Salazar v. Dc

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
OSCAR SALAZAR, et al., :
:
Plaintiffs, :
:
v. : Civil Action No. 93-452 (GK)
:
DISTRICT OF COLUMBIA, et al., :
:
Defendants. :
MEMORANDUM OPINION
Plaintiffs are a class of poor children who are eligible for
Medicaid services in the District of Columbia. Pursuant to 42
U.S.C. § 1983, they initiated this action almost two decades ago in
order to ensure that Defendants provide those services. During the
course of this long and difficult litigation, parties were able to
resolve their dispute in the form of a Consent Decree agreed to in
1999. For the past ten years, the Court has overseen Defendants’
compliance with the terms of that Consent Decree.
This matter is now before the Court on Defendants’ Motion to
Terminate Consent Decree and Subsequent Remedial Orders and to
Dismiss the Case (“Defs.’ Mot.”) [Dkt. Nos. 1456, 1481]. Upon
consideration of the Motion, Opposition, Reply, numerous
supplemental briefs and surreplies, and the entire record herein,
and for the reasons stated below, Defendants’ Motion is denied as
to the private right of action issue.
I. BACKGROUND
Prior opinions have described in some detail the lengthy and
complicated history of this case. See, e.g., Salazar v. District
of Columbia, 123 F. Supp. 2d 8 (D.D.C. 2000); Salazar v. District
of Columbia, 954 F. Supp. 278 (D.D.C. 1996) (“Salazar I”). The key
pieces of the narrative are set forth herein.
In their Complaint, Plaintiffs brought seven claims against
the District of Columbia.1 Complaint ¶¶ 103-25. One of
Plaintiffs’ most far-reaching claims was that Defendants had failed
to furnish “early and periodic screening, diagnostic, and
treatment” (“EPSDT”) services, as mandated by the Medicaid program,
42 U.S.C. § 1396a(a)(43). Complaint ¶¶ 120-22. Such a failure,
they claim, is actionable under 42 U.S.C. § 1983.
In 1994, Judge Norma Holloway Johnson, to whom the case was
originally assigned, ruled that Plaintiffs were permitted to bring
six of the seven Medicaid claims under § 1983. See Wellington v.
District of Columbia, 851 F. Supp. 1, 3-6 (D.D.C. 1994).2 The
Court held that “Section 1983 provides a private remedy for all of
the Title XIX provisions except those in [P]laintiffs’ third claim.
1
Three of the allegations in the Complaint were either
resolved before trial or dismissed as a matter of law. Salazar I,
954 F. Supp. at 280 n.4.
2
After Judge Johnson issued this Opinion, the lead
Plaintiff became Salazar.
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All of [P]laintiffs[’] Title XIX claims except Claim III are
sufficient to withstand the motion to dismiss.” Id. at 6.
On July 1, 1994, the case was transferred to this Court [Dkt.
No. 74]. After extensive pre-trial litigation, a seven-day bench
trial was held in 1996, to resolve the dispute over Plaintiffs’
EPSDT claim, as well as three additional claims. At the conclusion
of the trial, a lengthy opinion set forth the Court’s findings of
fact and conclusions of law. Plaintiffs prevailed, under 42 U.S.C.
§ 1983, on each of the four claims that went to trial.3 After the
Court entered remedial orders to effectuate this ruling, Defendants
appealed the judgment.
While the case was proceeding before our Court of Appeals,
parties engaged in settlement negotiations. On September 23, 1998,
those negotiations produced a proposed Settlement Order [Dkt. No.
624]. The next day, parties asked the Court of Appeals to remove
the case from its calendar and requested remand back to this Court.
On January 22, 1999, the Settlement Order was approved by the
Court. Order Modifying the Amended Remedial Order of May 6, 1997
and Vacating the Order of March 27, 1997 (“Settlement Order”) [Dkt.
3
The Court held that Defendants failed to “issue decisions
and provide Medicaid coverage within 45 days after initial
applications are submitted” (Claim 4); “provide advance notice of
the discontinuance or suspension of Medicaid benefits” (Claim 5);
“provide or arrange for the provision of [EPSDT] services to
Medicaid recipients who request such services” (Claim 6); and
failed to “effectively notify individuals of the availability of
EPSDT services” (Claim 7). Salazar I, 954 F. Supp. at 280.
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No. 663]. Since that time, this agreement has governed the case.
There have been various consensual amendments made to the
Settlement Order, as well as Court Orders resolving disputes over
Defendants’ compliance with the Order’s requirements.
In March of 2009, the District of Columbia filed the instant
Motion.4 In it, Defendants argue, inter alia, that Plaintiffs have
no private right of action to enforce the EPSDT provisions under §
1983, and, even if they do, Defendants have achieved compliance
with federal law governing provision of such services. Defs.’ Mot.
at 1-2. On May 26, 2009, the Court concluded, at the suggestion of
Defendants, that “the most efficient way to resolve the
Defendant[s’] pending Motion” would be to first consider the
discrete legal question of whether or not Plaintiffs have a private
right of action to enforce the EPSDT provisions. Order (May 26,
2009) [Dkt. No. 1489]. Accordingly, briefing was conducted on only
this legal issue, and was completed on September 18, 2009.
II. ANALYSIS
Defendants argue that Rule 60(b) provides grounds for vacating
the decision. Their chief argument is that a 2002 Supreme Court
decision, Gonzaga v. Doe, 536 U.S. 273 (2002), represents an
intervening change in law that alters the legal landscape on which
4
On May 20, 2009, Defendants re-filed the entire Motion,
along with a complete set of numerous exhibits, as an Errata Motion
[Dkt. No. 1481]. See Pls.’ Mot. to Take Discovery, at 1 n.1 [Dkt.
No. 1472].
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the Settlement Order rests. Such a significant change, they
maintain, makes Rule 60(b) an appropriate vehicle for re-arguing
whether Plaintiffs have a private right of action to enforce the
EPSDT provisions of Medicaid, a point previously decided in favor
of Plaintiffs. See Wellington, 851 F. Supp. at 6.
