S.R. v. Pa. Dep't of Human Servs.

• Decision Date: 23 March 2018
• Docket Number: 1:17–cv–2332
• Parties: S.R., BY AND THROUGH his next friend, Phillip ROSENBAUER, Theodore Smith, by and through his next friend, Ashley Maddison, S.H., by and through her next friend, Julia Shmilovich, M.T., by and through his next friend, Ashley Maddison, N.C., by and through his next friend, Sue Walther, Chrystal Steward, by and through her next friend, Deborah Fegan, on behalf, of themselves and all others similarly situated, Plaintiffs, v. PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES and Teresa, Miller, in her capacity as Secretary of the Department of Human Services, Defendants
• Court: U.S. District Court — Middle District of Pennsylvania

309 F.Supp.3d 250

S.R., BY AND THROUGH his next friend, Phillip ROSENBAUER, Theodore Smith, by and through his next friend, Ashley Maddison, S.H., by and through her next friend, Julia Shmilovich, M.T., by and through his next friend, Ashley Maddison, N.C., by and through his next friend, Sue Walther, Chrystal Steward, by and through her next friend, Deborah Fegan, on behalf, of themselves and all others similarly situated, Plaintiffs,

v.PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES and Teresa, Miller, in her capacity as Secretary of the Department of Human Services, Defendants,

1:17–cv–2332

United States District Court, M.D. Pennsylvania.

March 23, 2018

Gabriella Labella, Kelly L. Darr, Shanon S. Levin, Disability Rights Network of Pennsylvania, Philadelphia, PA, Jeni Hergenreder, Disability Rights Pennsylvania, Pittsburgh, PA, for Plaintiffs.

Matthew J. McLees, Department of Human Services Office of General Counsel, Harrisburg, PA, for Defendants.

MEMORANDUM & ORDER

John E. Jones III, U.S. District Judge

Presently pending before the Court is the Defendants' motion to dismiss. (the "Motion") (Doc. 15). On April 3, 2018, we granted Plaintiffs' motion for class certification. (Doc. 22). Plaintiffs represent a class of all Pennsylvania youth under the age of 21 who, now or in the future, are adjudicated dependent and have diagnosed mental health disabilities. ("Plaintiffs") (Doc. 22). Plaintiffs bring three claims against Defendants Pennsylvania Department of Human Services ("DHS") and Teresa Miller, as Acting Secretary of the DHS (collectively, Defendants), alleging systemic failures in the Pennsylvania Child Welfare and Medical Assistance programs. (Doc. 1). Defendants filed the instant Motion on February 26, 2018. (Doc. 15). The Motion has been fully briefed and is therefore ripe for our review. (Docs. 16, 18, 25). For the reasons that follow, the Motion shall be denied.

I. BACKGROUND

On December 18, 2017, Plaintiffs commenced this action, by and through their next friends, on behalf of themselves and all others similarly situated. (Doc. 1). On April 3, 2018, we granted Named Plaintiffs' motion for class certification, certifying all three claims within the complaint as class claims on behalf of all Pennsylvania youth under the age of 21 who are adjudicated dependent and diagnosed with mental health disabilities. (Doc. 22). The complaint alleges that DHS has failed to provide the required appropriate services to dependent children with diagnosed mental health disabilities in Pennsylvania. In accordance with the legal standard applicable on a motion to dismiss, the following facts are derived from the complaint.

DHS, through the Child Welfare system and its Office of Medical Assistance Programs ("Medical Assistance"), is responsible for providing appropriate mental health care. (Id. at ¶ 3). The complaint paints a picture of the sad reality for various dependent youths in Pennsylvania. Many dependent children with mental disabilities end up in large, congregate facilities for years while they wait for appropriate placement from DHS. (Id. at ¶ 4). Others end up waiting for months or years in inappropriate settings, such as psychiatric hospitals, juvenile detention facilities, and residential treatment facilities ("RTFs") while they wait for placement from DHS. (Id. at ¶ 5). Each of the named Plaintiffs in this action has been diagnosed with mental health disabilities and has been adjudicated dependent. (Id. at ¶ 9). They are all eligible for medical assistance from DHS. (Id. at ¶ 54).

Plaintiff S.R. is a ten year old dependent child with mental health disabilities. (Id. at ¶ 10). He has been in a RTF waiting for placement from DHS for over three years. (Id. ). His psychiatrist notes "lack of discharge options" as a barrier to his treatment. (Id. at ¶ 10). Though the RTF feels that S.R. has maximized his treatment and plans to discharge him when he has been assigned placement, DHS has not provided an appropriate family or community-based placement for S.R. with adequate services. (Id. ).

Plaintiff Teddy Smith is an eighteen year old with mental illnesses who spent several months unnecessarily in a juvenile detention center awaiting an appropriate placement from DHS. (Id. at ¶ 11). When Smith was moved to a secure state-operated youth development center, he was assaulted by staff within the first two weeks. (Id. ). Plaintiffs S.H., a fifteen year old with mental illnesses, and M.T., a sixteen year old with mental illness, are in the same local juvenile detention center awaiting services from Medical Assistance and a place to live from Child Welfare. (Id. at ¶ 12). Both S.H. and M.T. have been in the juvenile detention center for more than 200 days waiting for appropriate placement and services. (Id. ).

