State of N.Y. v. Heckler
| Decision Date | 07 October 1983 |
| Docket Number | 1531,Nos. 1318,D,s. 1318 |
| Citation | 719 F.2d 1191 |
| Parties | The STATE OF NEW YORK and The New York State Department of Health, Plaintiffs- Appellees, v. Margaret HECKLER, Secretary of the United States Department of Health and Human Services, Defendant-Appellant. MEDICAL AND HEALTH RESEARCH ASSOCIATION OF NEW YORK CITY, INC., etc., et al., Plaintiffs-Appellees, v. Margaret HECKLER, or her successor, Secretary of the Department of Health and Human Services, Defendant-Appellant. ockets 83-6073, 6075. |
| Court | U.S. Court of Appeals — Second Circuit |
Susan M. Campbell, Asst. U.S. Atty., S.D.N.Y., New York City (John S. Martin, Jr., U.S. Atty., S.D.N.Y., Peter C. Salerno, Asst. U.S. Atty., New York City, of counsel), for defendant-appellant.
Deborah Bachrach, Deputy Atty.-in-Chief, Public Advocacy Div., Office of the Atty. Gen. of the State of N.Y., New York City (Robert Abrams, Atty. Gen., State of N.Y., Alan D. Aviles, Asst. Atty. Gen., New York City, of counsel), for plaintiffs-appellees, State of N.Y.
Suzanne Lynn, American Civil Liberties Union, New York City, Janet Benshoof, Nan D. Hunter (Sarah Wunsch, Rhonda Copelon, Center for Constitutional Rights, New York City, Steven R. Shapiro, Madeline Kochen, New York Civil Liberties Union, New York City, of counsel), for plaintiffs-appellees, Medical and Health Research Ass'n of New York City, et al.
Maureen McLeod, Associate Counsel, Health and Hospitals Corp., New York City (Daniel E. Cohen, New York City, of counsel), for Health and Hospitals Corp., amicus curiae.
Paul M. Dodyk, New York City (Cravath, Swaine & Moore, New York City, Ruth J. Katz, Washington, D.C., of counsel), for United States Congressman Henry A. Waxman, amicus curiae.
Patricia Hennessey, Civil Liberties & Public Policy Program, Hampshire College, Amherst, Mass. (Judith Levin, New York City, Rabinowitz, Boudin, Standard, Krinsky & Lieberman, P.C., New York City), for the American Public Health Ass'n, et al., amicus curiae.
Frank Tuplin, Deputy Atty. Gen. of the State of Pa., Pittsburgh, Pa., LeRoy S. Zimmerman, Atty. Gen. of the State of Pa., Philadelphia, Pa. (Jim Mattox, Atty. Gen. of the State of Tex., Mary Keller, Asst. Atty. Gen. of the State of Tex., Austin, Tex., of counsel), for States of Pa., Tex., Alaska, Colo., Conn., Del., Haw., Ia., Mont., N.M., N.J., Vt., W.Va., Wis. and Wyo., amici curiae.
Before FEINBERG, Chief Judge, FRIENDLY and WINTER, Circuit Judges.
The Secretary of the Department of Health and Human Services (the Secretary) appeals from a judgment of the United States District Court for the Southern District of New York, Henry F. Werker, J., granting plaintiffs a permanent injunction against implementation of the Secretary's rules promulgated pursuant to Title X of the Public Health Service Act, 42 U.S.C. Secs. 300 et seq. The rules in question are described in detail below. The most controversial of them, the so-called "squeal rule," requires Title X grantees to notify a parent of an unemancipated minor within ten days after the grantee has provided prescription contraceptives to the minor that the services have been provided. For reasons set forth below, we affirm the judgment of the district court in part, and we reverse in part.
The relevant facts may be briefly stated: In 1970, Congress added Title X to the Public Health Service Act, 42 U.S.C. Secs. 300 et seq., establishing a system of federally funded public and nonprofit private family planning projects. A stated purpose of the Title was "to assist in making comprehensive voluntary family planning services readily available to all persons desiring such services...." Pub.L. No. 91-572, Sec. 2(1). Title X has been amended and refunded several times. In 1978, noting that "the problems of teenage pregnancy have become critical," H.R.Rep. No. 1191, 95th Cong., 2d Sess. 31 (1978), Congress amended Title X specifically to include coverage for "services for adolescents."
In 1981, Congress added the following language to Title X: "To the extent practical, entities which receive grants or contracts under this subsection shall encourage family participation in projects assisted under this subsection." 42 U.S.C. Sec. 300(a). 1 Pursuant to this amendment, the Secretary promulgated the regulations here at issue, to become effective on February 25, 1983. The sole reason asserted by the Secretary for the promulgation of these regulations was the necessity to implement the 1981 amendment to Title X directing grantees to encourage family participation in projects funded by that title. 48 Fed.Reg. 3600, 3601 (1983) ().
