Westside Mothers v. Haveman

• Decision Date: 26 March 2001
• Docket Number: No. 99-CV-73442-DT.,99-CV-73442-DT.
• Citation: 133 F.Supp.2d 549
• Parties: WESTSIDE MOTHERS, et al., Plaintiffs, v. James K. HAVEMAN, et al., Defendants.
• Court: U.S. District Court — Eastern District of Michigan

133 F.Supp.2d 549

WESTSIDE MOTHERS, et al., Plaintiffs, v. James K. HAVEMAN, et al., Defendants.

No. 99-CV-73442-DT.

United States District Court, E.D. Michigan, Southern Division.

March 26, 2001.

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Marilyn T. Mullane, Susan McParland Nash, Michigan Legal Services, Detroit, MI, Jennifer Clarke, Jacob Kobrick, Michael Doluisio, Robin Sumner, Dechert, Price & Rhoads, Thomas Gilhool, Philadelphia, PA, Lourdes Rivera, Jane Perkins, National Health Law Program, Los Angeles, CA, for Plaintiffs.

Erica W. Marsden, Michigan Dept. of Atty. Gen., Social Services Div., Lansing, MI, for Defendant.

Jeffrey S. Sutton, Jones, Day Reavis & Pogue, Columbus, OH, Howard C. Nielson, Jr., Jones, Day, Reavis & Pogue, Washington, DC, for Movant.

OPINION AND ORDER DENYING PLAINTIFFS' MOTION TO CERTIFY CLASS, AND GRANTING DEFENDANTS' MOTION TO DISMISS

CLELAND, District Judge.

I. Introduction

In this case, Plaintiffs' stated goal is to ensure that economically disadvantaged children throughout the State of Michigan obtain adequate medical care. The court can safely say that the endeavor is commendable. Having a virtuous goal in sight, however, does not endow a court with the power to hear a case, nor create a cause of action where none exists. In this case, neither jurisdiction nor a cause of action obtains.

Plaintiffs seek injunctive relief and the appointment of a special master to end the State of Michigan's ("Michigan" or "the State") alleged systemic deprivation of Early and Periodic Screening, Diagnosis, and Treatment Services ("EPSDT services"), which is part of the State's Medicaid or "Medical Assistance" program. The named plaintiffs are two organizations,¹ Families on the Move and Westside Mothers, and eight putative class representatives.² The named defendants are two State officials purportedly responsible for administering Michigan's EPSDT services; however, because the State of Michigan is the entity actually responsible for providing the contested EPSDT services, the court will refer to Michigan as the defendant. Plaintiffs bring their case under 42 U.S.C. § 1983, claiming that Michigan has failed to provide EPSDT services mandated by 42 U.S.C. § 1396, et seq., to the class of all Michigan children eligible for those services.

On November 9, 1999, Michigan moved for dismissal or, alternatively, for summary judgment, which both parties then addressed in written briefs. On December 21, 1999, the court sua sponte ordered the parties to further address in briefing certain threshold issues not raised in the initial round of briefing pertaining to the nature of the relationship between the federal government and the State under the Medicaid program, the plaintiffs' standing under § 1983 to bring suit against Michigan, and whether Michigan was legally amenable to suit. A second round of briefing ensued. Finding the State's discussion of these issues to be less than fully satisfactory, the court invited and accepted the participation of the Michigan Municipal League ("the League") as amicus curiae to address the issues raised by the court.³ Based upon the League's participation, a third round of briefing occurred, culminating in a hearing on August 14, 2000. At the hearing, Michigan adopted all of the League's arguments as its own, and the court will treat them as such in this order.

Given the length and complexity of the matters considered, a summary of the Court's opinion is in order. Plaintiffs' suit raises, in essence, two threshold issues that must be addressed before the court may consider the merits of their claims. First, does the court have jurisdiction over this suit, which is directed in substance at the State of Michigan, an entity that is ordinarily immune from suit? Second, even if such jurisdiction exists, is there a cause of action permitting plaintiffs to sue in the State or its officers in order to enforce the rights asserted? The court's review of these questions indicates that both are to be answered in the negative. The court's analysis is organized as follows:

Part II of this opinion provides an overview of the Medicaid EPSDT program at issue in this litigation. Part III explains the constitutional dimension of the Federal government's and Michigan's relationship under the Medicaid program, and why that relationship is necessarily contractual under the Constitution's Spending Clause. In Part IV, the court explains that it lacks jurisdiction over this case because Michigan is the real defendants, and therefore possesses sovereign immunity against suit. Plaintiffs' attempt to circumvent that immunity under the Ex parte Young by suing Michigan's officers fails for at least four different reasons, each of which is separately explained. Even assuming that Ex parte Young was applicable to the instant case, Part V explains that § 1983 does not create a cause of action to sue states or their officers under Spending Power programs, and that the statute also does not operate as an independent means by which sovereign immunity may be overcome if Ex parte Young is unavailable. Three distinct reasons concerning the interpretation of § 1983 foreclose its use as envisioned by plaintiffs, and each is discussed in Part V. Plaintiffs' assertions that the court's analyses are foreclosed by prior jurisprudence concerning Spending Clause programs are addressed in Part VI; a handful of other issues are discussed in Part VII; and the court's conclusion is found in Part VIII.

