Trihealth, Inc. v. Board of Commissioners, Hamilton County, Ohio

430 F.3d 783, 2005 U.S. App. LEXIS 27269, 2005 WL 3406473
CourtCourt of Appeals for the Sixth Circuit
DecidedDecember 14, 2005
Docket05-3195
StatusPublished
Cited by192 cases

This text of 430 F.3d 783 (Trihealth, Inc. v. Board of Commissioners, Hamilton County, Ohio) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Trihealth, Inc. v. Board of Commissioners, Hamilton County, Ohio, 430 F.3d 783, 2005 U.S. App. LEXIS 27269, 2005 WL 3406473 (6th Cir. 2005).

Opinion

OPINION

McKEAGUE, Circuit Judge.

This action presents a challenge to Hamilton County’s distribution of public funds for provision of indigent health care services. The County’s actions are alleged, by certain health care providers who have not received such funds, to have resulted in a denial of their due process and equal protection rights. The district court awarded summary judgment to the defendants. TriHealth, Inc. v. Board of Com’rs, 347 F.Supp.2d 548 (S.D.Ohio 2004). The plaintiffs now appeal. For the reasons set forth below, we affirm.

I. FACTUAL AND PROCEDURAL BACKGROUND

Since 1966, the voters of Hamilton County, Ohio, have used a series of tax *786 levies, each covering a five-year period, to fund delivery of health care services to indigent county residents. The most recent such Hamilton County Health and Hospitalization Tax Levy was approved by the voters in November 2001. Defendant Board of County Commissioners thereafter entered into an Agreement Regarding Use of Hamilton County Health and Hospitalization Tax Levy Proceeds (“Agreement”) with defendants University of Cincinnati, University Hospital, Inc., and Children’s Hospital Medical Center for the period January 1, 2002, to December 31, 2006. The Agreement provides for a continuation of the pre-existing relationship, whereby tax levy funds designated for indigent patient health care services (amounting to approximately $42 million per year) are distributed through the University of Cincinnati to University Hospital (80 percent) and Children’s Hospital (20 percent) in reimbursement for services rendered to the indigent and uninsured.

In unanimously approving the 2002 Agreement, the three-member Board of Commissioners rejected the request by other local health care providers, plaintiffs TriHealth, Inc., Good Samaritan Hospital and Bethesda North Hospital (referred to collectively as “TriHealth”), to “share” the levy funds among other Hamilton County hospitals as well. Although the “sharing” proposal was given serious consideration as an equitable approach, the comments of the Commissioners at the September 18, 2002, meeting in which the Agreement was approved reflect apprehension about the administrative difficulties and expenses associated with such a change. Recognizing that health care in the greater Cincinnati area was in a state of economic crisis, and concerned that increased administrative expenses would result in a reduction of funds available for actual delivery of health care, the Commissioners opted to retain the status quo. They decided to distribute the levy proceeds to the two hospitals with which the County had had long-term successful relationships, the two hospitals that undisputedly had been the predominant providers of indigent care in Hamilton County. “Sharing” was rejected in part for lack of information regarding its ultimate impact.

The Board reached its decision only after significant consultation and deliberation, a process in which TriHealth actively participated. An independent Tax Levy Review Committee conducted public hearings and received the report of consultant Jefferson Wells International. Despite the recommendation of Jefferson Wells that the County “consider” providing levy funds to all qualified health systems that provide indigent care, the Committee ultimately voted five to four against sharing until more information were made available. The Board’s approval of the Agreement was thus consistent with the recommendation of a majority of the Committee members, as well as the recommendation of the County Administrator.

Within three months, the TriHealth plaintiffs commenced this action. In relevant part, their amended complaint sets forth two federal civil rights claims under 42 U.S.C. § 1983, for infringement of their due process and equal protection rights; and a state law claim, alleging the Board’s approval of the Agreement is violative of competitive bidding requirements under Ohio law.

In the equal protection claim, TriHealth alleges the Board, by awarding the adult indigent care funds exclusively to University Hospital, unlawfully discriminated against other similarly situated hospitals without rational basis. 1 The district court *787 determined first that TriHealth had failed to state a valid equal protection claim. Second, the court held that even if a valid claim were deemed to have been stated, the evidence was insufficient as a matter of law to substantiate a finding either that the TriHealth hospitals were similarly situated to University Hospital or that every conceivable rational justification for the Board’s decision had been disproved.

In the due process claim, TriHealth alleges that hospitals denied the right to compete for a share of the levy proceeds were denied due process. The district court concluded that TriHealth had failed to establish the existence of a constitutionally protected property interest. For purposes of its analysis, the district court assumed, without actually resolving the question, that the Board was required by Ohio law to apply the competitive bidding process in awarding the contract. Even then, the court concluded that the Board would still have retained discretion to award the contract as it saw fit. Consequently, TriHealth would not have had a legitimate claim of entitlement to the contract, but only a unilateral expectation, which is insufficient to make out a protected property interest.

Accordingly, the district court awarded summary judgment to the Board on both of TriHealth’s federal civil rights claims. The court dismissed TriHealth’s remaining state law claim without prejudice, as it declined to exercise continuing supplemental jurisdiction. Subsequently, TriHealth filed suit in the Hamilton County Court of Common Pleas in pursuit of its state law remedies, TriHealth, Inc. v. Board of Com’rs, No. A-0501396, which action is still pending. 2 In addition, TriHealth now appeals the district court’s summary judgment ruling on both civil rights claims.

II. ANALYSIS

A. Standard of Review

The court of appeals reviews de novo an order granting summary judgment. Johnson v. Karnes, 398 F.3d 868, 873 (6th Cir.2005). Summary judgment is proper “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Fed.R.Civ.P. 56(c). The court must view the evidence in the light most favorable to the non-moving party and draw all reasonable inferences in its favor. Id. Not just any alleged factual dispute between the parties will defeat an otherwise properly supported motion for summary judgment; the dispute must present a genuine issue of material fact. Leadbetter v. Gilley,

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Bluebook (online)
430 F.3d 783, 2005 U.S. App. LEXIS 27269, 2005 WL 3406473, Counsel Stack Legal Research, https://law.counselstack.com/opinion/trihealth-inc-v-board-of-commissioners-hamilton-county-ohio-ca6-2005.