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            Title Sabree ex rel Sabree v. Richman

 

            Date 2004

            By

            Subject Other\Concurring

                

 Contents

 

 


180           367 FEDERAL REPORTER, 3d SERIES


devising a way to reason to this conclusion under the statute, I write separately to stress that this logic should not compel that we combine definitions within this sec- tion,  as  a  general  rule. Rather,  only where an offense is a hybrid—as I submit theft by deception is—and the aggravated felony classifications contain two distinct, clearly applicable tests, should we conclude that both must be fulfilled in order for the offense to qualify as an aggravated felony.



,






Hassan SABREE, By his Mother and Next–Friend, Hana SABREE;  Cather- ine Meade, By her Father and Next– Friend, Robert A. Meade;  Joseph Fra- zier, By his Mother and Next–Friend, Patricia Frazier, for Themsleves and All Others Similarly Situated


v.

* Estelle B. RICHMAN, In Her Official Capacity as Secretary of the Depart- ment of Public Welfare of the Com- monwealth of Pennsylvania


Hassan Sabree, Catherine Meade, and

Joseph Frazier, Appellants


* {Substitution Pursuant to Clerk’s Order dated 3/28/03 and F.R.A.P. Rule 43(c)}


No. 03–1226.


United States Court of Appeals, Third Circuit.

Argued Sept. 11, 2003. Filed May 11, 2004.


Background:   Class of mentally retarded

Medicaid recipients sued the Secretary of


Pennsylvania’s public welfare department, pursuant to § 1983, seeking to vindicate purported right to small community-based intermediate care facilities for mentally re- tarded persons. The United States District Court for the Eastern District of Pennsyl- vania,   Herbert   J.   Hutton,   J.,   245

F.Supp.2d 653, granted Secretary’s motion to dismiss, and recipients appealed. Holding:   The Court of Appeals, Barry, Circuit Judge, held, as a matter of first impression, that: Medicaid statute requir- ing states to provide medical assistance covering medical services from an interme- diate care facility for persons with mental retardation  with  reasonable  promptness unambiguously conferred individual feder- al rights enforceable under § 1983. Reversed and remanded.

Alito, Circuit Judge, concurred and filed opinion.



1. Civil Rights O1052

Medicaid statute requiring states to provide medical assistance covering medi- cal services from an intermediate care fa- cility for persons with mental retardation with reasonable promptness unambiguous- ly conferred individual federal rights that could be privately enforced through §  1983 action.   42 U.S.C.A. §  1983; Social Securi- ty Act, §§  1902(a)(8, 10), 1905(a)(15), as amended, 42 U.S.C.A. §§  1396a(a)(8, 10),

1396d(a)(15).


2. Civil Rights O1308

A plaintiff’s ability to invoke §  1983 cannot be defeated simply by the availabil- ity of administrative mechanisms to pro- tect the plaintiff’s interests.  42 U.S.C.A.

§ 1983.





Stephen F. Gold, (Argued), Philadelphia, PA and Ilene W. Shane, Disabilities Law Project, Philadelphia, PA, for Appellants.


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181


Doris M. Leisch, (Argued), Common- wealth  of  Pennsylvania,  Department  of Public Welfare, Philadelphia, PA and John A. Kane, Commonwealth of Pennsylvania, Office of Legal Counsel, Department of Public Welfare, Harrisburg, PA, for Appel- lees.


Sarah Somers, Jane Perkins, National Health Law Program, Chapel Hill, NC, for Amicus–Appellants.


Before ALITO, BARRY, and AMBRO, Circuit Judges.


OPINION OF THE COURT BARRY, Circuit Judge.



I.                      INTRODUCTION


When Congress offers money to the states, it often imposes conditions on ac- ceptance.    States welcome federal funding to help underwrite many of the core ser- vices they provide to their citizens.    Edu- cation, healthcare, and public safety, to name a few, while typically state concerns, are usually funded in part by federal dol- lars that come with strings attached.   This case raises the question-not new, but of first impression in this Court following Gonzaga University v. Doe, 536 U.S. 273,

122 S.Ct. 2268, 153 L.Ed.2d 309 (2002)-of what happens when a state allegedly fails


to live up to the conditions imposed on it by Congress.


Plaintiffs are a class of mentally retard- ed adults in need of medical services from an intermediate care facility for persons with mental retardation (‘‘ICF/MR ser- vices’’).                   Although they qualify for state assistance to obtain these services under the Medicaid Act, that assistance has not been forthcoming.      In an effort to force Pennsylvania to provide the needed ser- vices,  plaintiffs,  pursuant  to  42  U.S.C.

§  1983, sued the Secretary of the Pennsyl- vania   Department   of   Public   Welfare. Pennsylvania argues that it would provide assistance if it could but that it cannot, and that, in any event, the sole remedy for its non-compliance with the Medicaid Act is the suspension or revocation of funding

1from Congress.   We disagree.


The District Court, relying heavily on Gonzaga University, concluded that Con- gress had not unambiguously conferred the rights that plaintiffs sought to vindi- cate under §  1983, and dismissed the suit.2

Sabree v. Houston, 245 F.Supp.2d 653, 659

(E.D.Pa.2003).   At first blush, language in Gonzaga University would appear to sup- port that conclusion.   In Gonzaga Univer- sity, the Court foreclosed the ability of a student to enforce, by means of §  1983, provisions   of   the   Family   Educational Rights and Privacy Act of 1974 (‘‘FER-


1.    There appears to be a disagreement among our sister courts of appeals as to whether, pursuant to Medicaid, a state must merely provide financial assistance to obtain covered services, or provide the services themselves. See Bruggeman v. Blagojevich, 324 F.3d 906,

910 (7th Cir.2003) (‘‘ T he statutory reference to ‘assistance’ appears to have reference to financial  assistance  rather  than  to  actual medical services, though the distinction was missed in  Bryson v. Shumway, 308 F.3d 79,

81, 88–89 (1st Cir.2002) and  Doe v. Chiles,

136 F.3d 709, 714, 717 (11th Cir.1998).’’). The only issue before us, however, is whether plaintiffs  may  sue  Pennsylvania  under  42


U.S.C. §  1983 to obtain the ‘‘assistance’’ for which they qualify.    To resolve this issue we need not, and do not, address the remedy that might be available to plaintiffs, but leave that to the District Court in the first instance.


2.    Section 1983 imposes liability on anyone who, under color of state law, deprives a person ‘‘of any rights, privileges, or immuni- ties secured by the Constitution and laws.’’

42 U.S.C. §  1983.   Rights conferred by feder- al  statute  are  enforceable  under  §  1983. Maine v. Thiboutot, 448 U.S. 1, 4–8, 100 S.Ct.

2502, 65 L.Ed.2d 555 (1980).