II. Background

The Supreme Court has described the Medicaid program at issue in this litigation:

[It] was created in 1965, when Congress added Title XIX to the Social Security Act, 79 Stat. 343, as amended, 42 U.S.C. § 1396 et seq. (1976 ed. and Supp. II) for the purpose of providing federal financial assistance to States that choose to reimburse certain costs of medical treatment for needy persons. Although participation in the Medicaid program is entirely optional, once a State elects to participate, it must comply with the requirements of Title XIX.

Harris v. McRae, 448 U.S. 297, 301, 100 S.Ct. 2671, 65 L.Ed.2d 784 (1980). In other words, a State may either "comply[] with the conditions set forth in the Act or forego[] the benefits of federal funding." Pennhurst State Sch. and Hosp. v. Halderman, 451 U.S. 1, 11, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981) (internal citations omitted) ("Pennhurst I").

The Act creates a "cooperative federal-state program" entitled "Grants to States for Medical Assistance Programs" to provide statutorily-authorized health care services to economically disadvantaged individuals. See 42 U.S.C. § 1396 et seq.; Wilder v. Virginia Hospital Ass'n, 496 U.S. 498, 502, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990). If a State elects to participate in the Medicaid program, it must submit to the Secretary of Health and Human Services ("HHS") a state plan describing the scope of its medical assistance program, which will be administered by the State itself. See 42 U.S.C. § 1396a(b). Upon approval of the plan the Secretary allocates financial grants to help defray its cost. See 42 U.S.C. § 1396b; Harris, 448 U.S. at 308, 100 S.Ct. 2671. Michigan is authorized to participate in the Medicaid program pursuant to §§ 105-112e of the Michigan Social Welfare Act, M.C.L. §§ 400.105-400.112e. As previously mentioned, once a State agrees to participate in the Medicaid program, the requirements of Title XIX and the regulations promulgated thereunder become mandatory and binding upon the state. See Wilder, 496 U.S. at 502, 110 S.Ct. 2510; Boatman v. Hammons, 164 F.3d 286, 288 (6th Cir.1998) (citing 42 C.F.R. § 430.10 and Harris, 448 U.S. at 301, 100 S.Ct. 2671).

A State's plan must provide "assurance that [it] will be administered in conformity with the specific requirements of Title XIX, the regulations [promulgated thereunder] and other applicable official issuances of [HHS]." 42 C.F.R. § 430.10. Michigan's "State Plan Under Title XIX of the Social Security Act," includes such assurances of conformity. From time to time, Michigan submits plan amendments to the Secretary, as described at 42 C.F.R. § 430.12(c), to reflect changes in law or in the State's operation of its Medicaid program.

The Secretary retains the authority to monitor each participating State's performance, and to terminate or limit payments to the state if the Secretary finds less than substantial compliance with any plan provision:

[T]he Secretary shall notify such State agency that further payments will not be made to the State (or, in his discretion), that payments will be limited to categories under or parts of the State plan not affected by such failure, until the Secretary is satisfied that there will no longer be any such failure to comply. Until he is so satisfied he shall make no further payments to such State (or shall limit payments to categories under or parts of the State plan not affected by such failure).

42 U.S.C. § 1396c. The parties to the instant case agree that withholding funds from noncompliant states is the exclusive means by which the federal government may enforce the terms of the program, and that the federal government may not compel compliance through litigation.⁴ Furthermore, the Medicaid statute contains no provision permitting Medicaid-eligible beneficiaries to bring suit against noncompliant states. There are, however, procedures that grant hearings to individuals who believe that they have been wrongfully denied care. To this end, every Medicaid provider in Michigan must incorporate an internal administrative grievance procedure as a condition of its contract with the State. Moreover, Michigan also maintains an administrative hearing mechanism by which Medicaid-eligible individuals can complain to a county department of social welfare about the quality or level of care provided. See M.C.L. §§ 400.37, 400.9. Those administrative decisions may be appealed to the county circuit court. See...