Salcido ex rel. Gilliland v. Woodbury County, Iowa

• Decision Date: 30 October 2000
• Docket Number: No. C 98-4113-MWB.,C 98-4113-MWB.
• Citation: 119 F.Supp.2d 900
• Parties: Maximo SALCIDO, by his next friend, Amelia GILLILAND, Plaintiff, v. WOODBURY COUNTY, IOWA; Jessie Rasmussen, in her official capacity as Director of the Iowa Department of Human Services; and Thomas L. Vilsack, in his official capacity as Governor of the State of Iowa, Defendants.
• Court: U.S. District Court — Northern District of Iowa

119 F.Supp.2d 900

Maximo SALCIDO, by his next friend, Amelia GILLILAND, Plaintiff, v. WOODBURY COUNTY, IOWA; Jessie Rasmussen, in her official capacity as Director of the Iowa Department of Human Services; and Thomas L. Vilsack, in his official capacity as Governor of the State of Iowa, Defendants.

No. C 98-4113-MWB.

United States District Court, N.D. Iowa, Western Division.

October 30, 2000.

COPYRIGHT MATERIAL OMITTED

Frank Tenuta of Legal Services Corp. of Iowa, Sioux City, IA, for Plaintiff.

Doug Phillips of Klass, Stoik, Mugan, Villone Phillips, Orzechowski, Clausen & Lapierre, L.L.P., Sioux City, IA, for Defendant Woodbury County.

Gordon E. Allen, Deputy Iowa Atty. Gen., Mary W. Vavroch, Asst. Iowa Atty. Gen., Des Moines, IA, for State Defendants, Governor Thomas L. Vilsack and Director Jessie Rasmussen.

MEMORANDUM OPINION AND ORDER REGARDING THE PARTIES' MOTIONS FOR SUMMARY JUDGMENT OR PARTIAL SUMMARY JUDGMENT

BENNETT, Chief Judge.

                TABLE OF CONTENTS
                I. INTRODUCTION ........................................................ ..903
                     A. Factual Background ............................................. ..903
                        1. Salcido's commitment and placements ......................... ..903
                        2. Mental health funding and management ........................ ..905
                     B. Procedural Background .......................................... ..906
                        1. Preliminary matters ......................................... ..906
                        2. The present motions for summary judgment .................... ..907
                II. LEGAL ANALYSIS ..................................................... ..908
                     A. Standards For Summary Judgment ................................. ..908
                     B. Salcido's Procedural Due Process Claim ......................... ..909
                        1. The requirements of a procedural due process claim .......... ..909
                        2. Does Salcido have a protectible interest? ................... ..910
                           a. Sources of liberty interests ............................. ..910
                           b. The parties' arguments ................................... ..910
                           c. Liberty interests of involuntarily committed persons ..... ..912
                              i.   Youngberg v. Romeo .................................. ..912
                              ii.  Youngberg's Eighth Circuit progeny .................. ..913
                              iii. Iowa authorities .................................... ..913
                           d. Salcido's liberty interest ............................... ..915
                        3. Did Salcido receive the process he was due? ................. ..916
                           a. Salcido's interest ....................................... ..917
                           b. The government's interest ................................ ..918
                           c. Risk of erroneous deprivation ............................ ..918
                              i.   Arguments of the parties ............................ ..918
                              ii.  The statutory scheme for involuntary commitment ..... ..919
                                   Adequacy of the notice, hearing, and decision-maker
                iii. provisions on their face ............................ ..923
                                   Adequacy of the notice and hearing procedures
                iv.  actually provided ................................... ..926
                              v.   Impartiality of the decision-maker .................. ..927
                     C. Salcido's Disability Discrimination Claims ..................... ..931
                        1. Disability discrimination by the State Defendants ........... ..932
                

                a. Liability based on plan approval ......................... ..934
                           b. Liability based on refusal to admit ...................... ..934
                        2. Disability discrimination by the County ..................... ..936
                           a. Salcido's "qualification" for services ................... ..936
                           b. Discrimination "by reason of his disability" ............. ..937
                           c. The County's affirmative defense ......................... ..938
                     D. The State Defendant's Cross-Claim Against The County ........... ..939
                        1. Arguments of the parties .................................... ..939
                        2. The County's liability for the costs of Salcido's care ...... ..940
                III. CONCLUSION ........................................................ ..941
                

Who pays? That question often animates legal disputes between private persons or entities, but here it animates a dispute involving an individual who has been involuntarily committed pursuant to Iowa law, his "county of legal settlement," the governor of the state, and the director of the state department of human services. The plaintiff brought this action seeking a determination of whether the state or the county must pay for his placement at a state mental health institute. To compel that determination, the plaintiff has brought claims against the defendants for violation of his constitutional rights to equal protection and substantive and procedural due process, and disability discrimination claims pursuant to the Rehabilitation Act and Title II of the Americans with Disabilities Act. The state officials filed a cross-claim against the county seeking to compel the county to pay for the plaintiff's placement. All of the parties have now filed motions for summary judgment, which may resolve many of the claims at issue, at least in part.