182      367 FEDERAL REPORTER, 3d SERIES


PA’’).3              Gonzaga Univ., 536 U.S. at 283,

122 S.Ct. 2268.   The Chief Justice, writing for the Court, stated emphatically:   ‘‘We now reject the notion that our cases permit anything short of an  unambiguously con- ferred right to support a cause of action brought  under  §  1983.’’     Id.  (emphasis added).

The Court, no doubt, has set a high bar for plaintiffs.           Nonetheless, after having considered the relevant provisions of the Medicaid Act against the backdrop of Gon- zaga University, we are convinced that Congress  unambiguously  conferred  the rights which plaintiffs here seek to en- force.           Accordingly, we will reverse the order of the District Court.



II.             DISCUSSION

Title XIX of the Social Security Act, codified at 42 U.S.C. §§  1396–1396v and popularly known as the ‘‘Medicaid Act,’’ established  a  ‘‘cooperative  federal-state program under which the federal govern- ment furnishes funding to states for the purpose of providing medical assistance to eligible low-income persons.’’   Pa. Pharm. Ass’n v. Houstoun, 283 F.3d 531, 533 (3d


Cir.2002).   States are not required to par- ticipate in the program, but states that do accept federal funding must comply with the Medicaid Act and with regulations pro- mulgated by the Secretary of Health and Human Services (‘‘HHS’’).               Participating states must devise and implement a state medical assistance plan that is approved by  the  Secretary  of  HHS.  42  U.S.C.

§ 1396;   42 C.F.R. § 430.10. A state that fails to comply with its medical assistance plan runs the risk of having its funding revoked  by  the  Secretary. 42  U.S.C.

§ 1396c.


There is no dispute that plaintiffs qualify for ICF/MR services under Pennsylvania’s medical assistance plan.   Nor is it disputed that plaintiffs have languished on waiting lists for years, unable to obtain these ser- vices.    The only dispute, and the one now before us, is whether plaintiffs may sue Pennsylvania under §  1983 to enforce the provisions of Title XIX that require (1) a state to provide medical assistance cover- ing ICF/MR services, and (2) to do so with

‘‘reasonable   promptness.’’  42   U.S.C.

§§ 1396a(a)(8),4        1396a(a)(10),5        and

1396d(a)(15).6


3.    The relevant FERPA language mandated:

No funds shall be made available under any applicable  program  to  any  educational agency or institution which has a policy or practice of permitting the release of edu- cation records (or personally identifiable information contained therein  TTT) of stu- dents without the written consent of their parents to any individual, agency, or organ- ization.

20 U.S.C. §  1232g(b)(1).


4.    Section  1396a(a)(8)  provides  in  relevant part:

A State plan for medical assistance  must TTT provide that  all individuals wishing to make application for medical assistance un- der the plan shall have opportunity to do so, and that  such assistance shall be fur- nished with reasonable promptness to all eligible individuals TTTT

42 U.S.C. §  1396a(a)(8) (emphasis added).


5.    Section 1396a(a)(10) provides in relevant part:   ‘‘A State plan for medical assistance must  TTT provide  TTT for making medical as- sistance available, TTT to TTT all eligible indi- viduals TTTT’’    42 U.S.C. §  1396a(a)(10) (em- phasis added).


6.    Section 1396d(a)(15) provides in relevant part:


For purposes of this title 42 U.S.C. §§  1396 et seq. TTT t he term ‘‘medical assistance’’ means payment of part or all of the cost of the following care and services TTT for indi- viduals  TTT who are eligible:  TTT services in an intermediate care facility for the men- tally retardedTTTT

42 U.S.C. §  1396d(a)(15).


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That plaintiffs merit sympathy does not escape our notice, but neither does it gov- ern our reasoning.   Rather, Gonzaga Uni- versity  provides  the  dispassionate  lens through which this matter must be viewed. A three-step analysis is required.  First, we must examine  Gonzaga University to determine the essential characteristics of an ‘‘unambiguously conferred right.’’   Sec- ond, we must assess whether the statutory language of Title XIX imparts an ‘‘unam- biguously  conferred  right.’’   Third,  we must determine-if an individual right has been   unambiguously   conferred-whether Congress has precluded individual enforce- ment of that right.                This analysis, which, as will become clear, is assuredly not for the timid, compels the conclusion that the provisions invoked by plaintiffs–42 U.S.C.

§§  1396a(a)(8),         1396a(a)(10),         and

1396d(a)(15)-unambiguously confer rights vindicable under §  1983.


A.             Gonzaga University v. Doe and Un- ambiguously   Conferred   Rights— Step One

As the Court explained more than twen- ty years ago, ‘‘ i n legislation enacted pur- suant to the spending power, the typical remedy for state noncompliance with fed- erally imposed conditions is not a private cause of action for noncompliance but rath- er action by the Federal Government to


terminate funds to the State.’’   Pennhurst

State Sch. & Hosp. v. Halderman, 451

U.S. 1, 28, 101 S.Ct. 1531, 67 L.Ed.2d 694

(1981). Nonetheless, as the Court observed in  Gonzaga University, in some instances Congress  has  unambiguously  conferred rights that may be vindicated by individual suits brought under §  1983.7

In   Gonzaga  University,  the  plaintiff sought to enforce conditions imposed on the  State  of  Washington  by  FERPA.8

‘‘Congress  enacted  FERPA  under  its spending power to condition the receipt of federal funds on certain requirements re- lating to the access and disclosure of stu- dent    educational    records.’’                             Gonzaga Univ., 536 U.S. at 278, 122 S.Ct. 2268. Ultimately, the Court rejected the viability of plaintiff’s claim because it concluded that in FERPA Congress had not ‘‘intend- ed to create a federal right.’’          Id. at 283,

122 S.Ct. 2268 (emphasis in original);   see also id. at 291, 122 S.Ct. 2268 (Breyer, J., concurring) (‘‘The ultimate question, in re- spect to whether private individuals may bring a lawsuit to enforce a federal statute, through 42 U.S.C. §  1983 or otherwise,  is a question of congressional intent.’’ )  (em- phasis added).

Accordingly, we must determine wheth- er Congress intended to confer the rights claimed by plaintiffs.   Gonzaga University instructs that congressional intent is mani-


7.    We take as a given that when seeking re- dress under §  1983 for violation of a statutory right, a plaintiff need not establish that Con- gress intended to confer a remedy in addition to that right.    See, e.g., Gonzaga Univ., 536

U.S. at 284, 122 S.Ct. 2268 (‘‘Plaintiffs suing under §  1983 do not have the burden of showing an intent to create a private remedy because § 1983 generally supplies a remedy for the vindication of rights secured by federal statutes.   Once a plaintiff demonstrates that a statute confers an individual right, the right is presumptively enforceable by §  1983.’’).

That §  1983 provides a remedy for statuto- rily conferred rights ‘‘makes obvious sense.’’