Rule 60(b) permits a party to seek relief from a “final
judgment, order, or proceeding” for various reasons. Fed. R. Civ.
P. 60(b). Defendants seek relief under 60(b)(5) and (6). Defs.’
Mot. at 5. Rule 60(b)(5) allows a court to grant relief where “the
judgment has been satisfied, released or discharged; it is based on
an earlier judgment that has been reversed or vacated; or applying
it prospectively is no longer equitable.” Rule 60(b)(6) is a
catch-all provision that permits a court to grant relief for “any
other reason that justifies relief.” The party seeking
modification of a consent decree bears the burden of showing that
“a significant change in circumstances” warrants relief. Rufo v.
Inmates of the Suffolk County Jail, 502 U.S. 367, 383 (1992).
“Modification is an extraordinary remedy, as would be any
device which allows a party--even a municipality--to escape
commitments voluntarily made and solemnized by a court decree.”
Twelve John Does v. District of Columbia, 861 F.2d 295, 298 (D.C.
Cir. 1988) (discussing Rule 60(b)(5)). The district court has
discretion to grant or deny a motion brought under Rule 60(b). See
-5-
id.; see also United Mine Workers of Am. 1974 Pension v. Pittston
Co., 984 F.2d 469, 476 (D.C. Cir. 1993).
A. Defendants Are Time-Barred from Seeking Rule 60(b)
Relief.
A party seeking relief under Rule 60(b)(5) or (6) must do so
“within a reasonable time.” Fed. R. Civ. P. 60(c)(1). This
standard must be applied to the specific facts of each case, after
considering “whether the party opposing the motion has been
prejudiced by the delay in seeking relief and . . . whether the
moving party had some good reason for his failure to take
appropriate action sooner.” 11 Charles A. Wright, et al., Federal
Practice and Procedure, § 2866 (2d ed. 2009); see also Expeditions
Unlimited Aquatic Enterprises, Inc. v. Smithsonian Inst., 500 F.2d
808, 810 (D.C. Cir. 1974); Evans v. Fenty, Civ. No. 76-0293, 2010
WL 1337641, at *27 (D.D.C. Apr. 7, 2010) (“Factors to consider
include ‘the length of the delay, the explanations for the delay,
the prejudice to the opposing party caused by the delay and the
circumstances warranting relief.’”) (citations omitted). In this
case, Defendants filed their Motion in March of 2009. The Supreme
Court issued its opinion in Gonzaga--the asserted basis for
Defendants’ private right of action argument--in June of 2002.
Nearly seven years separate the two dates.
Defendants argue that ongoing enforcement of the decree in the
intervening time has minimized actual prejudice to the Plaintiffs.
Defs.’ Reply to Pls.’ Partial Opp’n to Defs.’ Mot. at 6-7 (“Defs.’
-6-
Reply”) [Dkt. No. 1503]; cf. Order (May 26, 2009) (finding no
prejudice to Plaintiff in bifurcating consideration of Defendants’
Motion to Terminate because “all parts of the consent decree
[would] remain in order”). That may well be true to some extent.
However, underlying the limitation on Rule 60(b) relief are the
important interests of finality and repose. See Randall v. Merrill
Lynch, 820 F.2d 1317 (D.C. Cir. 1987) (noting that 60(b) is “a tool
which trial courts are to use sparingly,” as it is the “mechanism
by which courts temper the finality of judgments with the necessity
to distribute justice”); Summers v. Howard Univ., 374 F.3d 1188,
1193 (D.C. Cir. 2004) (“Under Rule 60(b), a court must balance the
interest in justice with the interest in protecting the finality of
judgments.”). Allowing Defendants to file a motion that strikes at
the legal foundation of a ten-year-old decree, based on an issue
decided seven years ago, surely prejudices Plaintiffs’ interests in
finality and repose.
Courts in this Circuit have found far shorter delays to be
unreasonable. See, e.g., Gilmore v. Hinman, 191 F.2d 652, 652-53
(D.C. Cir. 1951) (concluding that a 60(b) motion filed 16 months
after final judgment was not filed within a reasonable time);
Karim-Panahi v. Washington Metro. Area Transit Auth., Civ. No. 08-
7093, 2008 WL 5460693, at *1 (D.C. Cir. 2008) (finding no abuse of
discretion where district court denied motion as untimely because
filed after 18 months and without justification); see also Emily Q.
-7-
v. Shrewy, 203 Fed. Appx. 35 (9th Cir. 2006) (affirming district
court denial of 60(b) motion on timeliness grounds, as Defendant in
an institutional-reform case waited four years before making
argument based on Gonzaga) (unpublished).
Defendants argue that because the “priorities of public
officials” overseeing the litigation for the District of Columbia
may change from one municipal administration to another, a decision
not to challenge a consent decree entered into by an earlier
administration should not prevent the current administration from
doing so. Defs.’ Reply at 4-6. In this particular case, the
current administration took office in January of 2007. See Elected
Officials, http://www.grc.dc.gov/grc/cwp/view,a,1203,q,447121,pm,
1,grcNav_GID,1424,,grcNav_GID,1421.asp. The current Attorney
General assumed his position in November of 2008, after serving as
Interim Attorney General since January of 2008 and as General
Counsel to the Mayor since January of 2007. See OAG: AG Bio - Peter
Nickles, http://occ.dc.gov/occ/cwp/view,a,3,q,638711.asp. Thus,
over two years passed between this administration’s initial
handling of the case and its decision to file a 60(b) Motion in
March of 2009 based on Gonzaga. Defendants’ asserted excuse is
hardly compelling and does not justify such a delay in filing.
Defendants come perilously close to asserting that the
finality of a case involving a municipality in an institutional-
reform context depends upon the policies and tenure of the
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administration litigating it at any given time. See Defs.’ Reply
at 4-5 (“The ‘reason’ for the asserted ‘delay’ goes to the heart of
the democratic process--the priorities of public officials
responsible for advancing their conceptions of the public interest.
