin with a brief review of the federal and State statutory schemes.

The Medicaid program, established by Title XEX of the Social Security Act, Title 42 U.S.C. § 1396, et seq., is a “jointly funded collaboration” in which the federal and state governments furnish medical services to low income persons who are *109 unable to meet the costs of their own medical care, as well as long-term care for eligible persons. Dept. of Health & Mental Hygiene v. Campbell, 364 Md. 108, 112, 771 A.2d 1051 (2001); see 42 U.S.C. §§ 1396-1396v; Md.Code (1982, 2000 Repl.Vol., 2005 Repl.Vol., 2006 Supp.), § 15-103(a)(2) of the Health-General Article (“H.G.”). Medicaid beneficiaries include low income adults and children, the elderly, and the disabled. 42 U.S.C. § 1396a(a)(10)(A); COMAR 10.09.24.03D(4) (including a disabled person in the list of “Medically Needy”).

State participation in Medicaid is voluntary. Campbell, 364 Md. at 112, 771 A.2d 1051. But, once a state opts to participate, it must operate its program in compliance with federal statutory and regulatory requirements. 42 U.S.C. 1396a(a)(l). A participating state must develop a state Medicaid Plan for the provision of services that the state intends to provide under the program, which is reviewed by the Health Care Financing Administration (“HCFA”). 42 U.S.C. § 1396a. Once HCFA approves the plan, the state is eligible for federal funding. Campbell, 364 Md. at 112, 771 A.2d 1051. When the state implements a plan for medical assistance, the plan becomes mandatory. 42 U.S.C. § 1396a(a)(l).

Maryland has opted to participate in the Medicaid program through the Maryland Medical Assistance Program. Campbell, 364 Md. at 112, 771 A.2d 1051. The program is administered by the Department and overseen at the federal level by the Department of Health and Human Services (“HHS”). 2

According to appellant, Maryland’s State Medicaid Plan indicates that Maryland provides services to eligible retarded persons in an Intermediate Care Facility for the Mentally Retarded (“ICF-MR”). 42 U.S.C. § 1396d(d). 3 ICF-MRs *110 provide residential health and rehabilitative services to mentally retarded individuals under “such standards as may be prescribed by the Secretary [of HSS].” 42 U.S.C. § 1396d(d). 4

Maryland has four ICF-MR facilities, all of which are designated SRCs. See Maryland Health Care Commission, An Analysis and Evaluation of the CON Program (2002). 5 They are operated by the Maryland Developmental Disabilities Administration (“DDA”), an agency within the Department. H.G. §§ 7-201, 7-501.

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

Related

Gray v. Fenton
226 A.3d 395 (Court of Special Appeals of Maryland, 2020)
In the Matter of Meddings
244 Md. App. 204 (Court of Special Appeals of Maryland, 2019)
CCI Entertainment, LLC v. State
81 A.3d 528 (Court of Special Appeals of Maryland, 2013)
Attorney Grievance Commission v. Levin
69 A.3d 451 (Court of Appeals of Maryland, 2013)
BALT. ST. PARKING v. Mayor & City Council of Baltimore
5 A.3d 695 (Court of Special Appeals of Maryland, 2010)
Montgomery v. Housing Authority of Baltimore City
731 F. Supp. 2d 439 (D. Maryland, 2010)
Helms v. State
990 A.2d 629 (Court of Special Appeals of Maryland, 2010)

Cite This Page — Counsel Stack

Bluebook (online)
934 A.2d 1009, 177 Md. App. 102, 2007 Md. App. LEXIS 139, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reese-v-department-of-health-mental-hygiene-mdctspecapp-2007.