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M.J. v. The District of Columbia

United States District Court, District of Columbia

July 25, 2019

M.J., et al., Plaintiffs,
THE DISTRICT OF COLUMBIA, et al., Defendants.


          Emmet G. Sullivan United States District Judge.

         Plaintiffs, M.J. and L.R., [1] two children who suffer from mental illnesses, and University Legal Services, Inc., the designated protection and advocacy program for such individuals in the District of Columbia, bring this action on behalf of themselves and a putative class of mentally-ill children who allegedly have been unnecessarily institutionalized or face unnecessary institutionalization. In their complaint, plaintiffs allege that the District of Columbia (“District of Columbia” or “District”) and its officials (collectively “Defendants”) have failed to provide intensive community-based services, in favor of admitting children to residential facilities even though the children are eligible for community-based treatment. Plaintiffs seek declaratory and injunctive relief based on alleged violations of federal law including the Medicaid Act 42 U.S.C. § 1396d et seq. and the Americans with Disabilities Act (“ADA”), 42 U.S.C. § 12131, et seq.

         Pending before the Court is defendants' motion to dismiss the complaint. Defendants argue that plaintiffs do not have standing to bring this action, and, in the alternative, that plaintiffs have failed to state a cognizable claim. Upon consideration of the parties' memoranda, the applicable law, and for the following reasons, defendants' motion to dismiss is


         I. Background

         Plaintiffs M.J. and L.R. are Medicaid-eligible children with mental health disabilities. Compl., ECF No. 3 ¶ 1. Both plaintiffs as well as all members of the plaintiffs' putative class have a mental health disability by virtue of having a serious emotional disturbance. Id. ¶ 13. Under District of Columbia law, a child has a serious emotional disturbance when a child has a mental health condition and that condition causes a functional impairment. Id. ¶ 14 (citing D.C. Mun. Regs. Tit. 22-A, § 1201.l). The functional impairment also needs to, on an episodic, recurrent or continuous basis, substantially limit the child's functioning in family, school, or community services; or limit the child from achieving or maintaining one or more developmentally appropriate social, behavioral, cognitive, communicative, or adaptive skills. Id. Because the children are “individuals with a disability” they are also protected by the ADA and the Rehabilitation Act. Id. (citing 42 U.S.C. § 12102; 29 U.S.C. § 705(20)(B)).

         Plaintiff University Legal Services is an independent, nonprofit corporation organized under the laws of the District of Columbia that does business under the name Disability Rights D.C. at University Legal Services (“Disability Rights D.C.”). Compl., ECF No. 3 ¶ 15. Disability Rights D.C. is the designated protection and advocacy program for individuals with disabilities for the District of Columbia. Id. The organization is authorized under the Protection and Advocacy for Individuals with Mental Illness Act, 42 U.S.C. § 10801 et seq., and the Protection and Advocacy for Individuals with Developmental Disabilities Act, 42 U.S.C. § 15041 et seq., to bring this action on behalf of the named individual plaintiffs and members of the putative class, who are its constituents. Id.

         Defendant District of Columbia is a public entity covered by Title II of the ADA, and, as a participant in the federal Medicaid program, its agencies receive federal financial assistance through that and other federal programs. Id. ¶ 16. Defendant Muriel Bowser is the Mayor of the District of Columbia and supervises the official conduct of the Departments of Health Care Finance (“DHCF”) and Behavioral Health (“DBH”). Id. ¶ 17. Defendants Wayne Turnage and Tanya Roster are the Directors of DHCF and DBH respectively. Id. ¶¶ 18-19. All four defendants play a role in ensuring the District is in compliance with federal law. Id. ¶¶ 16-19.

         Under the Medicaid Act, a state must provide “early and periodic screening, diagnostic, and treatment [“EPSDT”] services (as defined in subsection (r)) for individuals who are eligible under the plan and are under the age of 21.” 42 U.S.C. § 1396d(a)(4)(A). Those services are defined as screening services (including physical exams, immunizations, health and developmental health history review, and laboratory tests), vision services, dental services, hearing services, and “[s]uch other necessary health care, diagnostic services, treatment, and other measures . . . to correct or ameliorate defects and physical and mental illnesses and conditions discovered by screening services, whether or not such services are covered under the State plan.” 42 U.S.C. § 1396d(r)(5). Section 1396d(a) describes a list of services which, if medically necessary, must be provided to EPSDT beneficiaries.

         Plaintiffs allege that defendants have never created a functioning system for providing intensive community-based services (“ICBS”) to District of Columbia children who are entitled to receive it. See Compl., ECF No. 3 ¶ 38. ICBS is comprised of four components: (1) Intensive Care Coordination, (2) Intensive Behavior Support Services, (3) Mobile Crisis Services; and (4) Therapeutic Foster Care.[2] See Id. ¶ 39. Plaintiffs allege that these components are unique and are collectively necessary to meet the health care needs of eligible children. See Id. ¶¶ 38-41.

