Doe 1-13 By and Through Doe, Sr. 1-13 v. Chiles, 96-5144

• Decision Date: 26 February 1998
• Docket Number: No. 96-5144,96-5144
• Citation: 136 F.3d 709
• Parties: Medicare & Medicaid Guide P 46,088, 11 Fla. L. Weekly Fed. C 1071 John/Jane DOE, 1-13 by and through Mr./Mrs. DOE Sr. No.'s 1-13 as natural guardians on behalf of John/Jane Doe 1-13 and on behalf of those similarly situated, Florida Association of Rehabilitation Facilities Incorporated, A Not-For-Profit Association, United Cerebral Palsy of Florida, Incorporated, A Florida Not-for-Profit Corporation, Plaintiffs-Appellees, v. Lawton CHILES, in his official capacity as Governor of the State of Florida, Robert Williams, individually and in his official capacity as Secretary of the Department of Health & Rehabilitative Services of the State of Florida, Gary Clarke, individually and in his official capacity as Assistant Secretary for Medicaid, Department of Health & Rehabilitative Services of the State of Florida, Charles Kimber, in his official capacity as Assistant Secretary for Developmental Services of the Department of Health & Rehabilitative Services, State of Florida, Secretary of the Department of Health and Rehabilitative Services, Edward A. Feaver, in his official capacity, Defendants-Appellants.
• Court: U.S. Court of Appeals — Eleventh Circuit

Page 709

136 F.3d 709

Medicare & Medicaid Guide P 46,088,

11 Fla. L. Weekly Fed. C 1071

John/Jane DOE, 1-13 by and through Mr./Mrs. DOE Sr. No.'s 1-13 as natural guardians on behalf of John/Jane Doe 1-13 and on behalf of those similarly situated, Florida Association of Rehabilitation Facilities Incorporated, A Not-For-Profit Association, United Cerebral Palsy of Florida, Incorporated, A Florida Not-for-Profit Corporation Plaintiffs-Appellees, v. Lawton CHILES, in his official capacity as Governor of the State of Florida, Robert Williams, individually and in his official capacity as Secretary of the Department of Health &amp Rehabilitative Services of the State of Florida, Gary Clarke, individually and in his official capacity as Assistant Secretary for Medicaid, Department of Health &amp Rehabilitative Services of the State of Florida, Charles Kimber, in his official capacity as Assistant Secretary for Developmental Services of the Department of Health &amp Rehabilitative Services, State of Florida, Secretary of the Department of Health and Rehabilitative Services, Edward A. Feaver, in his official capacity, Defendants-Appellants.

No. 96-5144.

United States Court of Appeals, Eleventh Circuit.

Feb. 26, 1998.

Robert A. Butterworth, State Atty. Gen., Chesterfield Smith, Jr., Office of the General Counsel, Tallahassee, FL, Charlie McCoy, Asst. Atty. Gen., Office of the Atty. Gen., Tallahassee, FL, for Defendants-Appellants.

Steven M. Weinger and Helena Tetzeli, Kurzban, Kurzban, Kurzban, Weinger & Tetzeli, P.A., Miami, FL, for Plaintiffs-Appellees.

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

Before HATCHETT, Chief Judge, BARKETT, Circuit Judge, and PROPST ^*, Senior District Judge.

HATCHETT, Chief Judge:

In this action based on 42 U.S.C. § 1983, the district court found that officials of the Florida Department of Health and Rehabilitative Services were failing to furnish Medicaid assistance with "reasonable promptness" to eligible developmentally disabled individuals, and thus were violating a provision of the Medicaid Act, 42 U.S.C. § 1396(a)(8). ¹ Thereafter, the court enjoined the officials from failing to provide the assistance within a "reasonable" time period, not to exceed ninety days. The officials appeal, and, for the reasons stated herein, we affirm the judgment of the district court.

I. BACKGROUND

In March 1992, the plaintiffs-appellees--Medicaid-eligible, developmentally disabled (i.e., mentally retarded) individuals who had been placed on waiting lists for entry into intermediate care facilities for the developmentally disabled ("ICF/DD" or "ICF/MR")--instituted this lawsuit pursuant to section 1983, claiming that the defendants-appellants were causing unreasonable delays regarding the provision of ICF/DD services in violation of section 1396a(a)(8) and the Fifth and Fourteenth Amendments to the United States Constitution. The appellees' class-action complaint alleged that they were not "receiving the therapies, training and other active treatment to which they are entitled by virtue of [their] eligibility for a residential placement in an [ICF]." The complaint further averred that most of the appellees had been waiting for "over five years" for Medicaid services and were "languish[ing] without the training and therapies they so desperately need." ² The appellants do not contest that serious delays have occurred. In fact, in their initial brief to this court, they acknowledge that their practices "resulted in waiting periods of several years." ³ The appellees sought injunctive, declaratory and incidental monetary relief.

Amidst extended pre-trial proceedings, the appellees moved for class certification, and both sides moved for summary judgment. ⁴ On July 22, 1996, the district court granted the appellees summary judgment, holding:

Section 1396a(a)(8) of the Medicaid [A]ct, specifically the reasonable promptness clause, is enforceable under 42 U.S.C. § 1983. "Medical assistance under the plan" has been defined as medical services. The [S]tate is obliged to furnish medical services, however, only to the extent that such placements are offered in the Federal Health Care Financing Agency ("HCFA") approved State plan. Once a state elects to provide a service, that service becomes part of the state Medicaid plan and is subject to the requirements of Federal law.

