United States District Court, District of Columbia
G. Sullivan United States District Judge.
M.J. and L.R.,  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.
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
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)).
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
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.
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.
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. 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.
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.
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.
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.
Standard of Review
Rule 12(b)(1): Subject Matter Jurisdiction
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).
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
Rule 12(b)(6): Failure to State a Claim
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).
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.
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).