I. INTRODUCTION

A. Factual Background

Although the court provided some factual background to the present dispute in its ruling on a motion to dismiss in September of 1999, see Salcido v. Woodbury County, Iowa, 66 F.Supp.2d 1035 (N.D.Iowa 1999), the parties' factual statements in support of the summary judgment motions presently before the court provide a much more detailed picture. Nevertheless, what is presented here is primarily a statement of the nucleus of undisputed facts and essential factual disputes necessary to put the parties' motions for summary judgment or partial summary judgment in context, rather than an exhaustive dissertation of the undisputed and disputed facts as asserted by the parties.¹

1. Salcido's commitment and placements

Plaintiff Maximo Salcido, who is now 61 years old, was diagnosed in 1998 as suffering from dementia—secondary to multiple etiologies—and a mood disorder. On June 29, 1998, Dr. Davidson of Sioux City Neurology wrote a "To Whom It May Concern" letter in which he noted that Salcido had disinhibited behavior and was very abusive and aggressive, that Salcido's rehabilitation potential was poor, and that he is a danger to himself and others. Consequently, on July 8, 1998, affidavits were prepared by health care professionals pursuant to IOWA CODE CH. 229 alleging that Salcido was seriously mentally impaired and should be immediately taken into custody. The affidavits were filed on July 9, 1998, which commenced the civil commitment proceedings from which the present lawsuit arises.

Based on the affidavits, on July 9, 1998, the hospitalization referee entered an "Order for Immediate Custody Pursuant to Section 229.11, The Code," in which the referee ordered that Salcido be immediately detained at Marian Health Center until a hearing set for July 15, 1998. The referee also appointed attorney Wil Forker to represent Salcido and appointed Dr. P Muller to conduct a personal examination of Salcido to determine whether Salcido was seriously mentally impaired as defined in IOWA CODE § 229.1(14). Following the hearing on July 15, 1998, at which Mr. Forker appeared on behalf of Salcido² and Dr. Muller's report was entered into evidence, the referee found that Salcido was seriously mentally impaired, as defined by the Iowa Code, and was in need of immediate residential treatment as recommended by Dr. Muller. The referee also entered an order noting that Dr. Muller had recommended that, although Salcido remained mentally impaired, he was no longer in need of acute in-patient treatment. Therefore, the referee ordered that Salcido remain at Marian Health Center pending transfer to Clarinda Mental Health Institute (CMHI), a state mental health facility.

Next, on July 27, 1998, the referee ordered Salcido transferred to CMHI. CMHI initially indicated that it would accept Salcido under court order for the next available male bed. However, in late July of 1998, CMHI informed Marian Health Center that it would not accept Salcido, because defendant Woodbury County would not authorize Salcido's placement at CMHI. CMHI reported that the County had informed CMHI that Salcido's placement at CMHI would violate the County's Mental Health Services Management Plan.

An attempt to find state funding for Salcido's placement at CMHI failed when Merit Behavior Corporation, which contracts with the State of Iowa to administer mental health funds, including Title XIX funds, notified Marian Health Center and Salcido on August 4, 1998, that the State would not fund Salcido's placement at CMHI. Merit explained that residential services were not covered by the state's Merit Behavioral Care Mental Health Access Plan. The County contends that neither Salcido nor Marian Health Center pursued a grievance under the procedures afforded by Merit concerning Merit's denial of funding for Salcido's care at CMHI.

Attempts to find an alternative placement for Salcido also failed. The hospitalization referee entered an amended order on August 6, 1998, and an amended and substituted order on August 12, 1998, transferring Salcido from Marian Health Center to a suitable nursing home, skilled nursing home, or Alzheimer's facility. However, on August 27, 1998, Marian Health Center, through counsel, informed the referee that it had contacted eleven facilities, but all had declined to accept Salcido.

At about the same time, renewed attempts were made to obtain funding from the County for Salcido's placement at CMHI. On August 7, 1998, Assistant County Attorney Ann Long sent the referee a letter advising him that Marian Health Center should apply to the County's mental health funding management company, Tri-State Behavioral Health...