Id. at 285, 122 S.Ct. 2268.   While the creation of statutorily specific remedies would make our task easier, Congress has chosen to pro- vide §  1983 as an all purpose remedy.   Obvi- ously, we cannot require a clear statement rule mandating the specification of a right to sue within the statutory text;   to do so would effectively repeal §  1983.    Instead, we must, as the Court demonstrates in Gonzaga Univer- sity, examine the statutory text to determine whether Congress has unambiguously con- ferred an individual right.


8.    For the relevant FERPA language, see note

3, supra.


184      367 FEDERAL REPORTER, 3d SERIES


fest only when statutory language unam- biguously confers such rights.    Id. at 283,

122 S.Ct. 2268.    To determine what statu- tory language is necessary to confer rights unambiguously, we turn first to the cases in which the Court addressed statutory actions brought under §  1983.        We then consider what the Court means in  Gonza- ga University when it requires ‘‘rights- creating language.’’            Id. at 287, 122 S.Ct.

2268.


1.             Statutory  Rights  and  42  U.S.C.

§ 1983

Since   Pennhurst, only twice has the Court recognized a congressional intent to confer   statutory   rights   vindicable   via

§ 1983:     Wright  v.  Roanoke  Redevelop- ment & Housing Authority, 479 U.S. 418,

107 S.Ct. 766, 93 L.Ed.2d 781 (1987), ad- dressing the Public Housing Act;  and Wil- der v. Virginia Hospital Ass’n, 496 U.S.

498,  110  S.Ct.  2510,  110  L.Ed.2d  455

(1990), addressing Title XIX of the Social

Security Act. The Court has foreclosed

§  1983  suits  in  two  equally  significant cases (in addition to Gonzaga University ): Suter v. Artist M., 503 U.S. 347, 112 S.Ct.

1360, 118 L.Ed.2d 1 (1992), addressing the Adoption Assistance and Child Welfare Act of 1980;   and  Blessing v. Freestone,

520 U.S. 329, 117 S.Ct. 1353, 137 L.Ed.2d

569 (1997), addressing Title IV–D of the

Social Security Act.



While in  Gonzaga University the Court

‘‘reject ed  the notion that its  TTT cases permit anything short of an unambiguous- ly conferred right to support a cause of action brought under §  1983,’’ it carefully avoided disturbing, much less overruling, Wright and  Wilder.     Gonzaga Univ., 536

U.S. at 283, 122 S.Ct. 2268.   Indeed, as the ensuing  analysis  will  demonstrate,  the Court relied on those cases in crafting Gonzaga University.   Accordingly, we will assess the rights claimed by plaintiffs in light of  Wright, Wilder, Suter, and  Bless- ing, as construed by  Gonzaga University.



(a)  Wright v. Roanoke Redevelopment

& Housing Authority


In Wright, the Court permitted a §  1983 suit  by  tenants  to  recover  past  over- charges under a rent-ceiling provision of the Public Housing Act.9 As explained in Gonzaga University, three factors moti- vated the  Wright Court to conclude ‘‘that the provision unambiguously conferred ‘a mandatory benefit   focusing on the indi- vidual family and its income.’ ’’   Gonzaga Univ., 536 U.S. at 280, 122 S.Ct. 2268

(quoting Wright, 479 U.S. at 430, 107 S.Ct.

766).        First, ‘‘ t he key to the Court’s inquiry was that Congress spoke in terms that ‘could not be clearer.’ ’’    Id. Second, Congress  ‘‘conferred  entitlements  ‘suffi-


9.    The Public Housing Act provided in relevant part:

Dwelling units assisted under this chapter shall be rented only to families who are lower income families at the time of their initial occupancy of such units.   Reviews of family income shall be made at least annu- ally.   A family shall pay as rent for a dwell- ing unit assisted under this chapter (other than   a   family   assisted   under   section

1437f(o) of this title) the highest of the following amounts, rounded to the nearest dollar:

(1)  30 per centum of the family’s monthly adjusted income;


(2)  10 per centum of the family’s monthly income;  or

(3) if the family is receiving payments for welfare assistance from a public agency and a part of such payments, adjusted in accor- dance  with  the  family’s  actual  housing costs, is specifically designated by such agency to meet the family’s housing costs, the portion of such payments which is so designated.

42 U.S.C. § 1437a (1982 ed. and Supp. III)

(emphasis added).


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ciently specific and definite to qualify as enforceable rights under Pennhurst.’ ’’   Id.

(quoting Wright, 479 U.S. at 432, 107 S.Ct.

766).    Third, ‘‘the federal agency charged with administering the Public Housing Act

‘had never provided a procedure by which tenants could complain to it about the al- leged failures of state welfare agencies  to abide  by   the  Act’s  rent-ceiling  provi- sion .’ ’’           Id. (quoting  Wright, 479 U.S. at

426, 107 S.Ct. 766).


(b)  Wilder v. Virginia Hospital Ass’n In Wilder, the Court permitted a §  1983 action brought by health care providers to enforce a reimbursement provision of Title XIX of the Social Security Act, the same Title at issue here.10     According to Gonza- ga University, the  Wilder Court was per- suaded because the relevant Medicaid pro- visions:   (1) ‘‘explicitly conferred specific monetary entitlements upon the plaintiffs’’;

(2) ‘‘required States to pay an ‘objective’ monetary entitlement to individual health care providers, with no sufficient adminis- trative means of enforcing the requirement against States that failed to comply’’;   and

(3) because ‘‘Congress left no doubt of its


intent for private enforcement.’’    Gonzaga

Univ., 536 U.S. at 280–81, 122 S.Ct. 2268

(quoting  Wilder, 496 U.S. at 522–23, 110

S.Ct. 2510).


(c)  Suter v. Artist M.

In  Suter, the Court foreclosed an action under §  1983 brought by a class of parents and children who sought to enforce provi- sions of the Adoption Assistance and Child Welfare Act, which required that states have a ‘‘plan’’ to make ‘‘reasonable efforts’’ to keep children out of foster homes.11

According to Gonzaga University, the Su- ter  Court  recognized  that  because  the Adoption Act ‘‘conferred no specific, indi- vidually enforceable rights, there was no basis for private enforcement, even by a class of the statute’s principal beneficia- ries.’’   Gonzaga Univ., 536 U.S. at 281, 122

S.Ct. 2268 (citing  Suter, 503 U.S. at 357,

112 S.Ct. 1360).    Writing for the Court in

Suter, the Chief Justice explained:

Careful examination of the language TTT does not unambiguously confer an en- forceable right upon the Act’s beneficia- ries.  The term ‘‘reasonable efforts’’ in this context is at least as plausibly read


10.    Title XIX of the Social Security Act provid- ed in relevant part:


A State plan for medical assistance  must TTT provide  TTT for payment  TTT of hospital services, nursing facility services, and ser- vices in an intermediate care facility for the mentally retarded provided under the plan through the use of rates (determined in accordance with methods and standards de- veloped by the State  TTT) which the State funds, and makes assurances satisfactory to the Secretary, are reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated fa- cilities in order to provide care and services in conformity with applicable State and Federal laws, regulations, and quality and safety standards and to assure that individ- uals eligible for medical assistance have reasonable access  TTT to inpatient hospital services of adequate quality.