While one administration did not raise the issue, a different
administration, elected by the citizens of the District of Columbia
well after the Gonzaga decision, made the decision to raise this
argument in a filing that simultaneously asserts that the District
is in compliance with the law.”). To read the Rule’s “reasonable
time” requirement to allow a complete change of position with each
election of a new administration would completely undermine the
interests of finality and repose that the Rule is designed to
protect.5
Defendants urge the Court to consider the institutional-reform
context of the litigation and approach the issue with greater
flexibility. Rufo, they maintain, articulates a public interest in
allowing public officials in institutional-reform cases to focus on
“the sound and efficient operation of [the public’s] institutions,”
Rufo, 502 U.S. at 381. Defs.’ Reply at 7-8. Therefore, the delay
in filing--as well as continued enforcement of the Settlement
Order--has actually prejudiced the District of Columbia by
prohibiting it from running its programs as it sees fit. Id. at 8.
5
Indeed, such a reading would undoubtedly prejudice many
interests in a community and raise doubts about whether commitments
made and relied upon could be trusted for the future.
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Tellingly, no such interpretation of the “reasonable time”
requirement is even discussed, no less adopted, in Horne v. Flores,
129 S. Ct. 2579 (2009), a recent Supreme Court case addressing this
issue, or in any other cases relied on by Defendants. In Horne,
the Supreme Court observed that in “institutional reform
litigation,” Rule 60(b)(5) “serves a particularly important
function.” 129 S. Ct. at 2593. The Rule allows courts to re-
examine judgments or orders that “often raise sensitive federalism
concerns.” Id. Accordingly, the Horne Court took care to
emphasize its earlier holding in Rufo that courts should take a
“flexible approach” to Rule 60(b)(5) motions addressing consent
decrees. Id. at 2594-95. However, the Supreme Court also stated
that “[i]t goes without saying that federal courts must vigilantly
enforce federal law and must not hesitate in awarding necessary
relief.” Id. at 2595. The Horne Court went on to explain that the
appropriate inquiry under Rufo “takes the original judgment as a
given and asks only whether ‘a significant change either in factual
conditions or in law’ renders continued enforcement of the judgment
‘detrimental to the public interest.’” Id. at 2596-97.
Defendants cite two appellate decisions from other circuits
that have applied Rufo’s “flexible approach” in considering motions
to vacate. In Shakman v. City of Chicago, 426 F.3d 925 (7th Cir.
2005), the Seventh Circuit held that it was reversible error for a
district court not to factor in the “public nature of the
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litigation in reaching its conclusion that the City’s motion was
untimely.” Id. at 933-34. More recently, the Sixth Circuit upheld
a district court’s ruling that a Rule 60(b) motion brought 30 years
late was timely, because it appropriately considered more than
simply the amount of time which had passed--it looked as well at
the explanations for the delay, the prejudice to the opposing
party, and the circumstances of the case. Doe v. Briley, 562 F.3d
777, 781 (6th Cir. 2009).
These cases, which of course are not binding on this Court,
certainly do not require a conclusion, taking into account the Rufo
factors, that the Motion in this case was filed within a reasonable
amount of time. At most, they counsel courts to take more than a
rigid numerical view of delay in cases that implicate institutional
reform and are of great public concern. See Shakman, 426 F.3d at
933-34; see also Briley, 562 F.3d at 781.
In this case, parties have actively litigated the matter
throughout the time period in question. In the ten years since the
Settlement Order was entered, the Court has issued numerous orders
enforcing the Order’s terms. As was true in Evans, Defendants
“have been in Court continually and repeatedly” since agreeing to
the Settlement Order. Evans, 2010 WL 1337641, at *27. They
cannot, therefore, claim that they were unaware of the “existence
of the [Settlement Order] or its impact.” Id. To the contrary, the
District of Columbia has met regularly with Plaintiffs and the
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Court to narrow issues of dispute and to work through--and around--
bureaucratic stumbling blocks to ensure compliance with the terms
of the Settlement Order. While Defendants have sought to vacate
portions of that Order, they have not, until their filing in 2009,
relied on Gonzaga to attempt to undue the lawsuit by challenging
whether a private right of action exists. To allow Defendants to
do so nearly seven years after that decision was issued would deny
the Plaintiffs their bargained-for interest in finality, and would
put them in a position where judicial decisions made many years ago
could, at any time, be set aside by a different city administration
with different political priorities.
Given the circumstances of this case, and the prejudice that
Plaintiffs would suffer, seven years of delay does, in the Court’s
judgment, fall outside the limits of “flexibility” discussed in
Rufo, and represents an unreasonable time under Rule 60(b).
Therefore, the Court concludes that Defendants did not file their
Motion “within a reasonable time” under Rule 60(b).
B. Even if Defendants’ Motion Is Timely, They Have Not
Satisfied the Requirements of Rule 60(b) by Showing
Either the Existence of Extraordinary Circumstances or a
Significant Change in Law.
Timeliness is only one of the requirements that must be met in
order to justify Rule 60(b) relief. Even if Defendants’ Motion to
Terminate was timely, they would still need to demonstrate that
applying the Settlement Order prospectively is no longer equitable,
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or that “any other reason justifies relief.” Fed. R. Civ. P.
60(b)(5), (6).
1. Rule 60(b)(6) Relief Is Not Appropriate.
The Supreme Court has ruled that relief under Rule 60(b)(6) is
appropriate only in “extraordinary circumstances.” Ackermann v.
United States, 340 U.S. 193, 199 (1950). Our Court of Appeals has
made it clear that “plaintiffs [and presumably Defendants as well]
must clear a very high bar to obtain relief under Rule 60(b)(6).”
Kramer v. Gates, 481 F.3d 788, 791-93 (D.C. Cir. 2007).
