Sabree ex rel. Sabree v. Houston, 2:02-CV-03426.

Decision Date17 January 2003
Docket NumberNo. 2:02-CV-03426.,2:02-CV-03426.
Citation245 F.Supp.2d 653
PartiesHasson SABREE, by His Mother and Next Friend, Haba SABREE, et al. v. Feather O. HOUSTON, Official Capacity as Secretary of the Department of Public Welfare of the Commonwealth of Pennsylvania
CourtU.S. District Court — Eastern District of Pennsylvania

Ilene W. Shane, Disabilities Law Project, Stephen A. Whinston, Berger & Montague, Philadelphia, PA, for Hassan Sabree, Catherine Meade, Joseph Frazier, Plaintiffs.

Doris M. Leisch, Office of General Counsel, Philadelphia, PA, John A. Kane, Office of General Counsel, Harrisburg, PA, for Feather 0. Houston, Defendant.

MEMORANDUM AND ORDER

HUTTON, District Judge.

Currently before the Court are Defendant's Motion to Dismiss (Docket No. 3), Plaintiffs' Response in Opposition to Defendant's Motion to Dismiss (Docket No. 7), and Defendant's Reply Memorandum in Support of Defendant's Motion to Dismiss (Docket No. 9).

I. BACKGROUND

Pennsylvania participates in Medicaid, a cooperative federal-state medical assistance program, in which participating states receive federal reimbursement for a portion of its expenditures for medical services provided to eligible persons. The purpose of this program is to provide funds to States to enable those States, "as far as practicable under the conditions in such state[s]," to make Medical Assistance available to elderly, indigent and disabled persons. 42 U.S.C. § 1396. Title XIX requires a state to submit a "State Plan," for approval by the Department of Health and Human Services ("HHS"). Id.; 42 C.F.R. § 430.10. Under this program a State must pay for certain services, and may elect to pay for additional services. See 42 U.S.C. § 1396a(a)(10)(A), (C); 42 C.F.R. §§ 440.210, 440.220. Pennsylvania opted to provide "intermediate care facilities for the mentally retarded" or "ICF/MR" services,1 which provide health and rehabilitative services for people with mental retardation and developmental disabilities.2

The complaint shows that Plaintiffs are seeking to vindicate a right to "small community-based" ICFs/MR. The issue presented in the motion to dismiss is: Does Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396V, confer an enforceable right to small community-based intermediate care facilities for mentally retarded persons ("(ICFs/MR)")? The complaint is replete with allegations of entitlement under Title XIX to small community based ICF/MR services. See Complaint at 112, 21, 32, 40, 64, 66, 70, 71-75.

II. LEGAL STANDARD

A. Federal Rule of Civil Procedure 12(b)(6)

When considering a motion to dismiss a complaint for failure to state a claim under Rule 12(b)(6), the Court must accept as true all facts alleged in the complaint and any reasonable inferences that can be drawn therefrom. Markowitz v. Northeast Land Co., 906 F.2d 100, 103 (3d Cir.1990) (citing Ransom v. Marrazzo, 848 F.2d 398, 401 (3d Cir.1988)); see also H.J. Inc. v. Northwestern Bell Tel. Co., 492 U.S. 229, 249-50, 109 S.Ct. 2893, 106 L.Ed.2d 195 (1989). The legal standard for notice pleading under the Federal Rules is very lenient, requiring that the complaint be construed liberally in the plaintiffs favor. See Wilson v. Rackmill, 878 F.2d 772, 775 (3d Cir.1989); Weston v. Pennsylvania, 251 F.3d 420, 429-30 (3d Cir.2001). A court may only dismiss a complaint where plaintiff can prove no set of facts, consistent with his allegations, which justifies relief.3 See ALA, Inc. v. CCAIR, Inc., 29 F.3d 855, 859 (3d Cir. 1994); Crighton v. Schuylkill County, 882 F.Supp. 411, 414 (E.D.Pa.1995).

The Federal Rules of Civil Procedure do not impose upon a Plaintiff the burden of filing detailed, factually intense pleadings on which the claim is based. See Morse v. Lower Merion Sch. Dist., 132 F.3d 902, 906 (3d Cir.1997). At the same time, the court is not required to credit a plaintiffs "bald assertions" or "legal conclusions" when deciding a motion to dismiss. See Id. The Federal Rules merely require "a short and plain statement of the claim showing that the pleader is entitled to relief," enough to "give the defendant fair notice of what the plaintiffs claim is and the grounds upon which it rests." Fed.R.Civ.P. 8(a)(2) (West 2001).

The issue before the court on a 12(b)(6) motion is not "whether a plaintiff will ultimately prevail but whether the claimant is entitled to offer evidence to support the claims." John Hancock Mutual Life Insurance Co., v. King, Civ.A. No. 96-4983, 1997 WL 373512 (D.N.J. March 26, 1997); City of Pittsburgh v. West Penn Power Co., 147 F.3d 256, 263 (3d Cir.1998) (holding that when deciding a 12(b)(6) motion, the court has an obligation "to view the complaint as a whole and to base rulings not upon the presence of mere words but, rather, upon the presence of a factual situation which is or is not justiciable").