42    U.S.C.    §  1396a(a)(13)(A)    (1982    ed., Supp. V) (emphasis added).


11.  In  Suter, the Court considered provisions of the Adoption Assistance and Child Welfare Act, which provided in relevant part:


In order for a State to be eligible for pay- ments under this part, it shall have a plan approved by the Secretary which  TTT pro- vides that the plan shall be in effect in all political subdivisions of the State, and, if administered by them, be mandatory upon them;  TTT and  provides that, in each case, reasonable efforts will be made (A) prior to the placement of a child in foster care, to prevent or eliminate the need for removal of the child from his home, and (B) to make it possible for the child to return to his homeTTTT

42 U.S.C. §  671(a)(3), (15) (1988 ed. and

Supp. I) (emphasis added).


186      367 FEDERAL REPORTER, 3d SERIES


to impose only a rather generalized duty on the State, to be enforced not by private individuals, but by the Secretary in the manner of reducing or eliminat- ing payments .

Suter, 503 U.S. 363, 112 S.Ct. 1360 (quoted approvingly by Gonzaga Univ., 536 U.S. at

281, 122 S.Ct. 2268).


(d)  Blessing v. Freestone

In   Blessing,  the  Court  rejected  the claim under §  1983 of five mothers whose children were eligible to receive child sup- port services from the State of Arizona pursuant to Title IV–D of the Social Secu- rity Act.12 Title IV–D of the Social Security Act  enumerated  various  entitlements.13

Without claiming any specific rights under

Title IV–D, the plaintiffs asserted that

‘‘they had an enforceable individual right to have the State’s program achieve ‘sub- stantial compliance’ with the requirements of Title IV–D,’’ as required of the State in Title IV–A.14  Blessing, 520 U.S. at 333, 117

S.Ct. 1353.

In  Gonzaga University, the Court ex- plained the logic of the unanimous  Bless- ing holding:

Because the provision focused on ‘‘the aggregate  services  provided  by  the State,’’ rather than ‘‘the needs of any particular person,’’ it conferred no indi- vidual rights and thus could not be en-


forced by §  1983.   We emphasized:  ‘‘To seek  redress  through  §  1983,   TTT  a  plaintiff must assert the violation of a federal  right, not merely a violation of federal law.’’


Gonzaga Univ., 536 U.S. at 281, 122 S.Ct.

2268 (quoting  Blessing, 520 U.S. at 340,

117  S.Ct.  1353  (emphasis  in  original)). That   Blessing garnered unanimous sup- port is not surprising:   it is an easy case. The plaintiffs never asserted any individu- al rights but, instead, attempted to enforce Congress’s right to demand ‘‘substantial compliance’’ with the terms of a conditional grant of money.    To have allowed the ac- tion to proceed would have transformed

§  1983 from a vehicle to vindicate personal

rights into a qui tam mechanism.

To evaluate whether Congress had con- ferred enforceable  individual rights in a statute,  the    Blessing  Court  drew  on Wright, Wilder, and Suter, and formulated a three-prong test:   a statute must (1) be intended by Congress to benefit the plain- tiff, (2) not be ‘‘vague and amorphous,’’ and

(3) impose an unambiguous ‘‘binding obli- gation on the States.’’    Blessing, 520 U.S. at 340–41, 117 S.Ct. 1353.    While in  Gon- zaga University the Court did not aban- don this test, it did dispel

the    confusion   that    has  led  some courts to interpret  Blessing as allowing plaintiffs  to  enforce  a  statute  under


12.    42 U.S.C. §§  651–69 (1996) (as amended by the Personal Responsibility and Work Op- portunity Reconciliation Act of 1996, Pub.L.

104–193, 110 Stat. 2105 (‘‘PRWOR Act’’)).


13.    See, for example, the following provision: A State plan for child and spousal support must   TTT provide that the State will   TTT provide services relating to the establish- ment of paternity  TTT with respect to  TTT each child who is eligible   TTT and   TTT enforce any support obligation established with respect to eligible children TTTT

42 U.S.C. §  654(4)(A)-(B) (1996) (as amended by the PRWOR Act) (emphasis added).


14.    Title IV–A of the Social Security Act pro- vided in relevant part:


If a State program  TTT is found  TTT not to have   complied substantially with the re- quirements of the program , and the Secre- tary determines that the program is not complying substantially with such require- ments at the time the finding is made, the Secretary shall reduce the grant payable to the StateTTTT

42 U.S.C. §  609(a)(8) (1996) (as amended by the PRWOR Act) (emphasis added).


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§  1983 so long as the plaintiff falls with- in the general zone of interest that the statute is intended to protect;    some- thing less than what is required for a statute to create rights enforceable di- rectly from the statute itself under an implied private right of action.


Gonzaga Univ., 536 U.S. at 283, 122 S.Ct.

2268.       The Court clarified and ‘‘empha- size d  that it is only violations of  rights, not  laws, which give rise to §  1983 ac- tions.’’       Id. at 283, 122 S.Ct. 2268 (citing Blessing, 520 U.S. at 340, 117 S.Ct. 1353

(emphasis in original)).

Significantly, in  Blessing the Court did not decide that Title IV–D does not, in fact, confer individual rights.    Rather, the Court concluded that plaintiffs had failed to assert any specific rights, instead rely- ing on the general requirement that Ari- zona ‘‘substantially comply’’ with its Child Welfare Plan. Blessing, 520 U.S. at 345–46,

117 S.Ct. 1353 (‘‘We do not foreclose the possibility that some provisions of Title IV–D give rise to individual rightsTTTT

But,  it is not at all apparent that respon- dents sought any relief more specific than a declaration that their ‘rights’ were being violated  and  an  injunction  forcing  Ari- zona’s child support agency to ‘substantial- ly comply’ with all of the provisions of Title IV–D.’’).  Consequently,  the  Court  re- manded the case for a determination of whether specific provisions of Title IV–D gave rise to individual rights.    Id. at 346,

117 S.Ct. 1353.


2.   Rights–Creating  Language


To confer rights, Congress must use

‘‘rights-creating     language.’’                Gonzaga


Univ., 536 U.S. at 287, 122 S.Ct. 2268. Such language must clearly impart an ‘‘in- dividual entitlement,’’ and have an ‘‘unmis- takable focus on the benefitted class.’’   Id.

(quoting   Blessing, 520 U.S. at 343, 117

S.Ct. 1353, and  Cannon v. University of

Chicago, 441 U.S. 677, 690–93, 99 S.Ct.