Changes in the law, “by themselves[,] rarely constitute the
extraordinary circumstances required for relief” under this
subsection of the Rule. Agostini v. Felton, 521 U.S. 203, 239
(1997). In Gonzales v. Crosby, 545 U.S. 524 (2005), the Supreme
Court held that a “change in the interpretation of the AEDPA
statute of limitations” did not represent such an extraordinary
circumstance. 545 U.S. at 536. Thereafter, our Court of Appeals
interpreted Crosby to mean that “‘extraordinary circumstances’ are
not present when . . . there has been an intervening change in case
law.” Kramer, 481 F.3d at 792. Other courts of appeals have
adopted the same position. See, e.g., Bailey v. Ryan Stevedoring
Co., Inc., 894 F.2d 157, 160 (5th Cir. 1990); McKnight v. United
States Steel Corp., 726 F.2d 333, 336 (7th Cir. 1984); Title v.
United States, 263 F.2d 28, 31 (9th Cir. 1959).
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In this case Defendants’ private right of action argument
rests solely on the assumption that Gonzaga represents a
significant change in intervening law. Defs.’ Mot. at 4-6. As
the case law makes overwhelmingly clear, Rule 60(b)(6) provides no
avenue for relief where the motion is based solely on a change in
intervening law. Therefore, Defendants cannot rely on this section
of the Rule to raise their private right of action argument.
2. Rule 60(b)(5) Relief Is Not Warranted Because
Gonzaga Does Not Represent a Significant Change in
Decisional Law.
Thus, Defendants are left only with Rule 60(b)(5) as a
possible justification for relief. See Defs.’ Mot. at 5 (citing
subsections 60(b)(5) and (6) as sole bases of relief for their
assertion of private right of action argument). According to Rufo,
parties may be entitled to relief under this subsection if they can
show “a significant change either in factual conditions or law.”
502 U.S. at 384. Defendants assert a change only in decisional
law: they insist that Gonzaga rejected the analysis in cases that
this Court relied on when it concluded that Plaintiffs have a
private right of action, a conclusion which went on to serve as one
of the legal bases for Salazar I and the Settlement Order. See
Defs.’ Mot. at 5-6 (citing Wellington, 851 F. Supp. at 3-4).
Plaintiffs deny that Gonzaga represents a significant change in
law, and insist that it merely clarifies prior Supreme Court
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precedent in private right of action cases. Pls.’ Opp’n to Defs.’
Mot. at 11-14 (“Pls.’ Opp’n”) [Dkt. No. 1499].
In Agostini, a Supreme Court case that dealt with the
provision of remedial assistance by public school teachers to
students enrolled in religious schools, the Court’s 60(b)(5)
analysis “hinge[d] on whether [its] later Establishment Clause
cases have so undermined [Aguilar v. Felton, 473 U.S. 402 (1985)]
that it is no longer good law.” 521 U.S. at 217-18. Addressing
the issue in the context of a consent decree, the Supreme Court
stated that “a decision that clarifies the law will not, in and of
itself, provide a basis for modifying a decree.” Rufo, 502 U.S. at
390.
The question, therefore, is whether the 2002 opinion in
Gonzaga sufficiently undermines the validity of those Supreme Court
cases this Court relied upon in Wellington, where it held that a
private right of action exists to enforce Medicaid’s EPSDT
provisions under § 1983, so “that [they are] no longer good law.”
Agostini, 521 U.S. at 217, 18; Wellington, 851 F. Supp at 6
(analyzing 42 U.S.C. §§ 1396a(a)(10)(a) and (a)(43)).
In order to determine whether a private right of action
existed under § 1983, Wellington applied the test set forth in
Wilder v. Virginia Hospital Association, 496 U.S. 498 (1990). See
Wellington, 851 F. Supp. at 3-4 (applying Wilder and Suter v.
Artist M., 503 U.S. 347 (1992)). Wilder required that courts
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inquiring into the existence of a private right of action must
determine if 1) the statutory “provision was intended to benefit
the putative plaintiff”; 2) the statute reflects an unenforceable
“congressional preference for a certain kind of conduct rather than
a[n actionable] binding obligation on the governmental unit”; and
3) the “interest plaintiff asserts is ‘too vague and amorphous’” to
be judicially enforceable. Wellington, 851 F. Supp. at 3 (quoting
Wilder, 496 U.S. at 509-10) (internal citations and quotations
omitted)). The word “benefit” used in Wilder proved to be the
culprit creating much confusion in lower court decisions.
The first of the Supreme Court’s two holdings in Gonzaga
focused on the language used in Wilder and related cases to
determine whether the statute provides an enforceable right.6 See
536 U.S. at 283. Gonzaga aimed to resolve ambiguities within
earlier private right of action cases that the Court admitted had
hardly been “models of clarity.” Id. at 278. The Court did
clarify its precedents by holding that only “an unambiguously
conferred right [will] support a cause of action brought under §
1983.” Id. Because “Section 1983 provides a remedy only for the
deprivation of ‘rights, privileges, or immunities secured by the
6
The Court’s second holding resolved the narrow question
presented in that case, regarding whether nondisclosure provisions
in the Family Educational Rights and Privacy Act (“FERPA”), 20
U.S.C. § 1232g, confer enforceable rights. The Court concluded
that those provisions do not confer such rights. Gonzaga, 536 U.S.
at 287.
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Constitution and laws’ of the United States,” it is “rights, not
the broader or vaguer ‘benefits’ or ‘interests,’ that may be
enforced under the authority of that section.” Id. (emphasis in
original).
Part of the “confusion” that the doctrine created was due to
language from Wilder and a later Supreme Court case, Blessing v.
Freestone, 520 U.S. 329 (1997), both of which dealt with private
rights of action under § 1983. See Gonzaga, 536 U.S. at 282-83.
Both cases suggested that the provision of “benefits,” rather than
the creation of “rights,” might be sufficient to create an
enforceable private right of action. See id.
As noted earlier, Wilder set forth a test in which the key
inquiry was “whether ‘the provision in question was intend[ed] to
benefit the putative plaintiff.’” Wilder, 496 U.S. at 509 (quoting
Golden State Transit Corp. v. Los Angeles, 493 U.S. 103 (1989)).
The Wilder Court concluded that the Boren Amendment to the Medicaid
Act does “create[] a right enforceable by health care providers
under § 1983” because of the “benefits” it conferred upon those
eligible for Medicaid. Id. at 509-10.
