McGhee v. Director Dep't of Health & Mental Hygiene

• Decision Date: 10 October 1997
• Docket Number: Civil No. Y-97-673.
• Citation: 980 F.Supp. 155
• Parties: Mamie McGHEE, et al. v. DIRECTOR, DEPARTMENT OF HEALTH AND MENTAL HYGIENE, et al.
• Court: U.S. District Court — District of Maryland

980 F.Supp. 155

Mamie McGHEE, et al. v. DIRECTOR, DEPARTMENT OF HEALTH AND MENTAL HYGIENE, et al.

Civil No. Y-97-673.

United States District Court, D. Maryland.

October 10, 1997.

William A. Issacson, Washington, DC, Ron M. Landsman, Bethesda, MD, Bruce Vignery, Washington, DC, for Plaintiffs.

Elizabeth M. Kameen, Steven D. Keller, John F. Lessner, Baltimore, MD, for Defendants.

MEMORANDUM OPINION

JOSEPH H. YOUNG, Senior District Judge.

I.

This litigation represents the second attempt of Mamie McGhee ("McGhee") to challenge the implementation of federal Medicaid law regarding the distribution of income between nursing home residents and their spouses who continue to reside in the community, see 42 U.S.C. § 1396r-5, by the Maryland Department of Health and Mental Hygiene and the Prince George's County Department of Social Services (collectively, "the State").¹ The Court dismissed McGhee's first suit without prejudice on ripeness grounds by Memorandum Opinion dated November 13, 1996. McGhee v. Director, Dep't of Health & Mental Hygiene et al., Civil No. Y-96-1913 (Nov. 12, 1996) (Memorandum Opinion) ("McGhee I"). McGhee subsequently filed the instant suit on March 5, 1997.

Most of the facts of this case do not differ from those of McGhee I. On July 19, 1993, William McGhee ("Mr. McGhee"), Mrs. McGhee's husband, who is over eighty years old and suffers from Alzheimer's Disease, was admitted to a nursing home facility in Largo, Maryland. On November 5, 1993, he applied to Maryland for Medicaid coverage of his nursing home care and was granted eligibility effective November 1, 1993. In late 1994, Mrs. McGhee determined that her income was not sufficient to meet her needs.² Instead of applying to Maryland for a Community Spouse Monthly Income Allowance ("CSMIA"), Mrs. McGhee petitioned the Superior Court for the District of Columbia for an income support award from her husband's retirement benefits. On December 2, 1994, the Superior Court issued an order requiring that $956.90 be paid to Mrs. McGhee from her husband's retirement income as a CSMIA.

On December 7, 1994, Mrs. McGhee presented the court order to Maryland and requested that it be implemented as her CSMIA. Case workers handling the request sought information regarding Mrs. McGhee's household expenses. Without providing the information or allowing the request to be processed, Mrs. McGhee initiated an administrative review. After an administrative law judge ruled against her on ripeness grounds, she sought a continuance of further administrative review and filed McGhee I in this Court. After this Court dismissed McGhee I, McGhee appealed the ALJ's decision administratively, and the decision was affirmed on January 17, 1997. Meanwhile, the State had rejected a second application for Maryland Medicaid benefits which included the information sought by the State in the first application. This suit followed, seeking a declaratory judgment that the State, by refusing to give McGhee a $956.90 deduction for a spousal income allowance and by promulgating manuals and internal worksheets relating to spousal income allowances, is violating 42 U.S.C. §§ 1396a(a)(5), 1396r-5, 1396r-5(d) and 42 C.F.R. §§ 430.10 and 435.904. McGhee also seeks attorneys' fees and costs under 42 U.S.C. § 1988.

After McGhee filed this suit, Maryland Administrative Law Judge William J. Sommerville, III delivered an opinion and order on May 30, 1997 regarding McGhee's second application. The ALJ concluded that the local department correctly rejected McGhee's second application for a CSMIA, based on the information she submitted, because she failed to establish her threshold eligibility for a CSMIA. The ALJ concluded, however, that McGhee was "entitled to have the local department consider the D.C. court's support order ... if, and when, the local department first calculates a CSMIA and Recipient's available income...." In essence, the ALJ, relying on the federal statute's language and legislative history, found that the D.C. court's support order represents a minimum CSMIA amount when the local department, considering all the information submitted by McGhee, decides she is eligible for any CSMIA, even if nominal. The ALJ indicated that McGhee was free to reapply for medical assistance benefits at any time.

McGhee has moved for summary judgment, and the State has moved to dismiss, or in the alternative, for summary judgment. Both parties argue that their respective interpretations of the federal statute and regulations mandate a decision in their favor. The State also argues that its sovereign immunity from suit in federal court deprives this Court of subject-matter jurisdiction, relying on the recent Supreme Court case of Seminole Tribe of Florida v. Florida, 517 U.S. 44, 116 S.Ct. 1114, 134 L.Ed.2d 252 (1996), and further maintains that the Court should exercise equitable restraint and decline to hear the case, in accord with the principles announced in Younger v. Harris, 401 U.S. 37, 91 S.Ct. 746, 27 L.Ed.2d 669 (1971). As explained below, however, the Court need not reach the issues raised in the State's motion because subsequent events have rendered this case moot.