1946, 60 L.Ed.2d 560 (1979)).    Cf. Alexan- der v. Sandoval, 532 U.S. 275, 289, 121

S.Ct. 1511, 149 L.Ed.2d 517 (2001) (‘‘Stat- utes that focus on the person regulated rather than the individuals protected cre- ate ‘no implication of an intent to confer rights on a particular class of persons’ ’’)

(quoting   California v. Sierra Club, 451

U.S. 287, 294, 101 S.Ct. 1775, 68 L.Ed.2d

101 (1981)).

The Chief Justice invoked the implied private right of action cases to demon- strate the type of ‘‘rights-creating terms’’ that unambiguously confer rights.

‘‘ T he question whether Congress  TTT intended to create a private right of action is   definitively answered in the negative’’ where ‘‘a statute by its terms grants no private rights to any identifi- able class.’’   Touche Ross & Co. v. Red- ington, 442 U.S. 560, 576, 99 S.Ct. 2479,

61 L.Ed.2d 82 (1979).    For a statute to create such private rights, its text must be ‘‘phrased in terms of the persons benefitted.’’             Cannon v. University of Chicago, 441 U.S. 677, 692, n. 13, 99

S.Ct. 1946, 60 L.Ed.2d 560 (1979).    We have recognized, for example, that Title VI of the Civil Rights Act of 1964 15 and Title IX of the Education Amendments of 1972 16 create individual rights be- cause those statutes are phrased ‘‘with an unmistakable focus on the benefitted


15.    Title VI provides:   ‘‘No person in the Unit- ed States shall TTT be subjected to discrimina- tion under any program or activity receiving Federal financial assistance’’ on the basis of race, color, or national origin.  42 U.S.C.

§  2000d (emphasis added).


16.    Title IX provides:  ‘‘No person in the United States shall, on the basis of sex TTT be subject- ed to discrimination under any education pro- gram or activity receiving Federal financial assistance.’’    20 U.S.C. §  1681(a) (emphasis added).


188      367 FEDERAL REPORTER, 3d SERIES


class.’’     Id., at 691, 99 S.Ct. 1946 (em- phasis added).

Gonzaga Univ., 536 U.S. at 283–84, 122

S.Ct. 2268.

As with implied private rights of action, statutory claims under §  1983 must be premised on an unambiguous articulation and  conferral  of  rights  by  Congress.17

‘‘ W here the text and structure of a stat- ute provide no indication that Congress intends to create new individual rights, there is no basis for a private suit, whether under §  1983 or under an implied right of action.’’    Id. at 286, 122 S.Ct. 2268.    With this in mind, the Court evaluated FERPA. First, and most importantly, the Court contrasted    the    ‘‘individually    focused’’

‘‘rights-creating’’ language of Title VI and IX (‘‘no person shall be subjected to dis- crimination’’) 18  with  FERPA’s  general provisions addressing the Secretary of Ed- ucation (‘‘no funds shall be made available’’ to any ‘‘educational agency or institution’’ which has a prohibited ‘‘policy or prac- tice.’’).19      Gonzaga Univ., 536 U.S. at 287,

122 S.Ct. 2268.     The Court noted that

‘‘FERPA’s  nondisclosure  provisions   TTT speak only in terms of institutional policy and practice, not individual instances of disclosure.’’             Id. at 288, 122 S.Ct. 2268. The contrast between the language of Ti- tles VI and IX and that of FERPA is stark.   The specific, mandatory, individual- ly focused language of Titles VI and IX


confers individual rights, while the aggre- gate, programmatic focus of FERPA’s lan- guage merely creates law applicable to the states.      The  distinction  is  dispositive: rights are enforceable under §  1983;   laws are not.    Gonzaga Univ., 536 U.S. at 283,

122 S.Ct. 2268 (citing Blessing, 520 U.S. at

340, 117 S.Ct. 1353).


Despite the clarity of the statutory lan- guage, the Court went on to bolster its analysis by considering the structural ele- ments of FERPA, which emphasize the programmatic and aggregate focus of the statute.              Although references to the indi- vidual appear throughout the text of FER- PA, ‘‘ i n each provision the reference  TTT is in the context of describing the type of

‘policy or practice’ that triggers a funding prohibition.’’       Id. Indeed, the fact that Congress ‘‘expressly authorized the Secre- tary of Education to ‘deal with violations’ TTT and to ‘establish or designate a  re- view board’ ’’ buttressed the Court’s as- sessment that FERPA did not confer en- forceable rights.   Id. at 289, 122 S.Ct. 2268

(citing 20 U.S.C. §§  1232g(f)-(g)).20     Final- ly, the Court highlighted statutory lan- guage reminiscent of that in  Blessing that counseled against a finding of individual rights. See id.     (‘‘Recipient institutions can further avoid termination of funding so long  as  they  ‘comply  substantially’TTTT This, too, is not unlike   Blessing, which


17.    The distinction between implied private rights of action and §  1983 private rights of action rests not in the articulation of rights, but in the availability of a remedy.    Gonzaga Univ., 536 U.S. at 285, 122 S.Ct. 2268 (‘‘ T he initial inquiry in a private right of action under §  1983 -determining whether a statute confers any right at all-is no different from the initial inquiry in an implied right of action case, the express purpose of which is to deter- mine whether or not a statute ‘confers rights on a particular class of persons.’ ’’) (quoting California v. Sierra Club, 451 U.S. at 294, 101

S.Ct. 1775).


18.    See n.15 & n.16, supra.


19.    20 U.S.C. §  1232g(b)(1).


20.    Understandably, the Court did not reach the issue of whether the remedial scheme in FERPA was sufficient to preclude a §  1983 suit.    Gonzaga Univ., 536 U.S. at 289 n. 8,

122 S.Ct. 2268 (‘‘We need not determine whether FERPA’s procedures are ‘sufficiently comprehensive’ to offer an independent basis for precluding private enforcement due to our finding that FERPA creates no private right to enforce.’’) (citation omitted).


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found that Title IV–D failed to support a

§  1983 suit in part because it only re- quired ‘substantial compliance’ with feder- al regulations.’’) (citing  Blessing, 520 U.S.

329  at  335,  343,  117  S.Ct.  1353,  137

L.Ed.2d 569).


B.             Title XIX—Step Two

Having traced the Court’s treatment of statutory rights under §  1983, we now turn to the ‘‘text and structure’’ of Title XIX.  Gonzaga Univ., 536 U.S. at 286, 122

S.Ct. 2268.


1.   Statutory Text

‘‘We begin with the familiar canon of statutory construction that the starting point for interpreting a statute is the lan- guage of the statute itself.’’                 Consumer Product Safety Comm’n v. GTE Sylvania, Inc., 447 U.S. 102, 108, 100 S.Ct. 2051, 64

L.Ed.2d 766 (1980).