In Blessing, the Supreme Court conducted a similar inquiry but
arrived at a different conclusion. It held that Title IV-D of the
Social Security Act, 42 U.S.C. §§ 651-669b, “does not give
individuals a federal right to force a state agency to
substantially comply with” that Title’s provisions. Blessing, 520
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U.S. at 333. Using nearly the same language as Wilder, Blessing
began its analysis by stating “[f]irst, Congress must have intended
that the provision in question benefit the plaintiff.” Blessing,
520 U.S. at 340-41 (emphasis added).
The school teacher who brought suit under FERPA in Gonzaga
attempted to use these two cases to support his argument that a
private right of action is created where a statute merely
“benefits” putative plaintiffs. Gonzaga, 536 U.S. at 282.
However, as the Court discussed, other Supreme Court cases focused
on whether it was a right, rather than a benefit, was created in
order to determine whether a private right of action exists.
The Gonzaga Court examined several of these cases, which held
that for a right to be enforceable under § 1983, that right must be
unambiguously conferred by statutory language. See id. at 279-80.
Pennhurst State School and Hospital v. Halderman, 451 U.S. 1
(1981), “made clear that unless Congress ‘speak[s] with a clear
voice,’ and manifests an ‘unambiguous’ intent to confer individual
rights, federal funding provisions provide no basis for private
enforcement by § 1983.” Gonzaga, 536 U.S. at 280 (quoting
Pennhurst). Similarly, Wright v. Roanoke Redevelopment and Housing
Authority, 479 U.S. 418 (1987), held that tenants could bring a
private lawsuit under § 1983 for violations of the Public Housing
Act where a provision of that statute “conferred entitlements
‘sufficiently specific and definite to qualify as enforceable
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rights under Pennhurst.’” Gonzaga, 536 U.S. at 280 (quoting
Wright). Finally, in Suter, the Court also grounded its inquiry in
“rights” language, and found that the Adoption Assistance and Child
Welfare Act of 1980 did not “unambiguously confer an enforceable
right upon the Act’s beneficiaries.” Gonzaga, 536 U.S. at 281
(quoting Suter).
Gonzaga resolved the confusion in the case law between
“benefits” and “rights” by concluding that the “relatively loose”
“benefits” standard advocated by respondents in that case was
incorrect. The Supreme Court clarified that courts must examine
whether the statute unambiguously conferred a right, instead of
focusing on whether the statute granted benefits. Gonzaga, 536
U.S. at 282-83. In short, the Court clarified the standard to be
applied in determining the existence of a private right of action.
Turning to the instant case, it is clear that Gonzaga does not
represent a significant change in the law applied in Wellington.
First, the Wellington decision did not turn on application of
the “benefits” language that produced the confusion resolved in
Gonzaga. Defendants in this case never contested the issue of
whether Plaintiffs were beneficiaries of Medicaid, under the first
prong of the Wilder test; instead, they argued only that the
statutory provisions in question did not impose a “binding
obligation” on the governmental unit. Wellington, 851 F. Supp. at
3. Because Gonzaga said nothing about this aspect of the Wilder
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test, it does not represent a significant change in the law relied
on in this case which established a private right of action for
Plaintiffs. In sum, Judge Johnson did not rely on the “benefits”
test in determining whether these Plaintiffs had a private cause of
action.
This fact therefore distinguishes Johnson v. City of Detroit,
446 F.3d 614 (6th Cir. 2006), which Defendants argue supports
adoption of a “more rigorous standard” for establishing enforceable
rights under § 1983. Defs.’ Mot. at 7. In that case, the Sixth
Circuit stated that “any cases premised upon a ‘benefits’ analysis
must be reexamined in light of Gonzaga.”7 Johnson, 446 F.3d at
624. Wellington was not based on a “benefits analysis,” and
therefore the Sixth Circuit’s instruction to reexamine such cases
does not apply.
Second, the Supreme Court itself, in Gonzaga, essentially said
that its decision does not represent a significant change in law.
The Court characterized its analysis of the private right of action
question as one designed to “resolve the conflict among the lower
courts and in the process resolve any ambiguity in our own
opinions.” Gonzaga, 536 U.S. at 278. The “ambiguity” that the
Court intended to resolve sprang from “[s]ome language in [its]
opinions [that] might be read to suggest that something less than
7
Johnson also described Gonzaga as having simply
“allay[ed] . . . confusion” in the case law. Johnson, 446 F.3d at
618-19.
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an unambiguously conferred right is enforceable by § 1983.” Id. at
282. The Court clarified that only unambiguously conferred rights
are actionable, thereby dispelling any confusion on the matter.
Id. at 282-83.
In explaining its ruling, the Court in Gonzaga noted that the
Blessing opinion used benefits language alongside language that
focused on whether “rights” were created, thereby producing
confusion. Gonzaga, 536 U.S. at 283. The Wilder decision also
used “benefits” language and “rights” language in crafting its
test, which generated the same confusion as did the language in
Blessing. See Wilder, 496 U.S. at 509-10. Gonzaga merely
clarified that the first prong of these tests requires the right to
be unambiguously conferred: “it is rights, not the broader or
vaguer ‘benefits’ or ‘interests,’ that may be enforced.” Id. at
283 (emphasis in original). The Court did not disturb or limit
Pennhurst or Golden State, upon which Wilder relied in announcing
its test. In addition, it did not abandon Blessing, as discussed
further below.8
Third, many courts which have addressed, in the Medicaid
context, whether or not plaintiffs can enforce a private right of
action for a state’s failure to comply with that statute’s
8
Indeed, after clarifying its analysis, Gonzaga then
relied on Blessing’s reasoning in conducting its analysis of
FERPA’s language, thereby further suggesting that the analysis in
Blessing had not been changed so significantly as to no longer
qualify as good law. See Gonzaga, 536 U.S. at 287-88.
