Stogsdill v. Anthony Keck & the S.C. Dep't of Health & Human Servs., C/A No. 3:12-cv-0007-JFA

CourtUnited States District Courts. 4th Circuit. United States District Court of South Carolina
Decision Date10 November 2014
Docket NumberC/A No. 3:12-cv-0007-JFA
PartiesRichard Stogsdill, Nancy Stogsdill, Mother of Richard Stogsdill, Robert Levin, and Mary Self, Mother of Robert Levin, Plaintiffs, v. Anthony Keck and the South Carolina Department of Health and Human Services, Defendants.

Richard Stogsdill, Nancy Stogsdill, Mother of Richard Stogsdill, Robert Levin,
and Mary Self, Mother of Robert Levin, Plaintiffs,
Anthony Keck and the South Carolina Department of Health and Human Services, Defendants.

C/A No. 3:12-cv-0007-JFA


November 10, 2014



This case arises out of the reduction in benefits provided to two Medicaid-eligible individuals and seeks to challenge the policies and procedures in the operation of two Medicaid programs. Richard Stogsdill ("Stogsdill"), Nancy Stogsdill, Mother of Richard Stogsdill, Robert Levin ("Levin"), and Mary Self, Mother of Robert Levin (collectively "Plaintiffs") allege violations of statutory and constitutional due process, violations of the S.C. Administrative Procedures Act, violations of the Americans with Disabilities Act, violations of Section 504 of the Rehabilitation Act, and violations of 42 U.S.C. §§ 1983 and 1985 (Civil Rights) against Anthony Keck ("Keck") and the South Carolina Department of Health and Human Services ("SDHHS") (collectively "Defendants").

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Plaintiffs are Medicaid-eligible disabled adults who have been receiving services under either the South Carolina Intellectually Disabled and Related Disabilities waiver or the Head and Spinal Cord Injury waiver. Waivers are mechanisms within the Medicaid Program that allow participants to receive a mix of services through the South Carolina Department of Disabilities and Special Needs ("SCDDSN"). The waivers allow certain generic requirements of the Medicaid program to be "waived" so states can provide services to Medicaid-eligible participants in ways not allowed under the regular Medicaid program. SCDHHS is the single agency that administers Medicaid in South Carolina. SCDHHS contracts with SCDDSN to administer the day-to-day operations of the waiver programs.

On January 1, 2010, the five (5) year renewal of the waivers, as approved by the Centers for Medicare and Medicaid Services ("CMS") went into effect. The renewed waivers included a cap or limit on some services and completely excluded others. These limits and exclusions form the basis of Plaintiffs' lawsuit.

A. Richard Stogsdill

Prior to the January 1, 2010, waiver changes, Stogsdill was receiving 96 hours of Personal Care Aide and Companion services per week. He also received approximately 36 hours per week of Respite Care. Personal Aide II services consist of hands-on care that a participant requires for daily living, such as bathing, dressing, and toileting. Adult Companion services are similar, except they include an aspect of community integration. Respite Care includes a range of services designed to provide care for the participant when the normal caregiver is absent or needs relief. The January 1, 2010, waiver capped any combination of Personal Aide II services and Adult Companion services at 28 hours per week. Respite Care services under the January 1,

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2010, waiver is typically 68 hours per month, but can be increased up to 240 hours per month under certain circumstances.

Effective January 1, 2010, Stogsdill's Personal Aide II services and Adult Companion Services were reduced to 28 hours per week combined. Respite Care services were limited to 68 hours per month; however, an increase of 172 hours per month of Respite Care was granted following the reductions at the request of Stogsdilll's service coordinator. Stogsdill's Occupational and Speech Therapies were discontinued.1

On Febraury 13, 2009, after Stogsdill's services were reduced, he sought reconsideration by SCDDSN. This request was subsequently denied on March 3, 2009. On April 1, 2009, Stogsdill then appealed the SCDDSN determination to the Appeals Division. The Appeals Division affirmed the reductions on September 14, 2010. This decision was then appealed to the South Carolina Administrative Law Court ("ALC") on October 20. 2010.2 While the appeal was pending at the ALC, the current suit was filed in Federal Court. On March 13, 2013, the ALC issued an order upholding the decision rendered by SCDDSN.3 Subsequently, Stogsdill appealed the ALC decision to the South Carolina Court of Appeals. The Court of Appeals heard oral argument in March of 2014, but at the time of briefing of these motions, had not rendered a decision.