Plaintiffs seek to enforce the right to acquire ICF/MR services, by virtue of 42

U.S.C.            §§  1396a(a)(10) 21            and

1396d(a)(15).22                        The language of the stat- ute requires that a state ‘‘must provide TTT medical assistance  TTT to  TTT all eligible individuals,’’  and  includes  intermediate care facilities in the definition of ‘‘medical assistance.’’  42 U.S.C. §§ 1396a(a)(10) &

1396d(a)(15).          Plaintiffs also seek to en- force the right to acquire ICF/MR services with ‘‘reasonable promptness,’’ as required by 42 U.S.C. §  1396a(a)(8).23                                               The lan- guage of the statute declares that a state

‘‘must provide TTT assistance TTT with rea- sonable promptness to all eligible individu- als.’’   42 U.S.C. §  1396a(a)(8).

In each of these provisions, the statuto- ry language is clear and unambiguous.


Indeed, we can hardly imagine anyone disputing that a state must provide the as- sistance necessary to obtain ICF/MR ser- vices, and that it must do so with ‘‘reason- able  promptness,’’  and  the  government does not do so.        Our inquiry, however, does not end there.                 Indisputably, these provisions create law, binding on those states choosing to accept Medicaid fund- ing.    Whether the same provisions confer rights, enforceable by individuals, is an- other question, and is the question we are called upon to answer.

1             To determine whether these provi- sions provide plaintiffs with unambiguous- ly conferred rights, we begin with what has come to be called the ‘‘Blessing Test.’’ Blessing, 520 U.S. at 340–41, 117 S.Ct.

1353.       As discussed above, the plain lan- guage of the statute clearly conveys that a state ‘‘must provide’’ plaintiffs with ‘‘medi- cal  assistance,’’  including  ICF/MR  ser- vices, with ‘‘reasonable promptness.’’            42

U.S.C.      §§  1396a(a)(10),      1396d(a)(15),

1396a(a)(8).             Without difficulty, we con- clude  that  these  provisions  satisfy  the Blessing Test because:   (1) plaintiffs were the        intended        beneficiaries        of

§§  1396a(a)(10),        1396d(a)(15),        and

1396a(a)(8);   (2) the rights sought to be enforced by them are specific and enumer- ated, not ‘‘vague and amorphous’’;  and (3) the obligation imposed on the states is unambiguous and binding.   Id.

But, again, our inquiry does not end there because, as is explained in  Gonzaga University, the   Blessing Test may only indicate that plaintiffs ‘‘fall   within the general zone of interest that the statute is intended to protect;   something less than what is required for a statute to create


21.    For    the    relevant    text    of    Section

1396a(a)(10), see note 5, supra.


22.    For    the    relevant    text    of    Section

1396d(a)(15), see note 6, supra.


23.    For    the    relevant    text    of    Section

1396a(a)(8), see note 4, supra.


190      367 FEDERAL REPORTER, 3d SERIES


rights enforceable directly from the stat- ute itselfTTTT’’               Gonzaga Univ., 536 U.S. at 283, 122 S.Ct. 2268.           To ensure that Congress  unambiguously  conferred  the rights asserted, we must determine wheth- er Congress used ‘‘rights-creating terms.’’ Id. at 284, 122 S.Ct. 2268.


The Court identified the text of Titles VI 24 and IX 25 as exemplars of rights- creating language.              Gonzaga Univ., 536

U.S. at 287, 122 S.Ct. 2268.   Viewing Titles VI and IX, we find it difficult, if not impos- sible, as a linguistic matter, to distinguish the import of the relevant Title XIX lan- guage-‘‘A State plan must provide’’-from the ‘‘No person shall’’ language of Titles VI and IX. Just as in Titles VI and IX, the relevant  terms  used  in  Title  XIX  are

‘‘mandatory    rather    than    precatory.’’ Blessing, 520 U.S. at 341, 117 S.Ct. 1353. Further, the ‘‘individual focus’’ of Sections

1396a(a)(10), 1396d(a)(15), and 1396a(a)(8) is unmistakable.   Gonzaga Univ., 536 U.S. at 287, 122 S.Ct. 2268.   The relevant Title XIX  provisions  enumerate  the  entitle- ments available to ‘‘all eligible individuals.’’ See, e.g., 42 U.S.C. §  1396a(a)(8).             The provisions do not focus on ‘‘the entity TTT regulated rather than the individuals pro- tected.’’    Alexander v. Sandoval, 532 U.S. at 289, 121 S.Ct. 1511.  Neither do the statutory references to the individual ap- pear ‘‘in the context of describing the type of ‘policy or practice’ that triggers a fund- ing prohibition.’’   Gonzaga Univ., 536 U.S. at 288, 122 S.Ct. 2268.


In requiring states which accept Medic- aid funding to provide ICF/MR services with  reasonable  promptness,  Congress conferred specific entitlements on individu- als ‘‘in terms that ‘could not be clearer.’ ’’ Gonzaga Univ., 536 U.S. at 280, 122 S.Ct.

2268 (quoting Wright, 479 U.S. at 430, 107

S.Ct.   766).            There   is   no   ambiguity. Where, as here, the plain meaning of the text is evident, we need not look further to determine congressional intent.               See, e.g., Darby v. Cisneros, 509 U.S. 137, 147, 113

S.Ct. 2539, 125 L.Ed.2d 113 (1993) (‘‘Re- course to the legislative history  TTT is un- necessary in light of the plain meaning of the statutory text.’’).26


2.   Statutory Structure

‘‘As a general rule of statutory construc- tion, where the terms of a statute are unambiguous, judicial inquiry is complete.’’ Adams Fruit Co. v. Barrett, 494 U.S. 638,

642,  110  S.Ct.  1384,  108  L.Ed.2d  585

(1990).   ‘‘General’’ rules, however, are sus- ceptible to exceptions, and we have before us one of those instances in which our inquiry does not end with the plain lan- guage of the statute.      We recognize, of course, that ‘‘ s tatutory construction ‘is a holistic  endeavor,’  and,  at  a  minimum, must account for a statute’s full text, lan- guage as well as punctuation, structure, and subject matter.’’    United States Nat’l Bank v. Independent Ins. Agents of Am.,

508 U.S. 439, 455, 113 S.Ct. 2173, 124

L.Ed.2d 402 (1993) (quoting  United Sav- ings Ass’n of Texas v. Timbers of Inwood Forest Associates, Ltd., 484 U.S. 365, 371,


24.    For the relevant text of Title VI, see note

15, supra.


25.    For the relevant text of Title IX, see note

16, supra.


26.    We note, however, that plaintiffs have cit- ed legislative history that may be construed to support our reading of the statute.    See App. Br. at 20–21 (citing various congressional leg-


islative materials for the proposition that Title XIX authorizes individual suits under §  1983). See, e.g., H.R.Rep. No. 104–651, at 213–14,

731–32, 2019–20 (1996);   H.R.Rep. No. 104–

350, at 211, 270, 288, 1069 (1995);    and H.R.Rep. No. 97–158, vol.    II, at 301 (1981). Because we find the statute unambiguous, however, we do not base our decision on legislative materials, or otherwise pass judg- ment on their relevance to our inquiry.


