United States v. Secretary Florida Agency for Health Care Administration

938 F.3d 1221
CourtCourt of Appeals for the Eleventh Circuit
DecidedSeptember 17, 2019
Docket17-13595
StatusPublished
Cited by8 cases

This text of 938 F.3d 1221 (United States v. Secretary Florida Agency for Health Care Administration) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. Secretary Florida Agency for Health Care Administration, 938 F.3d 1221 (11th Cir. 2019).

Opinion

Case: 17-13595 Date Filed: 09/17/2019 Page: 1 of 66

[PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT ________________________

No. 17-13595 ________________________

D.C. Docket No. 0:12-cv-60460-WJZ

UNITED STATES OF AMERICA, Plaintiff-Appellants, versus

STATE OF FLORIDA, Defendant-Appellees. ________________________

Appeal from the United States District Court for the Southern District of Florida ________________________

(September 17, 2019)

Before JILL PRYOR, BRANCH, and BOGGS,∗ Circuit Judges.

Table of Contents ANALYSIS ................................................................................................................5 I. An Overview of Title II of the ADA ......................................................................5 II. The Remedial Structure of Title VI of the Civil Rights Act ...............................12 A. Title VI Enforcement Regulations Contemplate Department of Justice Enforcement Suits ................................................................................................14

∗ Honorable Danny J. Boggs, United States Circuit Judge for the Sixth Circuit, sitting by designation. Case: 17-13595 Date Filed: 09/17/2019 Page: 2 of 66

B. Enforcing Title VI: Any Other Means Authorized By Law ...........................17 III. Section 505 of the Rehabilitation Act ................................................................21 A. Rehabilitation Act Enforcement Regulations Tracked Title VI Regulations .22 B. Department of Justice Enforcement of the Rehabilitation Act .......................27 IV. Enforcement of Title II of the ADA ..................................................................32 A. Title II Enforcement Regulations Follow Regulations Promulgated Under the Rehabilitation Act and Title VI............................................................................33 B. Title II of the ADA Permits Department of Justice Enforcement ..................39 C. The Legislative History of Title II Supports the Attorney General’s Authority to File Suit ............................................................................................................46 D. The Department of Justice Has Filed Suit to Enforce Title II ........................51 E. Federalism Principles Do Not Alter Our Conclusion......................................54 CONCLUSION ........................................................................................................58

BOGGS, Circuit Judge:

In September 2012, after completing a six-month investigation, the

Department of Justice issued a Letter of Findings notifying Florida that it was failing

to meet its obligations under Title II of the Americans With Disabilities Act of 1990

(“ADA”) and its implementing regulations, by “unnecessarily institutionalizing

hundreds of children with disabilities in nursing facilities.” The Department of

Justice also asserted that Florida’s Medicaid policies and practices placed other

2 Case: 17-13595 Date Filed: 09/17/2019 Page: 3 of 66

children who have “medically complex” 1 conditions, or who are “medically

fragile,” 2 at risk of unnecessary institutionalization.

The Department of Justice negotiated with Florida to attempt to resolve the

violations identified in the Letter of Findings. After concluding that it could not

obtain voluntary compliance, the Department of Justice filed suit in the Southern

District of Florida in July 2013, seeking declaratory and injunctive relief under Title

II of the ADA and 28 C.F.R. § 35.130(d).

In December 2013, pursuant to Fed. R. Civ. P. 42(a), the district court

consolidated the Department of Justice’s suit with a previously-filed class-action

complaint from a group of children who similarly alleged that Florida’s policies

1 The Letter of Findings relied on Florida’s then-operative definition of “medically complex.” The term describes “a person [who] has chronic debilitating diseases or conditions of one (1) or more physiological or organ systems that generally make the person dependent upon twenty-four (24) hour-per-day medical, nursing, or health supervision or intervention.” Fla. Admin. Code R. 59G-1.010(164) (2012). Florida has since amended its Administrative Code, and this definition no longer appears. See Fla. Admin. Code R. 59G-1.010. 2 At the time the Letter of Findings was issued, Florida defined “medically fragile” as a person who is:

medically complex and whose medical condition is of such a nature that he is technologically dependent, requiring medical apparatus or procedures to sustain life, e.g., requires total parenteral nutrition (TPN), is ventilator dependent, or is dependent on a heightened level of medical supervision to sustain life, and without such services is likely to expire without warning.

Fla. Admin. Code R. 59G-1.010(165) (2012). This definition no longer appears in Florida’s Administrative Code. See Fla. Admin. Code R. 59G-1.010. 3 Case: 17-13595 Date Filed: 09/17/2019 Page: 4 of 66

caused, or put them at risk of, unnecessary institutionalization and unlawful

segregation on the basis of disability. See A.R. v. Sec’y Fla. Agency for Health Care

Admin., 769 F. App’x 718 (11th Cir. 2019).

Shortly before the consolidation, Florida filed a Motion for Judgment on the

Pleadings, asserting that Title II of the ADA did not authorize the Attorney General

to file suit. The district court denied Florida’s motion, concluding that the

Department of Justice had reasonably interpreted Title II and had the authority to

file suit to enforce Title II. See A.R. v. Dudek, 31 F. Supp. 3d 1363, 1367 (S.D. Fla.

2014).

In 2016, the district court sua sponte revisited the issue3 and dismissed the

Department of Justice’s case because it concluded that the Attorney General lacked

standing to sue under Title II of the ADA. See C.V. v. Dudek, 209 F. Supp. 3d 1279,

1282 (S.D. Fla. 2016). After further litigation, the district court dismissed the

children’s case. This appeal followed.

3 There do not appear to be any significant factual or legal changes between the 2014 decision and the 2016 decision. The consolidated cases were reassigned in 2014, shortly after the district court decided Florida’s Motion for Judgment on the Pleadings. In 2016, the district court justified its departure from the 2014 decision because it concluded that the 2014 decision erroneously applied Chevron U.S.A. Inc. v. Nat. Res. Defense Council, Inc., 467 U.S. 837 (1984), and improperly deferred to the Department of Justice’s interpretation of the statute. See C.V. v. Dudek, 209 F. Supp. 3d 1279, 1291 n.11 (S.D. Fla. 2016). 4 Case: 17-13595 Date Filed: 09/17/2019 Page: 5 of 66

ANALYSIS

This case requires us to determine whether the Attorney General has a cause

of action to enforce Title II of the ADA. This is a purely legal question, requiring

statutory interpretation. Therefore, the proper standard of review is de novo.

Stansell v. Revolutionary Armed Forces of Colombia, 704 F.3d 910, 914 (11th Cir.

I. An Overview of Title II of the ADA

The ADA was intended to “provide a clear and comprehensive national

mandate for the elimination of discrimination against individuals with disabilities,”

and establish strong, enforceable standards to achieve that goal.

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