II.

A.

In a declaratory judgment action, as in any other action, a case or controversy must exist under Article III of the Constitution before a federal court may grant the requested relief. Muskrat v. United States, 219 U.S. 346, 356, 31 S.Ct. 250, 253, 55 L.Ed. 246 (1911) (unanimous decision); Iron Arrow Honor Soc'y v. Heckler, 464 U.S. 67, 70, 104 S.Ct. 373, 374, 78 L.Ed.2d 58 (1983) (per curiam); Nome Eskimo Community v. Babbitt, 67 F.3d 813, 816 (9th Cir.1995); Natural Resources Defense Council v. Watkins, 954 F.2d 974, 984 (4th Cir.1992); Syndicated Publications, Inc. v. Montgomery County, 921 F.Supp. 1442, 1445 (D.Md.1996). If this case is moot, the Court is without jurisdiction to grant the requested relief because the Court cannot grant a remedy to redress McGhee's injuries. Iron Arrow, 464 U.S. at 70, 104 S.Ct. at 374; Syndicated Publications, 921 F.Supp. at 1445.

In City of Houston v. HUD, 24 F.3d 1421 (D.C.Cir.1994), the court cogently analyzed the availability of declaratory relief against continuing government administrative action when the plaintiff's individual claim is rendered moot. If the plaintiff does not challenge an ongoing policy or practice, but merely attacks the agency's isolated action against the plaintiff, the case is moot unless it falls within an exception to the mootness doctrine. Id. at 1429. If the plaintiff challenges an ongoing agency action, but lacks standing to attack future applications of that policy, the court is unable to award relief. Id. at 1430. Finally, if the plaintiff challenges both specific agency action and an ongoing agency policy or practice, declaratory relief may be granted if the plaintiff has standing to challenge future implementation of the policy, and the claim is ripe for review. Id.

McGhee's well-pleaded complaint seeks this Court's declaration that the State, by refusing to give McGhee a $956.90 deduction for a spousal income allowance and by promulgating manuals and internal worksheets relating to spousal income allowances, is continuously violating 42 U.S.C. §§ 1396a(a)(5), 1396r-5, 1396r-5(d) and 42 C.F.R. §§ 430.10 and 435.904. McGhee thus challenges both the specific actions of the State in her case and the State's continuing practice regarding CSMIAs. The Court may, therefore, exercise jurisdiction to grant declaratory relief if McGhee's individual claim is ripe for review and she has standing to challenge the State's continuing practice.

B.

ALJ Sommerville determined that McGhee, upon establishing her eligibility for a CSMIA, was entitled to a minimum CSMIA of $956.90 based on the D.C. court's order. Accordingly, McGhee's individual claim for relief is not ripe for review because ALJ Sommerville's decision renders her claim moot in this Court. ALJ Sommerville has held that McGhee is entitled to a minimum CSMIA of $956.90 based on the D.C. court's order upon an administrative threshold determination that McGhee is entitled to a CSMIA of any amount. ALJ Sommerville has, in essence, granted McGhee's requested relief by holding that the local department must consider a foreign court's support order in calculating a CSMIA once the department has determined the applicant's eligibility for a CSMIA in any amount. McGhee does not, and cannot, contend that under federal law she is entitled to a $956.90 CSMIA based on the D.C. court's order regardless of whether, as threshold matter, she is entitled to a CSMIA at all under the relevant federal law and state regulation. See 42 U.S.C. § 1396r-5(d)(3) (defining general eligibility for CSMIA); MD.REGS.CODE tit. 10, § 09.24.10(C)(5-7) (same). The ALJ's determination renders McGhee's individual claim moot because it constitutes essentially the same relief requested of this Court, and would render a grant of declaratory relief by this Court nugatory.

Nor has McGhee come forward with evidence tending to show that the facts of this case are "capable of repetition, yet evading review." McGhee bears the burden of introducing evidence demonstrating the applicability of this exception to the mootness doctrine, see City of Los Angeles v. Lyons, 461 U.S. 95, 103 S.Ct. 1660, 75 L.Ed.2d 675 (1983), and she has not demonstrated that the State's allegedly illegal policy will continue if the Court declines to grant declaratory relief. Further, the factual record does not disclose a realistic risk that McGhee will have no effective remedy; indeed, the ALJ's decision grants McGhee essentially the same relief requested in this litigation. Finally, McGhee has not demonstrated that she will be affected if the State were to continue its allegedly illegal practice.³

C.

Although McGhee's individual claim is moot, the Court may entertain a request for declaratory relief regarding the State's future violations if she can...