At oral argument on this issue, Defendants conceded that Florida's [HCFA] State approved plan does provide for placement in ICF/MR facilities. Further, Defendants have not disputed the facts alleging the [S]tate's failure to conform with the provisions set forth in that statute, which the Court construes as an admission of unreasonable delays in placing developmentally disabled persons into ICF/MR facilities.

(Citations and footnote omitted.) ⁵

On August 26, 1996, a magistrate judge signed a report recommending that the district court grant the appellees' motion to certify as a class "all those developmentally disabled persons who have not received prompt [ICF/DD] placement." After conducting a hearing on August 28, 1996, the district court entered final judgment that day, ordering that the appellants "shall, within 60 days of the date of this Order, establish within the State's Medicaid Plan a reasonable waiting list time period, not to exceed ninety days, for individuals who are eligible for placement in ICF/DD."

On September 3, 1996, the appellants filed their notice of appeal. ⁶ On January 6, 1997, the district court denied the appellants' emergency motion to stay the final judgment pending appeal. On January 29, 1997, this court ordered an expedited briefing schedule; denied the appellants' emergency motion for a stay pending appeal as to the named appellees; and granted the appellants' emergency motion for a stay pending appeal as to relief for putative class members.

II. CONTENTIONS

The appellants challenge the district court's determination as to liability on four grounds. According to the appellants: (1) the appellees lack standing to bring this lawsuit; (2) recipients of Medicaid services cannot assert a cause of action under section 1396a(a)(8); (3) section 1396a(a)(8) does not give rise to a federal right enforceable under section 1983; and (4) the Eleventh Amendment bars this action. The appellants also contend that the district court abused its discretion in rendering the injunctive relief it imposed.

We find the appellants' standing argument meritless and unworthy of further discourse. ⁷ Accordingly, part A of the discussion section below addresses the appellants' statutory arguments as to liability; part B assesses the appellants' Eleventh Amendment claim; and part C addresses the appellants' contentions regarding the injunctive relief the district court rendered.

III. STANDARDS OF REVIEW

We review a district court's conclusions of law de novo. DeKalb County Sch. Dist. v. Schrenko, 109 F.3d 680, 687 (11th Cir.) (per curiam), cert. denied, --- U.S. ----, 118 S.Ct. 601, 139 L.Ed.2d 489 (1997). "We review the district court's grant of injunctive relief for abuse of discretion, meaning we must affirm unless we at least determine that the district court has made a clear error of judgment or has applied an incorrect legal standard." SunAmerica Corp. v. Sun Life Assurance Co. of Canada, 77 F.3d 1325, 1333 (11th Cir.) (internal quotation marks and citations omitted), cert. denied, --- U.S. ----, 117 S.Ct. 79, 136 L.Ed.2d 37 (1996).

IV. DISCUSSION

A.

Section 1983 imposes liability on anyone who, acting under color of state law, deprives a person of "any rights, privileges, or immunities secured by the Constitution and laws." 42 U.S.C.A. § 1983 (West Supp.1997). In Maine v. Thiboutot, 448 U.S. 1, 4-8, 100 S.Ct. 2502, 2504-06, 65 L.Ed.2d 555 (1980), the Supreme Court held that section 1983 can be used to vindicate violations of federal statutory rights. See also Golden State Transit Corp. v. City of Los Angeles, 493 U.S. 103, 105, 110 S.Ct. 444, 448, 107 L.Ed.2d 420 (1989) ("As the language of the statute plainly indicates, the remedy encompasses violations of federal statutory as well as constitutional rights."). As the Court recently made clear in Blessing v. Freestone, 520 U.S. 329, ----, 117 S.Ct. 1353, 1359, 137 L.Ed.2d 569 (1997):

In order to seek redress through § 1983, however, a plaintiff must assert the violation of a federal right, not merely a violation of federal law. We have traditionally looked at three factors when determining whether a particular statutory provision gives rise to a federal right. First, Congress must have intended that the provision in question benefit the plaintiff. Second, the plaintiff must demonstrate that the right assertedly protected by the statute is not so "vague and amorphous" that its enforcement would strain judicial competence. Third, the statute must unambiguously impose a binding obligation on the States. In other words, the provision giving rise to the asserted right must be couched in mandatory rather than precatory terms.

(Citations omitted.) See also Wilder v. Virginia Hosp. Ass'n, 496 U.S. 498, 509, 110 S.Ct. 2510, 2517, 110 L.Ed.2d 455 (1990) ("Such an inquiry turns on whether the provision in question was intended to benefit the putative plaintiff. If so, the provision creates an enforceable right unless it reflects merely a congressional preference for a certain kind 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.") (internal quotation marks, citations and brackets omitted); Harris v. James, 127 F.3d 993, 999 & n. 7 (11th Cir.1997); Maynard v. Williams, 72 F.3d 848, 852 (11th Cir.1996). If a statutory provision meets these three factors, a rebuttable presumption "that the right is enforceable under § 1983" arises. Blessing, at ----, 117 S.Ct. at 1360. ⁸

"Medicaid is a...