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PETTIES v. DISTRICT OF COLUMBIA

November 7, 2005.

NIKITA PETTIES, et al., Plaintiff,
v.
THE DISTRICT OF COLUMBIA, et al., Defendant.



The opinion of the court was delivered by: PAUL FRIEDMAN, District Judge

REPORT AND RECOMMENDATION OF THE SPECIAL MASTER IN A MATTER RELATING TO JUST-A-MITE
Provider Just-A-Mite, Inc., ("JAM") is a private organization that delivers residential, special education and related services to students in the District of Columbia. On July 11, 2005, JAM filed a request for an invoice dispute proceeding. That request involved a dispute regarding invoices that had been submitted in May 2005 to the District of Columbia Public Schools ("DCPS") for two students, E.W. and T.J. The July 2005 hearing request also included a dispute regarding JAM's rate increase that DCPS had denied.

The administration of the JAM dispute was delegated to the designee of the Special Master, Steven M. Schneebaum, Esq., a shareholder in the Washington, D.C. office of Greenberg Traurig LLP.*fn1 Mr. Schneebaum's submission, attached hereto, is entitled Report and Recommendation of the Special Master in the Mater of the Just-A-Hearing (First Part) Held on September 7, 2005 ("Report and Recommendation"). As noted in the Report and Recommendation, only the matters involving charges for E.W. and T.J. have been adjudicated. The dispute regarding the rates of JAM will be the subject of a hearing later in November 2005.

  A proposed Order covering the matters addressed in the Report and Recommendation is also attached. REPORT AND RECOMMENDATIONS OF THE SPECIAL MASTER IN THE MATTER OF THE JUST-A-MITE HEARING (FIRST PART) HELD ON SEPTEMBER 7, 2005

  Background

  This Report and Recommendations are filed pursuant to the Order in this case dated October 11, 2002, modifying and supplementing the August 25, 1997 Order Regarding Payment System for third-party providers of special education and related services. Provider, Just-A-Mite ("JAM"), filed a request for a proceeding before the Special Master, in accordance with the October 11 Order, on July 11, 2005, to resolve a dispute over two unpaid invoices totaling $2,900.00.*fn2 The Special Master, through her undersigned designee acting as Hearing Officer, held a hearing with representatives from the District of Columbia Public Schools ("DCPS"), JAM, and University Legal Services (counsel for the Plaintiff class), on Wednesday, September 7, 2005. I. Findings of Fact

  JAM is a provider of special education services. Eric Weaver and Tavon Johnson were special education students receiving services from JAM.

  On December 6, 2004, judge Johnson of the D.C. Superior Court ordered that Eric Weaver be examined by the Child Guidance Clinic and the Mental Health Administration ("the Weaver Order"), in connection with a delinquency hearing to take place on January 7, 2005. On March 31, 2005, Dr. Willie T. Hamlin, a psychiatrist, evaluated Eric Weaver based upon a referral from JAM, and prepared a report.

  On March 9, 2005, Dr. Hamlin wrote to Tavon Johnson's grandmother and advised her that Tavon was in need of a psychiatric evaluation. He noted that Tavon had missed his appointment set for that day, as well as an earlier one, on February 16, 2005. On March 18, 2005, DCPS Hearing Officer Banks entered an interim order ("the Johnson Order") ordering that Tavon Johnson "obtain an independent psychiatric evaluation in accordance with 5 D.C.M.R. Section 3027.5." The Johnson Order was silent about who was to perform the evaluation. Although the Order authorized Tavon to receive wrap-around services from JAM, including counseling, it did not authorize JAM to conduct the "independent psychiatric evaluation."

  On May 11, 2005, JAM submitted its Invoice # 112.DCPS ("the May Invoice") to DCPS. The May Invoice included the two charges for "psychiatric sessions" at issue here: a $1,500 charge for Tavon Johnson for February 2005 ("the Johnson Invoice"), and a $1,400 charge for Eric Weaver for March 2003 ("the Weaver Invoice").

  In the first half of 2005, JAM and DCPS had a number of disputes about fees, billings, and payments. On May 23, 2005, the parties entered into a settlement, effective May 16, 2005, "to resolve outstanding disputes for October 2004, February 2005, and March 2005." Among other things, this settlement recited that: "DCPS will not pay, nor shall Just-A-Mite invoice DCPS, for services or amounts of services that are not authorized specifically for payment by DCPS by [IEPs, HODs, Court Orders or Settlement Agreements] or are in excess of amounts set forth in these documents." With respect to time periods other than October 2004, February 2005, and March 2005, the parties agreed that "payments will be made based on current IEPs, HODs, Court Orders, or Settlement Agreements."

  On June 6, 2005, DCPS submitted a billing dispute regarding eight charges on the May Invoice, including the two at issue here.*fn3 DCPS refused to pay the two disputed charges, indicating as its reason the legend, "No authorization for `Psychiatric Session." JAM responded on June 23, 2005, contending that a psychiatric session for Tavon Johnson was authorized the Johnson Order; and that Eric Weaver's psychiatric session was authorized by the Weaver Order.

  On July 8, 2005, DCPS issued its Final Administrative Decision with respect to the May Invoice disputes. In addition to the lack of authorization, DCPS denied payment for the Johnson Invoice on the grounds that "JAM did not submit the evaluation report." JAM then requested this proceeding with respect to the remaining May Invoice issues.

  DCPS submitted its Preliminary Statement on September 1, 2005. In essence, DCPS argues that it should not have to pay the Johns on Invoice because Tavon Johnson was never examined. With respect to Eric Weaver, DCPS contends that the Weaver Order did not provide a basis for any action to be taken by JAM. JAM presented no Preliminary Statement, but did submit exhibits.

  A hearing was convened on September 7, 2005. JAM offered no documentary evidence and no witnesses, Transcript of the Hearing ("Tr."), at 5. Class Counsel made no submission at all. Tr., at 8. Noting that JAM as petitioner bears the burden of proof, the Special Master's Designee suggested that Mr. Dickerson of JAM present testimony as a fact witness, and then be ...


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