         The first component, intensive care coordination, is “an intensive form of case management in which a provider convenes a ‘child and family team,' including the child, the child's family, service providers, and other individuals identified by the family, to design and supervise a plan that provides and coordinates services for children with mental health disabilities.” Id. ¶ 39. The second component, intensive behavior support services, consists of “individualized therapeutic interventions provided on a frequent and consistent basis that are designed to improve behavior and delivered to children and families in any setting where the child is naturally located.” Id. The third component, mobile crisis services, involves a “mobile, onsite, in-person response, available at any time or place to a child experiencing a crisis, for the purpose of identifying, assessing, and stabilizing the situation and reducing any immediate risk of harm.” Id. Mobile crisis services may be “delivered in the child's home, school, or community.” Id.

         Plaintiffs' complaint alleges that the District of Columbia has failed to offer the plaintiff children all of the required components of ICBS, which are collectively necessary to meet their mental health needs. Compl., ECF No. 3 ¶¶ 38-48. As a result, plaintiffs allege that the children are deprived of the ICBS that they need to improve their conditions and avoid unnecessary institutionalization or the serious risk of institutionalization. Id. ¶¶ 49-65. Plaintiffs therefore bring this action for violations of the ADA, Section 504 of the Rehabilitation Act, and violations of the Medicaid Act enforced through 42 U.S.C. § 1983. Id. ¶¶ 66-73.

         Defendants have moved to dismiss plaintiffs' complaint under Federal Rule of Civil Procedure 12(b)(1) for lack of subject matter jurisdiction and 12(b)(6) for failure to state a claim. See generally Defs.' Mot., ECF No. 21. Plaintiffs have filed their opposition to the motion to dismiss. Pls.' Opp'n, ECF No. 29. And defendants have filed a reply thereto. Defs.' Reply, ECF No. 33. This motion is ripe for adjudication.

         II. Standard of Review

         A. Rule 12(b)(1): Subject Matter Jurisdiction

         “A federal district court may only hear a claim over which [it] has subject matter jurisdiction; therefore, a Rule 12(b)(1) motion for dismissal is a threshold challenge to a court's jurisdiction.” Gregorio v. Hoover, 238 F.Supp.3d 37 (D.D.C. 2017)(citation and internal quotation marks omitted). To survive a Rule 12(b)(1) motion, the plaintiff bears the burden of establishing that the court has jurisdiction by a preponderance of the evidence. Lujan v. Defenders of Wildlife, 504 U.S. 555, 561, (1992). Because Rule 12(b)(1) concerns a court's ability to hear a particular claim, “the court must scrutinize the plaintiff's allegations more closely when considering a motion to dismiss pursuant to Rule 12(b)(1) than it would under a motion to dismiss pursuant to Rule 12(b)(6).” Schmidt v. U.S. Capitol Police Bd., 826 F.Supp.2d 59, 65 (D.D.C. 2011)(citations omitted). In so doing, the court must accept as true all of the factual allegations in the complaint and draw all reasonable inferences in favor of the plaintiff, but the court need not “accept inferences unsupported by the facts alleged or legal conclusions that are cast as factual allegations.” Rann v. Chao, 154 F.Supp.2d 61, 64 (D.D.C. 2001).

         In reviewing a motion to dismiss pursuant to Rule 12(b)(1), the court “may consider such materials outside the pleadings as it deems appropriate to resolve the question [of] whether it has jurisdiction to hear the case.” Scolaro v. D.C. Bd. of Elections & Ethics, 104 F.Supp.2d 18, 22 (D.D.C. 2000). Faced with motions to dismiss under Rule 12(b)(1) and Rule 12(b)(6), a court should first consider the Rule 12(b)(1) motion because “[o]nce a court determines that it lacks subject matter jurisdiction, it can proceed no further.” Ctr. for Biological Diversity v. Jackson, 815 F.Supp.2d 85, 90 (D.D.C. 2011) (citations and internal quotation marks omitted).

         B. Rule 12(b)(6): Failure to State a Claim

         A motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6) tests the legal sufficiency of a complaint. Browning v. Clinton, 292 F.3d 235, 242 (D.C. Cir. 2002). A complaint must contain “a short and plain statement of the claim showing that the pleader is entitled to relief, in order to give the defendant fair notice of what the . . . claim is and the grounds upon which it rests.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007)(internal quotation marks omitted).

         Despite this liberal pleading standard, to survive a motion to dismiss, a complaint “must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). A claim is facially plausible when the facts pled in the complaint allow the court to “draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. The standard does not amount to a “probability requirement, ” but it does require more than a “sheer possibility that a defendant has acted unlawfully.” Id.

         “[W]hen ruling on a defendant's motion to dismiss [pursuant to Rule 12(b)(6)], a judge must accept as true all of the factual allegations contained in the complaint.” Atherton v. D.C. Office of the Mayor, 567 F.3d 672, 681 (D.C. Cir. 2009) (internal quotation marks omitted). In addition, the court must give the plaintiff the “benefit of all inferences that can be derived from the facts alleged.” Kowal v. MCI Commc'ns Corp., 16 F.3d 1271, 1276 (D.C. Cir. 1994).

         III. ...

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