Plaintiff N.C. is a fifteen year old boy diagnosed with mental illness and has bounced around foster care and institutions for years while waiting for appropriate placement from DHS. (Id. at ¶ 13). He was scheduled to be sent to an out-of-state placement on December 13, 2017 because DHS provided no services or placement in Pennsylvania. (Id. ). Plaintiff Chrystal Steward, a nineteen year old diagnosed with mental illnesses, is waiting in a psychiatric hospital for placement. (Id. at ¶ 14). Although she has been ready for discharge for nearly one year, she has not been discharged because DHS has not given her an appropriate placement. (Id. ).

Plaintiffs bring three counts against Defendants, on behalf of themselves and others similarly situated. Counts I and II are brought pursuant to 42 U.S.C. § 1983. (" Section 1983"). In Count I, Plaintiffs allege that Defendants have violated Title XIX of the Social Security Act ("Title XIX" or the "Medicaid Act"), 42 U.S.C. § 1396a(a)(10)(A) and 1396a(a)(43)(C). Title XIX, Section 1396a(a)(10)(A) requires a state plan for medical assistance to "provide for making medical assistance available" to a list of enumerated eligible individuals. Section 1396a(a)(43) requires the state plan to "provide for informing all persons in the State who are under the age of 21 and who have been determined to be eligible for medical assistance ... of the availability of early and periodic screening, diagnostic, and treatment services." Section 1396a(a)(43)(C) requires the plan to provide for arranging those Early and Periodic Screening, Diagnosis and Treatment ("EPSDT") services.

In Count II, Plaintiffs allege that Defendants have violated Title XIX, Section 1396a(a)(8), which requires a state plan for medical assistance to "provide that all individuals wishing to make application for medical assistance under the plan shall have the opportunity to do so, and that such assistance shall be furnished with reasonable promptness to all eligible individuals." In Count III, Plaintiffs allege that Defendants have violated the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12131(2), Section 504 of the Rehabilitation Act (" Section 504" or "RA"), 29 U.S.C. § 794, and their respective implementing regulations. Plaintiffs allege that the Defendants' policies and practices fail to provide them with mental health services in the most integrated setting appropriate, and fail to afford equal access to other services to achieve stability and permanency based on their disabilities or the severity of their disabilities.

Plaintiffs request that the Court "[i]ssue declaratory relief determining that Defendants' actions and omissions as described above violate Title XIX of the Social Security Act, the ADA, and the RA," "[i]ssue injunctive relief requiring Defendants to develop a full array of appropriate Child Welfare and MA services and placements to meet the needs of children with mental illness and behavior health disabilities in the most integrated settings appropriate to their needs," and "[g]rant such other relief as may be appropriate, including awarding reasonable attorneys' fees and costs." (Doc. 1, pp. 41–42).

II. LEGAL STANDARD

In considering a motion to dismiss pursuant to Rule 12(b)(6), courts "accept all factual allegations as true, construe the complaint in the light most favorable to the plaintiff, and determine whether, under any reasonable reading of the complaint, the plaintiff may be entitled to relief." Phillips v. Cty. of Allegheny , 515 F.3d 224, 231 (3d Cir. 2008) (quoting Pinker v. Roche Holdings, Ltd. , 292 F.3d 361, 374 n.7 (3d Cir. 2002) ). In resolving a motion to dismiss pursuant to Rule 12(b)(6), a court generally should consider only the allegations in the complaint, as well as "documents that are attached to or submitted with the complaint, ... and any matters incorporated by reference or integral to the claim, items subject to judicial notice, matters of public record, orders, [and] items appearing in the record of the case." Buck v. Hampton Twp. Sch. Dist. , 452 F.3d 256, 260 (3d Cir. 2006).

A Rule 12(b)(6) motion tests the sufficiency of the complaint against the pleading requirement of Rule 8(a). Rule 8(a)(2) requires that a complaint contain a short and plain statement of the claim showing that the pleader is entitled to relief, "in order to give the defendant fair notice of what the claim is and the grounds upon which it rests." Bell Atl. Corp. v. Twombly , 550 U.S. 544, 555, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007) (quoting Conley v. Gibson , 355 U.S. 41, 47, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957) ). While a complaint attacked by Rule 12(b)(6) motion to dismiss need not contain detailed factual allegations, it must contain "sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’ " Ashcroft v. Iqbal , 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). To survive a motion to dismiss, a civil plaintiff must allege facts that "raise a right to relief above the speculative level...." Victaulic Co. v. Tieman , 499 F.3d 227, 235 (3d Cir. 2007) (quoting Twombly , 550 U.S. at 555, 127 S.Ct. 1955 ). Accordingly, to satisfy the plausibility standard,...