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provisions, have agreed that Gonzaga simply “resolve[d] any
ambiguity in [the Supreme Court’s] own opinions.” Gonzaga, 536
U.S. at 278. The Ninth Circuit, in a post-Gonzaga decision, was
faced with the question of whether 42 U.S.C. §§ 1396a(a)(10) and
(a)(17) of the Medicaid Act create private rights of action.
Watson v. Weeks, 436 F.3d 1152, 1159 (9th Cir. 2006). That court
began its inquiry by stating the Blessing test. Id. at 1158.
According to the Ninth Circuit, “the Supreme Court clarified the
first prong of [this] test in [Gonzaga].” Id. at 1159. The Weeks
decision stated that Gonzaga requires a right to be “unambiguously
conferred” in order to be enforceable under § 1983, and that it is
only rights, and not “benefits” or “interests” that can be
enforced. Id. The Ninth Circuit then went on to apply the rest of
the Blessing test, and concluded that § 1396(a)(10) creates an
enforceable right. Id. at 1159-60.
In a similar case, the Third Circuit explicitly explained that
the Supreme Court in Gonzaga “carefully avoided disturbing, much
less overruling, Wright and Wilder.” Sabree v. Richman, 367 F.3d
180, 184 (3d Cir. 2004). According to the Third Circuit, Gonzaga
“did not abandon [the Blessing] test”--which, again, contains
language similar to Wilder--but did “dispel” confusion in the case
law. Id. at 186-87. See also Westside Mothers v. Olszewski, 454
F.3d 532, 541 (6th Cir. 2006) (“Westside Mothers II”) (finding that
Gonzaga “clarified” Blessing requirement regarding “benefits”);
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S.D. ex rel. Dickson v. Hood, 391 F.3d 581, 602-03 (5th Cir. 2004)
(same); Hunter ex rel. Lynah v. Medows, Civ. No. 08-2930, 2009 WL
5062451, at *2 (N.D. Ga. Dec. 16, 2009) (noting that Gonzaga
“clarified” case law, and ruling that plaintiffs could enforce
private right of action for violations of 42 U.S.C. §
1396a(a)(43)).
Finally, many other courts, construing Gonzaga in contexts
other than the Medicaid statute, have characterized it as doing no
more than clarifying the Supreme Court’s private right of action
jurisprudence. See, e.g., Ball v. Rodgers, 492 F.3d 1094, 1105
(9th Cir. 2007) (reasoning that Supreme Court “clarified” first
prong of test for determining federal rights under § 1983); Day v.
Apoliona, 496 F.3d 1027, 1035-36 (9th Cir. 2007) (characterizing
Gonzaga as “[c]larifying a potential tension in earlier cases” and
“offer[ing] guidance”); 31 Foster Children v. Bush, 329 F.3d 1255,
1269 (11th Cir. 2003) (Gonzaga “clarified” first prong of Blessing
test); Judicial Watch, Inc. v. Nat’l Energy Policy Dev. Group, 233
F. Supp. 2d 16, 22 (D.D.C. 2002) (Gonzaga “clarified” precedent
with respect to enforcement of federal rights under § 1983).9
9
Defendants attempt to cast Gonzaga as a “conclusive
adoption of a more rigorous standard” for meeting the first prong
of the Wilder private right of action test. Defs.’ Mot. at 7.
Admittedly, there are some appellate decisions that lend support to
this position. For instance, the Fifth Circuit acknowledged that
Gonzaga may have “partially overruled” one of its own earlier
decisions. Equal Access for El Paso, Inc. v. Hawkins, 509 F.3d
697, 701 n.4 (5th Cir. 2007). The First Circuit treated Gonzaga as
(continued...)
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Based on the reasoning set forth above, the Court agrees with
Sabree, Westside Mothers II, and Hood, among other decisions, that
Gonzaga merely clarified Supreme Court doctrine. By the same token,
the Court disagrees with Equal Access and Long Term Care to the
extent that they regard Gonzaga as a significant change in private
right of action case law that renders earlier Supreme Court
precedents as “no longer good law” under Agostini. Consequently,
the Court does not adopt the reasoning of the Fifth or First
Circuits as persuasive.
C. Even if Intervening Case Law Does Provide a Basis for Re-
Examination of the Private Right of Action Question,
Plaintiffs Have Established, Under Gonzaga, Their Private
Right of Action to Enforce Medicaid’s EPSDT Provisions.
Had Defendants filed a timely motion, and had Gonzaga
represented a significant change in decisional law, Defendants
would still need to establish under Gonzaga that Plaintiffs have no
private right of action to enforce the relevant Medicaid
provisions.
1. Statutory Provisions
Parties dispute exactly which Medicaid provisions should be
analyzed under Gonzaga. Plaintiffs insist that the private right
9
(...continued)
an intervening decision that justified departure from circuit
precedent. Long Term Care Pharmacy Alliance v. Ferguson, 362 F.3d
50, 57 (1st Cir. 2004). That same decision, however, was itself
not clear on whether Gonzaga constituted “a tidal shift or merely
a shift in emphasis” in private right of action case law. Id. at
59.
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of action analysis must be based on the EPSDT allegations made in
the Complaint. Pls.’ Opp’n at 20. They alleged that the District
of Columbia violated 42 U.S.C. §§ 1396a(a)(10)(a), (a)(43)(a),
1396d(a)(4)(B), and 1396d(r). Accordingly, these provisions formed
the basis of the Settlement Order. See Pls.’ Surreply at 4 [Dkt.
No. 1508-3]. They further argue that these EPSDT provisions,
though not all cited to in Salazar I, are the provisions that the
Court referred to in Wellington. Pls.’ Opp’n at 27, 27 n.2 (citing
Salazar I, 954 F. Supp. at 328-33, and Wellington, 851 F. Supp. at
6).
Defendants maintain that the Complaint is not the source of
the statutory provisions at issue. In their view, 42 U.S.C. §
1396a(a)(10) is irrelevant to the Gonzaga analysis because it was
not ruled on in Salazar I and was not incorporated into the
Settlement Order. Defs.’ Reply at 14. Defendants argue that
without a finding that Defendants violated this statutory
provision, and because it “did not form the basis for the portion
of the consent decree at issue,” the Court cannot look to §
1396a(a)(10) as the basis of the Gonzaga analysis. Defs.’ Sur-
Surreply at 1.