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191


108 S.Ct. 626, 98 L.Ed.2d 740 (1988)).    In Gonzaga University, the Court instructs that not only should the text of the statute be examined, but also its structure.    Gon- zaga Univ., 536 U.S. at 286, 122 S.Ct.

2268.    This instruction makes good sense: we cannot presume to confer individual rights-that is a task for Congress.   As the Court aptly put it, we ‘‘may play the sor- cerer’s apprentice but not the sorcerer himself.’’   Alexander v. Sandoval, 532 U.S. at 291, 121 S.Ct. 1511.    Our judicial func- tion is limited to recognizing those rights which Congress ‘‘unambiguously confers,’’ and in doing so we would be remiss if we did not consider the whole of Congress’s voice on the matter-the statute in its en- tirety.


Turning our sights beyond the narrow provisions invoked by plaintiffs gives us some pause.  Indeed, the District Court, basing its decision largely on the structur- al elements of Title XIX, reached the op- posite conclusion from that we reach.   The District Court in large part grounded its analysis on 42 U.S.C. §§  1396 and 1396c, and concluded that those provisions do not contain the rights-creating language re- quired by  Gonzaga University.   Sabree,


245 F.Supp.2d at 659.         Undoubtedly, the

Court was correct in that regard.

The opening section of Title XIX–Sec- tion 1396–is the appropriations and gener- al introductory statement of the Medicaid Act.27 As that Section explains, Title XIX was enacted ‘‘ f or the purpose of enabling each State  TTT to furnish  TTT medical as- sistance.’’             42 U.S.C. §  1396. This lan- guage says nothing of individual entitle- ments or rights, but reminds us that we are dealing with an agreement between Congress and a particular state, and re- calls the axiom of  Pennhurst:   ‘‘In legisla- tion  enacted  pursuant  to  the  spending power, the typical remedy for state non- compliance with federally imposed condi- tions is not a private cause of action for noncompliance but rather action by the Federal Government to terminate funds to the  State.’’    Pennhurst  State  Sch.  & Hosp., 451 U.S. at 28, 101 S.Ct. 1531. Turning next, as did the District Court, to Section 1396(c) does not help in the search for rights-creating language.  Sa- bree, 245 F.Supp.2d at 660.   Section 1396c empowers the Secretary of HHS to sus- pend payments to a state if it fails to

‘‘comply substantially’’ with the require- ments of Title XIX.28 This language not


27.    Section 1396 provides:

For the purpose of enabling each State, as far as practicable under the conditions in such State, to furnish (1) medical assistance on behalf of families with dependent chil- dren and of aged, blind, or disabled individ- uals, whose income and resources are in- sufficient to meet the costs of necessary medical services, and (2) rehabilitation and other services to help such families and individuals attain or retain capability for independence or selfcare, there is hereby authorized to be appropriated for each fis- cal year a sum sufficient to carry out the purposes of this title. The sums made avail- able under this section shall be used for making payments to States which have sub- mitted, and had approved by the Secretary, State plans for medical assistance.

42 U.S.C. §  1396.


28.    Section 1396c provides:


If the Secretary, after reasonable notice and opportunity for hearing to the State agency administering or supervising the adminis- tration of the State plan approved under this title, finds (1) that the plan has been so changed that it no longer complies with the provisions of section 1902;   or (2) that in the administration of the plan there is a failure to   comply substantially with any such provision;   the 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 Sec- retary is satisfied that there will no longer be any such failure to comply.    Until he is so satisfied he shall make no further pay-


192      367 FEDERAL REPORTER, 3d SERIES


only confirms that Title XIX by its terms creates a relationship between Congress and a particular state, but it recalls, as well, the ‘‘comply substantially’’ language in    Blessing  and           Gonzaga  University. Blessing, 520 U.S. at 343, 117 S.Ct. 1353; Gonzaga Univ., 536 U.S. at 289, 122 S.Ct.

2268.   Of course, in Blessing and Gonzaga University,    such    language    counseled against the recognition of an unambiguous- ly conferred right.

But while the District Court correctly recognized that Sections 1396 and 1396c do not contain the ‘‘sort of explicit, rights- creating language found in Title VI,’’ it did not consider the existence of rights-creat- ing language in other relevant provisions of Title XIX. Sabree, 245 F.Supp.2d at 659. The language used by Congress in 42

U.S.C. §§  1396a(a)(10), 1396d(a)(15), and

1396a(a)(8),  however,  explicitly  creates rights.   Admittedly, plumbing for congres- sional intent by balancing the specific lan- guage of a few discrete provisions of Title XIX against the larger structural elements of the statute is a difficult task.   Nonethe- less, it is evident, at least to us, that the statutory language, despite countervailing structural elements of the statute, unam- biguously confers rights which plaintiffs can enforce.

We conclude that Section 1396, the ap- propriations   and   general   introductory statement, cannot neutralize the rights- creating language of Sections 1396a(a)(10),

1396d(a)(15), and 1396a(a)(8).             Our confi- dence in this conclusion rests securely on the fact that the Court has refrained from overruling  Wright and  Wilder, which up- held the exercise of individual rights under statutes that contain similar (or, in the case of  Wilder, identical) provisions to 42

U.S.C. §  1396.


Section 1396 was in effect at the time of Wilder, in which the Court allowed claims to proceed under Title XIX, and a similar provision was in effect when the Court allowed claims to proceed in  Wright.  42

U.S.C. §§  1396 & 1437.      But   Gonzaga University did not overrule  Wilder;   rath- er, it explained that ‘‘Congress left no doubt of its intent for private enforce- ment.’’    Gonzaga Univ., 536 U.S. at 280–

81, 122 S.Ct. 2268 (quoting  Wilder, 496

U.S. at 522–23, 110 S.Ct. 2510).            Neither did the Court overrule  Wright;   rather, it identified it as an instance in which Con- gress ‘‘unambiguously conferred ‘a manda- tory benefit   focusing on the individual family and its income.’ ’’    Gonzaga Univ.,

536 U.S. at 280, 122 S.Ct. 2268 (quoting

Wright, 479 U.S. at 430, 107 S.Ct. 766). We do not diminish the significance of the  ‘‘comply  substantially’’  language  in Section 1396c.    Rather, we recognize that the plaintiffs in   Blessing sued under a provision  requiring  ‘‘substantial  compli- ance’’ by a state.   The Court held that the plaintiffs had no such right in the aggre- gate,  but specifically reserved decision on whether they might have individual rights under other provisions of the statute, and remanded for a determination of that is- sue.    Blessing, 520 U.S. at 345–46, 117

S.Ct. 1353.             This distinction makes good sense:   that Congress provides a remedy for itself for non-compliance does not nec- essarily preclude a coherent and coexisting intent to create an enforceable right in individual beneficiaries.    Significantly, and unlike the plaintiffs in  Blessing and  Gon- zaga, plaintiffs here have advanced specific claims, rooted in discrete, rights-creating provisions of Title XIX.


ments 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 (emphasis added).