III. DISCUSSION
A. Title XIX

This action concerns Title XIX of the Social Security Act ("Title XIX"), 42 U.S.C. § 1396 et seq., which concerns a federal medical assistance program, commonly referred to as Medicaid. See Elizabeth Blackwell Health Center for Women v. Knoll, 61 F.3d 170, 172 (3d Cir.1995). Under Title XIX, a state receives federal funding in exchange for setting up and operating a program within the parameters established by Congress. See Id.; 42 C.F.R. § 430.0 (1994).

This program is not mandatory upon the States. When a State chooses to participate, however, it must develop its own plan, and have it approved by the Secretary HHS. In order to receive federal funding, a "state's plan must conform, both on its face and as applied, with various federal requirements."

B. 42 U.S.C. § 1983

In Maine v. Thiboutot, 448 U.S. 1, 100 S.Ct. 2502, 65 L.Ed.2d 555 (1980), the Supreme Court established for the first time that § 1983 is available as a remedy for violations of federal statutes as well as constitutional violations. As a predicate to seeking redress under section 1983, a plaintiff "`must assert the violation of a federal right,' and not merely a violation of federal law." Pennsylvania Pharmacists Ass'n v. Houstoun, 283 F.3d 531, 535 (3d Cir.2002) (quoting Golden State Transit Corp. v. City of Los Angeles, 493 U.S. 103, 106, 110 S.Ct. 444, 107 L.Ed.2d 420 (1989)). It follows, therefore, that as prerequisite to proceeding under § 1983 for an alleged violation of a federal statute (1) the statute creates "enforceable rights, privileges, or immunities within the meaning of § 1983" and (2) that Congress has not specifically foreclosed plaintiffs ability to use § 1983 as a vehicle for enforcement of the statute within the enactment itself. Pennsylvania Pharmacists Ass'n, 283 F.3d at 535 (citing Wright v. Roanoke Redevelopment and Housing Auth., 479 U.S. 418, 423, 107 S.Ct. 766, 93 L.Ed.2d 781 (1987)).

C. Spending Power Legislation

The Medicaid Act was enacted by Congress pursuant to its spending power.4 It is well established that Congress may fix the terms under which federal moneys are dispersed to the States. See Pennhurst State School and Hospital v. Halderman, 451 U.S. 1, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981). It is similarly well established that:

In legislation enacted pursuant to the spending power, the typical remedy for State noncompliance with federally imposed conditions is not a private cause of action for noncompliance but rather action by the Federal Government to terminate funds to the State. Id. at 28, 101 S.Ct. 1531 (emphasis added).

Moreover, the legitimacy of the power to condition the dissemination of federal money is based on a State's voluntary and knowing acceptance of Congress' terms.

Since Pennhurst, the Supreme Court has only twice found spending legislation to confer individual rights. See Wright v. Roanoke Redevelopment and Housing Authority, 479 U.S. 418, 107 S.Ct. 766, 93 L.Ed.2d 781 (1987) (permitting a § 1983 suit, finding that Congress spoke in terms that "could not be clearer" and bestowing entitlements sufficiently specific and definite to qualify as enforceable rights under Pennhurst); Wilder v. Virginia Hospital Assn., 496 U.S. 498, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990) (permitting suit where Congress left no doubt if its intent for private enforcement).

More recent Supreme Court cases, however, have refused to infer individual rights from spending legislation. See Gonzaga University v. Doe, 122 S.Ct. at 2274. In the 1992 case, Suter v. Artist M., 503 U.S. 347, 112 S.Ct. 1360, 118 L.Ed.2d 1 (1992), the Supreme Court refused to permit the private enforcement of the Adoption Assistance and Child Welfare Act of 1980 through § 1983. Id. at 363, 112 S.Ct. 1360. The Act required States that received federal funding for adoption programs to create a Plan which would require "reasonable efforts" to keep children out of foster homes. Id. at 358, 112 S.Ct. 1360. Upon examining the statutory language, the Court concluded that the "term `reasonable efforts' in this context is at least as plausibly read to impose a rather generalized duty on the State, to be enforced not by private individuals, but by the Secretary in the manner [of reducing payments]." Id. at 363, 112 S.Ct. 1360.5; see also Gonzaga, 122 S.Ct. at 2274.

In Blessing v. Freestone, 520 U.S. 329, 117 S.Ct. 1353,137 L.Ed.2d 569 (1997), five mothers sought a § 1983 remedy, alleging that State agencies consistently failed to comply with Title IV-D of the Social Security Act, which required States that receive federal funds to "substantially comply" with the conditions designed to ensure prompt payment of child support. Id. at 343, 117 S.Ct. 1353. The court held that the statute did not provide for individual entitlement. Id. "The standard is simply a yardstick to measure the systemwide performance of a State's Title IV-D program." Id. (emphasis in original). As such, the Secretary's function is to assess the "aggregate function of the State," rather than monitoring whether the "needs of any particular person have been satisfied." Id.

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