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However, prior to this Court's hearing on the parties' cross motions, a judgment was entered by the South Carolina Court of Appeals4 on several issues pending before this Court. The Court of Appeals ruling (1) affirmed that approval by state regulation was not required to give the waiver's provisions the force and effect of law, (2) affirmed Stogsdill fully exercised his opportunity for a hearing and judicial review, and thus, his due process rights were not violated, (3) reversed the Administrative Law Court's conclusion that Stogsdill's risk of institutionalization was speculative, and (4) under Pashby found SCDHHS failed to establish a fundamental alteration defense. The case was "remanded for consideration of the appropriate services to be provided without the restrictions of the 2010 waiver." Id. at *7. The Court of Appeals has denied both parties' petitions for rehearing. However, according to representations made by counsel at the hearing on this matter, the parties may still seek appellate review of the Court of Appeals' decision by the South Carolina Supreme Court.

B. Robert Levin

Levin receives services under the HASCI waiver. Effective January 1, 2010, Levin's Attendant Care/Personal Services were reduced from 56 hours per week to 49 hours per week. Levin is authorized for 30 hours per year of back up emergency attendant care for use through an agency, should one of his attendants not be available to provide his regularly scheduled care, and he also receives incontinence supplies through both the Medicaid Sate Plan and the HASCI waiver. Subsequent to his reduction in services, Levin never requested reconsideration of this determination, and his caregivers never took an appeal to SCDHHS challenging the reduction.

Plaintiffs' complaint lists six causes of action and seeks both declaratory and injunctive relief. Both parties have moved for summary judgment on all six causes of action, and the Court

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heard oral argument on October 27, 2014. Because subject matter jurisdiction presents a threshold matter, the Court will address it fist.


Subject matter jurisdiction refers to a court's authority to hear a case and can be raised at any time, even sua sponte by the court. United States v. Beasley, 495 F.3d 142, 147 (4th Cir. 2007); Plyler v. Moore, 129 F.3d 728, 732 n. 6 (4th Cir. 1997). Because Federal courts are courts of limited jurisdiction, "they possess only that power authorized by Constitution and statute, which is not to be expanded by judicial decree." Kokkonen v. Guardian Life Ins. Co. of Am., 511 U.S. 375, 377 (1994) (internal citations omitted). Parties cannot bestow federal courts with subject matter jurisdiction by consent. See, e.g., Ins. Corp. of Ireland, Ltd. v. Compagnie des Bauxites de Guinee, 456 U.S. 694, 702 (1982); Roche v. Lincoln Prop. Co., 373 F.3d 610, 621 (4th Cir.2004), rev'd on other grounds, 546 U.S. 81 (2005); City Nat. Bank v. Edmisten, 681 F.2d 942, 945 n. 5 (4th Cir. 1982). Accordingly, "a federal court is obliged to dismiss a case whenever it appears the court lacks subject matter jurisdiction." Fed. R. Civ. P. 12(h)(3); Lovern v. Edwards, 190 F.3d 648, 654 (4th Cir. 1999).

After review of the briefs submitted and the underlying state court proceedings, the Court concludes there are several impediments to exercising subject matter jurisdiction over the claims made by Stogsdill.

A. Declaratory Judgment Act

The Declaratory Judgment Act empowers federal district courts to hear declaratory judgment actions. However, "the operation of the Declaratory Judgment Act is procedural only" in that, "Congress enlarged the range of remedies available in the federal courts but did not extend their jurisdiction. [T]he requirements of jurisdiction—the limited subject matters which

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alone Congress had authorized the District Courts to adjudicate—were not impliedly repealed or modified." Skelly Oil Co. v. Phillips Petroleum Co., 339 U.S. 667, 672 (1950) (internal quotations marks and citations omitted).

Accordingly, "the exercise of jurisdiction under the Federal Declaratory Judgments Act is certainly not compulsory; it is discretionary." Brillhart v. Excess Ins. Co. of Am., 316 U.S. 491, 499 (1942). Federal courts have discretion in deciding whether to hear a declaratory action. Mitcheson v. Harris, 955 F.2d 235, 237 (4th Cir. 1992); See also, 28 U.S.C. § 2201 ("In a case of actual controversy within its jurisdiction, . . . any court of the United States, upon the filing of an appropriate pleading, may declare the rights and other legal relations of any interested party seeking such declaration, whether or not further relief is or could be sought.") (emphasis added). "Consistent with the nonobligatory nature of the remedy, a district court is authorized, in the sound exercise of its discretion, to stay or to dismiss an action seeking a declaratory judgment before trial or after all arguments have drawn to a close. In the declaratory judgment context, the normal principle that federal courts should adjudicate claims within their jurisdiction yields to considerations of practicality and wise judicial administration." Centennial Life Ins. Co. v. Poston, 88 F.3d 255, 257 (4th Cir. 1996) (citing Wilton v. Seven Falls, Co., 515 US 277 (1995)).

Other considerations are especially appropriate when a related state court proceeding is pending at the time the parties to federal litigation request declaratory relief from the district court. In such situations, the federal court should consider whether the controversy "can better be settled in the proceeding...

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