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193


C.   Congressional               Preclusion—Step

Three

Even where a right has been unambigu- ously conferred, a state may rebut the presumption of the availability of §  1983 by demonstrating that Congress, either ex- pressly or by providing a comprehensive remedial scheme, intended to preclude in- dividual suits.   See, e.g., Blessing, 520 U.S. at 346, 117 S.Ct. 1353 (‘‘Because petitioner does not claim that any provision of Title IV–D expressly curtails §  1983 actions, she must make the difficult showing that allowing §  1983 actions to go forward in these circumstances ‘would be inconsistent with      Congress’      carefully      tailored scheme.’ ’’)  (quoting  Golden State Transit Corp. v. Los Angeles, 493 U.S. 103, 107,

110 S.Ct. 444, 107 L.Ed.2d 420 (1989)). We note, however, that ‘‘ t he burden to demonstrate that Congress has expressly withdrawn the remedy is on the defen- dant,’’ and that a court should ‘‘not lightly conclude that Congress intended to pre- clude reliance on §  1983 as a remedy’’ for deprivation of an unambiguously conferred right. Golden State Transit Corp., 493

U.S. at 107, 110 S.Ct. 444 (citations omit- ted).    Indeed, only twice has the Court found a remedial scheme sufficiently com- prehensive to supplant §  1983.    See Mid- dlesex County Sewerage Auth. v. Nat’l Sea Clammers Ass’n, 453 U.S. 1, 13, 14, 20, 101

S.Ct. 2615, 69 L.Ed.2d 435 (1981) (‘‘Sea Clammers’’ ) (acknowledging the ‘‘unusual- ly elaborate enforcement provisions’’ em- powering the E.P.A., coupled with several provisions allowing specific instances of private enforcement of the Federal Water Pollution Control Act, and concluding that Congress intended to preclude individual actions not explicitly allowed);   Smith v.


Robinson, 468 U.S. 992, 1009–11, 104 S.Ct.

3457, 82 L.Ed.2d 746 (1984) (concluding that because the Education of the Handi- capped Act permitted aggrieved individu- als to invoke carefully tailored local admin- istrative procedures followed by federal judicial review, Congress could not have intended individuals to bypass the enumer- ated procedure and advance directly to court via §  1983).

2             Title XIX contains no provision ex- plicitly precluding individual actions.   As a result, there is a substantial burden on a state seeking to establish that Congress has provided a comprehensive remedial scheme with which individual actions can- not be reconciled.              Title XIX does allow for a state administrative hearing.29      This is, however, the only remedial component of Title XIX, and clearly falls short of the comprehensive enforcement schemes seen in  Sea Clammers and  Smith.    ‘‘ A  plain- tiff’s ability to invoke §  1983 cannot be defeated simply by ‘the availability of ad- ministrative  mechanisms  to  protect  the plaintiff’s interests.’ ’’             Blessing, 520 U.S. at  347  (quoting   Golden  State  Transit Corp., 493 U.S. at 106, 110 S.Ct. 444).   See also Wilder, 496 U.S. at 523, 110 S.Ct.

2510 (‘‘The availability of state administra- tive procedures ordinarily does not fore- close resort to §  1983.’’).


III.           CONCLUSION

Plaintiffs have advanced specific claims rooted in statutory text that identify them as the intended recipients of medical assis- tance from the Commonwealth of Pennsyl- vania.   That Congress may choose to sanc- tion Pennsylvania for failure to comply with its own medical assistance plan does not necessarily preclude other repercus-


29.    Section 1396a(a)(3) provides in relevant part:   ‘‘A State plan for medical assistance must  TTT provide for granting an opportunity for a fair hearing before the State agency to


any individual whose claim for medical assis- tance under the plan is denied or is not acted upon with reasonable promptnessTTTT’’    42

U.S.C. §  1396a(a)(3).


194      367 FEDERAL REPORTER, 3d SERIES


sions, such as individual actions against the Commonwealth.   Congress clearly and un- ambiguously conferred the rights of which plaintiffs have allegedly been deprived by Pennsylvania, and has not precluded indi- vidual enforcement of those rights.            Ac- cordingly, the order of the District Court will be reversed, and this case will be remanded for further proceedings in accor- dance with this Opinion.



ALITO, Circuit Judge, concurring.


While the analysis and decision of the District Court may reflect the direction that future Supreme Court cases in this area will take, currently binding precedent supports the decision of the Court. I there- fore concur in the Court’s decision.



,






UNITED STATES of America, Plaintiff–Appellee,


v.


Michael A. THOMAS, Defendant– Appellant.


No. 03–4506.


United States Court of Appeals, Fourth Circuit.

Argued:   Feb. 26, 2004. Decided:   May 4, 2004.

Background:   Motorist was convicted un- der the Assimilative Crimes Act of fourth- offense driving while intoxicated (DWI) on federal  reservation  in  Virginia,  by  the United States District Court for the East- ern District of Virginia, Robert E. Payne, J., and he appealed.


Holding:   The Court of Appeals, William W. Wilkins, Chief Judge, held that subsec- tion of Maryland driving under the influ- ence (DUI) statute, under which motorist is per se guilty of DUI offense if he or she has threshold blood-alcohol concentration, was not ‘‘substantially similar’’ to Virginia driving while intoxicated (DWI) statute, so that motorist’s prior Maryland convictions, to extent based on this subsection of stat- ute, could not serve as predicate offenses in prosecution for the Virginia crime of fourth-offense DWI.

Vacated and remanded.



1. Criminal Law O1026.10(5)

Defendant’s   appeal   from   district court’s denial of motion to dismiss indict- ment would be treated as challenge to adequacy of factual basis supporting his conditional guilty plea, where defendant, as part of the plea agreement, had re- served right to appeal denial of motion to dismiss, and where, despite purporting to appeal denial of the motion to dismiss, defendant did not challenge sufficiency of indictment allegations, but rather sufficien- cy of record to support finding that he was guilty of offense charged.


2.  Indictment         and         Information

O144.1(1)

To warrant dismissal of indictment, defendant would have to demonstrate that allegations therein, even if true, did not state an offense.


3. Criminal Law O273(4.1)

Federal Rule of Criminal Procedure requiring court, prior to entering judg- ment on guilty plea, to first determine that there is factual basis for plea ensures that court will make clear exactly what defen- dant admits to, and whether those admis- sions are factually sufficient to constitute alleged  crime.          Fed.Rules  Cr.Proc.Rule

11(b)(3), 18 U.S.C.A.



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