There appears to be little case law on point. Plaintiffs
attempt to patch together pieces of dicta from Supreme Court cases
to support their position, but none of the cases they rely on
involved a consent decree or settlement agreement. Therefore, they
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ultimately are unhelpful in resolving whether the Complaint or the
Settlement Order is the governing text. See Pls.’ Surreply at 2
(citing Blessing and Gonzaga).
The Court need not decide, however, whether § 1396a(a)(10)
applies. Assuming that Defendants are correct, and that only
§ 1396a(a)(43) can provide the basis for Plaintiffs’ private right
of action, that statutory provision does, under Gonzaga, establish
such a right.
2. Plaintiffs Can Enforce 42 U.S.C. § 1396a(a)(43)
Under § 1983.
Gonzaga requires that, in order to find a federal right
enforceable under § 1983, that right must have been “unambiguously”
conferred. 536 U.S. at 283. To guide analysis in this area,
Gonzaga instructs us to examine whether Congress used “rights-
creating” language. Id. at 284. As an example of this type of
language, the Gonzaga Court looked to the provisions of Title VI of
the Civil Rights Act of 1964 and Title IX of the Education
Amendments of 1972, which both provide in relevant part that “no
person . . . shall . . . be subjected to discrimination.” Id. at
287 (quoting statutory text). In addition to the text, courts
should assess the structure of the statute to determine if Congress
intended to confer individual rights. Id. at 286. If there is an
unambiguously conferred right, courts then must look to the
remaining factors articulated in Blessing: “the plaintiff must
demonstrate that the right assertedly protected by the statute is
-26-
not so ‘vague and amorphous’ that its enforcement would strain
judicial competence”; and, last, “the statute must unambiguously
impose a binding obligation on the States.” Blessing, 520 U.S. at
340-41; see Gonzaga, 536 U.S. at 295.
Beginning with the text, § 1396a(a)(43) states in part that a
State plan “must . . . provide for . . . informing all persons in
the State who are under the age of 21 and who have been determined
to be eligible for medical assistance including services described
in section 1396d(a)(4)(B) of this title, of the availability of
early and periodic screening, diagnostic, and treatment services as
described in section 1396d(r) of this title and the need for
age-appropriate immunizations against vaccine-preventable diseases
. . .” 42 U.S.C. § 1396a(a)(43)(A).
The portion of that statutory section which contains “rights-
creating” language under Gonzaga is that “a State plan must provide
for . . . informing all persons . . . of the availability of [EPSDT
services] . . . and the need for age-appropriate immunizations
against vaccine-preventable diseases.” Id. This language, like
that in Titles VI and IX of the Civil Rights Act, which the Gonzaga
Court offered as examples of statutes that create private rights of
action, is “individually focused.” Gonzaga, 536 U.S. at 287. The
State is required to inform “all persons” under the age of 21 who
are Medicaid-eligible of the services specified in § 1396d(A)(4)(B)
to which they are entitled, clearly indicating that the focus of
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the provision is on the “individuals protected,” as opposed to the
“persons regulated.” Alexander v. Sandoval, 532 U.S. 275, 289
(2001).10 Therefore, under prong one of the appropriate tests, the
Court concludes that the federal right is “unambiguously”
conferred.
Other courts have adopted a similar textual analysis in
deciding whether § 1396a(a)(43) creates a private right of action.
For example, in Memisovski ex rel. Memisovski v. Maram, Civ. No.
92-C-1982, 2004 WL 1878332, at *10-11 (N.D. Ill. 2004), the court
held that § 1396a(a)(43) of the Medicaid Act is enforceable under
§ 1983. The court reasoned that the EPSDT services mandated by
this section “provide[] several specific entitlements that
plaintiffs ‘must’ be provided.” Id. (enumerating required
services). Similarly, in Hunter, the district court found that the
EPSDT requirements of § 1396a(a)(43) were focused on the individual
receiving the services. 2009 WL 5062451, at *2. See also John B.
v. Goetz, 661 F. Supp. 2d 871, 874 (M.D. Tenn. 2009) (denying
defendants’ motion to vacate in part because § 1396a(a)(43) confers
private right of action); Clark v. Richman, 339 F. Supp. 2d 631,
640 (M.D. Pa. 2004) (holding that Ҥ 1396a(a)(43) affords
10
Although Sandoval is an implied right of action case and
not a § 1983 case, its reasoning can be applied when determining
whether an enforceable right exists in the § 1983 context. See
Gonzaga, 536 U.S. at 284-85 (“[T]he initial inquiry [in a § 1983
case]--determining whether a statute confers any right at all--is
no different from the initial inquiry in an implied right of action
case.”).
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plaintiffs vindicable private rights”); Westside Mothers II, 454
F.3d at 544 (reversing lower court and ruling that plaintiffs
“stated a cognizable claim under § 1983 for violations of §
1396a(a)(43)(A)”); but see Charlie H. v. Whitman, 83 F. Supp. 2d
476 (D.N.J. 2000).
Defendants insist that the framework of the statute belies the
conclusion that § 1396a(a)(43) confers a privately enforceable
right.11 Defs.’ Mot. at 8-15; Defs.’ Reply at 15-20. They cast the
EPSDT provisions as merely “plan requirements,” the fulfillment of
which is only one of the many conditions that a state must meet in
order to receive funding.12 Defs.’ Mot. at 9.
11
Defendants also argue that the EPSDT language tracks
closely the type of language that our Court of Appeals found
insufficient to create a private right of action in Doe by Fein v.
District of Columbia, 93 F.3d 861 (D.C. Cir. 1996) (per curiam).