The most important change effected by the regulations, which are reproduced in the margin, 2 is the requirement that when prescription drugs or devices are initially provided by a project to an unemancipated minor, the project must within ten working days notify the minor's parent or guardian that the services have been provided. See 42 C.F.R. Sec. 59.5(a)(12)(i)(A). The minor must be informed of the necessity of notification before the provision of these services, and receipt of notification by the parent or guardian must be verified. See id. In addition, the grantee must retain records of all notifications and determinations not to notify, which are to be available to the Secretary upon request. See id. at Sec. 59.5(a)(12)(i)(D). There are two exceptions to the requirement to notify: If the project director or designated clinic head determines that notification will result in physical harm to the minor by the parent or guardian, id. at Sec. 59.5(a)(12)(i)(B), or if services are provided for the treatment of a sexually transmitted disease, id. at Sec. 59.5(a)(12)(i)(E).
The new rules provide for two other changes. The first requires Title X grantees to comply with state laws requiring parental notice or consent with respect to the provision of family planning services to a minor. See 42 C.F.R. Sec. 59.5(a)(12)(i)(E)(ii). The other change is the deletion from 42 C.F.R. Sec. 59.2 of a provision added in 1980, 45 Fed.Reg. 37,436 (1980), that in defining "low income family," an unemancipated minor wishing to receive services on a confidential basis must be considered on the basis of his or her own resources.
On January 26, 1983, two separate actions challenging the legality of the new regulations were filed in the Southern District of New York. Plaintiffs in the first action were the State of New York and its Department of Health (NYSDH). Plaintiffs in the second action included a class of physicians and a private nonprofit corporation formed to assist in developing health facilities in New York City suing on behalf of two of its service divisions and other providers similarly situated. Following oral argument in both cases, Judge Werker denied the Secretary's motion to transfer the cases to the District of Columbia where a similar suit was pending or to stay the New York cases pending disposition in the District of Columbia. On February 14, 1983, following a determination that plaintiffs New York State, NYSDH and the physicians had standing to contest the regulations, Judge Werker preliminarily enjoined their implementation, finding that plaintiffs had demonstrated both irreparable harm and a likelihood of success on the merits. 557 F.Supp. 354.
On the issue of irreparable harm, Judge Werker found, among other things, that plaintiffs had shown that "the deterrent effect of the regulations will cause increased adolescent pregnancies ... [which are] fraught with dangers to the health of both the young mother and her child" and place great socio-economic burdens on the young mother, her family and society at large. See id. at 359. In addition, the court found irreparable harm in the breaching of confidentiality required by adherence to the regulations, and the loss of funding and jobs by Title X grantees that decided not to comply with the regulations. Id. at 359-60. As to likelihood of success on the merits, the court found that the parental notification requirement was illegal since "it contradicts and subverts the intent of Congress," id. at 362, as indicated by Title X and its legislative history. In particular, Judge Werker cited the Conference Committee report on the 1981 amendment, which stated:
The conferees believe that, while family involvement is not mandated, it is important that families participate in the activities authorized by this Title as much as possible. It is the intent of the Conferees that grantees will encourage participants in Title X programs to include their families in counseling and involve them in decisions about services.
H.R.Conf.Rep. No. 208, 97th Cong., 1st Sess. 799, reprinted in 1981 U.S.Code Cong. & Ad.News, 1010, 1161 (Conference Report).
The district court also concluded that the Secretary's redefinition of "low income family" constituted a de facto notice requirement, and it too was therefore held illegal. 557 F.Supp. at 362. Finally, the court found invalid the regulation mandating compliance with state law that required parental notice or consent since the Secretary could not render state law applicable when contrary federal legislation clearly preempts the field. Id. at 362 n. 6, citing Doe v. Pickett, 480 F.Supp. 1218 (S.D.W.Va.1979). 3 Shortly after the preliminary injunction issued, both sides moved for summary judgment. On March 7, 1983, Judge Werker granted plaintiffs' motion for summary judgment and permanently enjoined the Secretary from implementing the regulations. From this judgment, the Secretary appeals.
A few days after Judge Werker had issued his preliminary injunction in New York, the United States District Court for the District of Columbia enjoined the Secretary from implementing or enforcing the regulations. Planned Parenthood Federation of America, Inc. v. Schweiker, 559 F.Supp. 658 (D.D.C.). 4 The appeal from that order was heard on May 9, 1983. O...
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