Wood v. Wallace

825 F. Supp. 177, 1993 U.S. Dist. LEXIS 8227, 1993 WL 213290
CourtDistrict Court, S.D. Ohio
DecidedMarch 30, 1993
DocketC-1-92-654
StatusPublished
Cited by1 cases

This text of 825 F. Supp. 177 (Wood v. Wallace) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wood v. Wallace, 825 F. Supp. 177, 1993 U.S. Dist. LEXIS 8227, 1993 WL 213290 (S.D. Ohio 1993).

Opinion

ORDER GRANTING IN PART AND DENYING IN PART DEFENDANTS’ MOTION TO DISMISS AND IN THE ALTERNATIVE FOR SUMMARY JUDGMENT AND GRANTING DEFENDANTS’ MOTION TO CERTIFY FOR INTERLOCUTORY APPEAL

SPIEGEL, District Judge.

This matter is before the Court on the Defendants’ Motion to Dismiss and in the Alternative for Summary Judgement (doc. 15), the Plaintiffs’ Memoranda in Opposition (doc.’s 5 & 17), and the Defendants’ Motion to Certify for Interlocutory Appeal (doc. 16). Due to the complexity of the legislation at the heart of this matter, a hearing was held on March 17, 1993 at which the parties were provided an opportunity to argue the merits of their claims.

BACKGROUND

This case involves the Medicaid Act’s (“The Act”) Medically Fragile Home and Community Based Waiver Program (“The Waiver Program”). 1 42 U.S.C. §§ 1396 et seq., 1396n(c). Medicaid is a cooperative federal-state program through which the Federal Government provides financial assistance to the states so that they may furnish medical care to needy individuals. Although participation is voluntary, participating states must comply with certain requirements imposed by the Act and regulations promulgated by the Secretary of Health and Human Services (“The Secretary”).

The Waiver Program was designed to provide home and community based medical and support services for medically fragile and or severely handicapped children in lieu of hospitalization or other institutionalization. The Plaintiffs, Randy and Diane Wood, have brought this action individually, on behalf of their three year old son Evan, and on behalf of all similarly situated parents and children in the State of Ohio. The Plaintiffs claim that the state has deprived them of their rights under the Act in violation of 42 U.S.C. § 1983, by failing to provide the services required under The Waiver Program.

The Plaintiffs claim, among other things, that the state has failed to reasonably estimate the per capita costs of institutionalization as required by section 1396n(c)(2)(D) of the Act. This, according to the Plaintiffs, resulted in an unjustifiable reduction in the number of hours of community and home based care the state was willing to provide under The Waiver Program. This, the Plaintiffs maintain, has deprived them of their rights under the Act to community and home based care based on reasonable per capita estimates, and is actionable under section 1983.

*179 The Defendants maintain that under the test enunciated in Suter v. Artist M., — U.S. -, 112 S.Ct. 1360, 118 L.Ed.2d 1 (1992) the Waiver Program does not create rights actionable under section 1983. Rather, the requirements placed on -the states under the Act are simple manifestations of congressional preference for a certain kind of conduct, as opposed to a binding obligation. The Act’s Waiver Program provisions, the argument goes, lack the specificity and clarity required to create an enforceable right under section 1983.

Despite the Defendants’ persuasive and thorough analysis of the relevant case law, for the reasons discussed below, we find that consistent with the holdings and reasoning of Suter and Wilder v. Hospital Assn., 496 U.S. 498, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990), the Waiver Program provisions of the Act do create rights actionable under section 1983.

DISCUSSION

I

This case requires the-Court to determine, among other things, whether a stated alleged failure to reasonably estimate the per capita cost of institutionalization under 42 U.S.C. § 1396n(c)(2)(D) implicates a right actionable under section 1983. In 1990, the Supreme Court was called upon to determine whether the Boren Amendment to the Medicare Act, 42 U.S.C. § 1396a(a)(13)(A), was enforceable in an action pursuant to section 1983. Wilder v. Hospital Assn., 496 U.S. 498, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990). The Boren Amendment provides for reimbursement to health care providers according to rates that the “State finds, and makes assurances to the Secretary, are reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated facilities.” 42 U.S.C. § 1396a(a)(13)(A).

In its analysis, the Supreme Court observed that section 1983 provides a cause of action for the deprivation of any rights, privileges, or immunities secured by the Constitution and laws of the United States. Wilder, 496 U.S. at 508, 110 S.Ct. at 2517. The Court continued that because section 1983 speaks in terms of rights, privileges and immunities, and.not violations of federal law, the courts must determine if the statute in question creates a “federal right” enforceable under section 1983. Id. at 509, 110 S.Ct. at 2517. Thus, a plaintiff alleging the violation of. a federal statute may sue under section 1983, unless the statute either does not create an enforceable right, or Congress has foreclosed enforcement of the statute in the enactment itself. Id. at 508, 110 S.Ct. at 2517 (citing Wright v. Roanoke Redevelopment and Housing Authority, 479 U.S. 418, 423, 107 S.Ct. 766, 770, 93 L.Ed.2d 781 (1987)).

In determining whether a statute creates a federal right, the court must determine whether the provision in question was designed to benefit the putative plaintiff. Wilder, 496 U.S. at 509, 110 S.Ct. at 2517 (citing Golden State Transit Corp. v. Los Angeles, 493 U.S. 103, 106, 110 S.Ct. 444, 448, 107 L.Ed.2d 420 (1989)). “If so” the Court continued, “the provision creates an enforceable right unless it reflects merely a ‘congressional preference’ for a certain land of conduct rather than a binding obligation on the governmental unit ... or unless the interest the plaintiff asserts is too ‘vague and amorphous’ such that it is ‘beyond the competence of the judiciary to enforce.’” Wilder, 496 U.S. at 509, 110 S.Ct. at 2517 (citations omitted).

The Court concluded that the Medicaid Act creates an enforceable right under section 1983 for the “adoption of reimbursement rates that are reasonable and adequate to meet the costs of an efficiently and economically operated facility that provides care to Medicaid patients.

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

Related

Martin v. Voinovich
840 F. Supp. 1175 (S.D. Ohio, 1993)

Cite This Page — Counsel Stack

Bluebook (online)
825 F. Supp. 177, 1993 U.S. Dist. LEXIS 8227, 1993 WL 213290, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wood-v-wallace-ohsd-1993.