Defs.’ Mot. at 13-14; Defs.’ Reply at 21-22. That case involved a
statute requiring states, as a condition of funding, to “provide
that upon receipt of a report of known or suspected instances of
child abuse or neglect an investigation shall be initiated promptly
to substantiate the accuracy of the report.” Doe by Fein, 93 F.3d
at 865 (quoting 42 U.S.C. § 5106(b)(2) (1994)). This language is
plainly different in focus and content from the language at issue
here. It is programmatic language that targets the persons
regulated, i.e., those who administer a state’s child abuse
programs, and not any individual beneficiary.
12
In terms of the statute’s structure, § 1396a(a)(43)
appears in the same section, § 1396a, as provisions that are
individually focused, as well as those that are focused on more
systemic state obligations. Courts have found that surrounding
provisions both do support a private right of action, see, e.g.,
Sabree, 367 F.3d at 182 (finding private right of action under §
§1396a(a)(8),(a)(10), and 1396d(a)(15)), and that some provisions
do not support a private right of action, see, e.g., Equal Access,
509 F.3d at 703 (construing § 1396a(a)(30)). The framework
(continued...)
-29-
As the Supreme Court made clear in Gonzaga, the text is
central to determining whether Congress intended to convey a
privately enforceable right. Gonzaga, 536 U.S. at 286. Defendants
do not focus their analysis on the language in § 1396a(a)(43);
instead, Defendants concentrate on that section’s surrounding
provisions--and not the actual text of § 1396a(a)(43)--to argue
that no enforceable private rights exist. As the Third Circuit
concisely put it, “[a]dmittedly, plumbing for congressional intent
by balancing the specific language of a few discrete provisions of
Title XIX against the larger structural elements of the statute is
a difficult task. Nonetheless, it is evident, at least to us, that
the statutory language, despite countervailing structural elements
of the statute, unambiguously confers rights which plaintiffs can
enforce.” Sabree, 367 F.3d at 192.
In sum, the Court concludes that § 1396a(a)(43) does
“unambiguously” confer a private right of action as required by
Gonzaga. The remaining prongs of the private right of action
test--whether the right asserted is so “vague and amorphous” that
its enforcement “strain[s] judicial competence,” and whether the
statute imposes an unambiguous obligation on Defendants--also favor
Plaintiffs’ position.
12
(...continued)
argument therefore is not dispositive of the question, and does not
deserve the great weight that Defendants have placed upon it.
While the inquiry into the statute’s structure is indeed important,
it cannot ignore the actual language Congress used in the statute.
-30-
The right is not too vague and amorphous to be enforced. It
plainly requires Defendants to inform eligible individuals of
certain services available to them. The services are delineated in
§ 1396d(r), a sub-section referred to specifically in §
1396a(a)(43). Section 1396d(r) sets forth in detail the types and
timing of treatment that shall be provided as part of the
screening, vision, dental, and hearing services due to the patient.
42 U.S.C. § 1396d(r).
These statutory provisions establish that Defendants’
obligation is both clear and enforceable; further, courts can
competently determine whether such statutory guidance is being
followed. The Court agrees with the Fifth Circuit’s assessment in
Hood that “[t]he EPSDT provisions at issue are no more ‘vague and
amorphous’ than other statutory terms that . . . courts . . . have
found capable of judicial enforcement.” 391 F.3d at 605. For
instance, the right at issue in this case is no more unenforceable,
and does no more to strain judicial competence, than the right to
reimbursement at “reasonable and adequate rates,” upheld in Wilder.
496 U.S. at 511-12.
In satisfaction of the third prong, the statutory language
creates a binding obligation. The statute speaks in terms that are
clearly mandatory, as it says that states “must . . . provide.” 42
U.S.C. § 1396a(a)(43); 42 U.S.C. § 1396d(r) (describing services in
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detail, including what those services “shall at a minimum
include”).
Courts look to such language to determine whether a binding
obligation has been created. See Blessing, 520 U.S. at 340 (“[T]he
provision giving rise to the asserted right must be couched in
mandatory, rather than precatory, terms.”); Richman, 339 F. Supp.
2d at 640 (“Section 1396a(a)(43) speaks in mandatory terms, as it
mandates that a state plan ‘must’ provide for informing eligible
individuals of EPSDT services, as well as mandates that a state
plan ‘must’ provide or arrange for the provision of EPSDT
services.”). For instance, in Wilder, the Supreme Court concluded
that, for purposes of § 1983, a binding obligation arose from the
language, “a state plan ‘must’ ‘provide for payment . . . of
hospital[s].’” 496 U.S. at 2519 (emphasis in original).
For all the reasons just discussed, the Court concludes that
the statutory text imposes a binding obligation on Defendants to
provide EPSDT services.
D. Plaintiffs’ Private Right of Action Is Not Foreclosed by
Their Status as Third-Party Beneficiaries.
Defendants also argue that, because Plaintiffs are only third-
party beneficiaries of what is essentially a contract between the
federal government and the District of Columbia, they cannot
enforce Medicaid’s provisions under § 1983. Defs.’ Mot. at 15-17.
To support this far-reaching position, Defendants cite a
concurrence by Justice Scalia in Blessing suggesting that the only
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rights that can be secured under § 1983 are those that would have
been recognized as rights when § 1983 was originally enacted in
1871. He reasoned that because a third-party beneficiary had no
enforceable right to compel “a State to make good on its promise to
the Federal Government” in 1871, at the time of the Section’s
enactment, beneficiaries in such cases may have no right to sue in
2010. 520 U.S. at 349-50 (Scalia, J., concurring).
Obviously, Justice Scalia’s view is not that of the Supreme
Court. Further, he stresses in the remainder of his concurrence
that the argument above was not even raised before the Court, and
that he addresses it only because he “is not prepared without
further consideration to reject the possibility that third-party-
beneficiary suits simply do not lie.” Id. at 350. In short, he
was simply giving an advisory opinion, without even having the
benefit of briefing.
III. CONCLUSION
For the foregoing reasons, Defendants’ Motion to Terminate is
denied as to the private right of action issue. An Order shall
issue with this Memorandum Opinion.
/s/
August 5, 2010 Gladys Kessler
United States District Judge
Copies to: attorneys on record via ECF
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