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J.T., By and Through His Mother A.F v. Julie Hamos

October 4, 2012

J.T., BY AND THROUGH HIS MOTHER A.F., PLAINTIFF,
v.
JULIE HAMOS, IN HER OFFICIAL CAPACITY AS DIRECTOR OF THE ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES, DEFENDANT.



The opinion of the court was delivered by: Sue E. Myerscough, U.S. District Judge:

E-FILED

Friday, 05 October, 2012 04:23:04 PM Clerk, U.S. District Court, ILCD

OPINION

This matter comes before the Court on the Motion to Dismiss Counts II, III, and IV of the Complaint (d/e 10) filed by Defendant Julie Hamos. For the reasons that follow, the Motion is GRANTED IN PART and DENIED IN PART.

I. FACTUAL BACKGROUND

On August 2, 2012, J.T., by and through his mother A.F.*fn1 , filed a four-count Complaint (d/e 1) against Defendant, Julie Hamos, in her official capacity as Director of the Illinois Department of Healthcare and Family Services. The Complaint contains four counts. Plaintiff seeks injunctive and declaratory relief in the first three counts: (1) Count I, a violation of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDTP) program of Medicaid and 42 U.S.C. § 1983; (2) Count II, a violation of the Americans with Disabilities Act (ADA) and 42 U.S.C. § 1983; (3) Count III, a violation of the Rehabilitation Act and 42 U.S.C. § 1983. Plaintiff seeks money damages in Count IV, which is identified as a claim for a violation of the Rehabilitation Act and 42 U.S.C. § 1983.

According to the Complaint, J.T., is a Medicaid-eligible, 13-year-old boy who suffers from Bipolar Disorder (mixed type with psychotic features) and Mild Mental Retardation. Cmplt. ¶¶ 1, 26, 39, 74, 92. J.T. has been psychiatrically hospitalized numerous times within the past year for severe agitation and physical and verbal aggression. Cmplt. ¶ 75. Prior to each psychiatric hospital admission, J.T. was screened by Defendant, through the Screening, Assessment and Support Services program (SASS) and Defendant determined that psychiatric hospitalization was the least restrictive setting available through Medicaid to provide J.T. with medically necessary psychiatric treatment. Cmplt. ¶ 76.

On July 10, 2012, Dr. Eddie Y. Ramirez recommended that J.T. receive comprehensive treatment at a residential facility. Cmplt. ¶ 77. On July 12, 2012, legal counsel for J.T. forwarded Dr. Ramirez's recommendation to Defendant with a request that Defendant implement Dr. Ramirez's recommendations. Cmplt. ¶ 78. However, J.T. has been unable to obtain the medically necessary services to treat and ameliorate his disorders as prescribed by Dr. Ramirez. Cmplt. ¶ 79. Plaintiff further alleges, on information and belief, that between July 1, 2012 and July 18, 2012, J.T. was evaluated numerous times by SASS but SASS failed to arrange for and provide medically necessary treatment to J.T. Cmplt. ¶ 81.

On July 18, 2012, J.T. was placed in the Vermilion County Juvenile Detention Center for violating the conditions of his home confinement. Cmplt. ¶ 82. J.T. was placed on home confinement after being charged with domestic battery of Plaintiff. Cmplt. ¶ 82, n. 1. On July 28, 2012, while in the Vermilion County Juvenile Detention Center, J.T. was evaluated for admission to Options, a psychiatric residential treatment facility in Indianapolis, Indiana. Cmplt. ¶ 83. On July 30, 2012, J.T. was found to be an appropriate candidate for treatment in the Options program. Cmplt. ¶ 84.

Plaintiff alleges that if J.T. does not receive residential treatment, he will be at risk for further hospitalization/institutionalization. Cmplt. ¶ 86. When J.T. is in the hospital, he is unable to attend school or leave the hospital at all. Cmplt. ¶ 87. Moreover, "[w]hen J.T. is discharged from the hospital, outpatient services have been unsuccessful at maintaining a sufficiently supervised and therapeutic setting." Cmplt. ¶ 88. Plaintiff alleges J.T. "needs residential treatment to treat and ameliorate his disorders." Cmplt. ¶ 89.

In Count I of the Complaint, Plaintiff alleges Defendant is violating the federal Medicaid Act, 42 U.S.C. § 1396 et seq., because Defendant has failed and continues to fail to provide J.T. with "medically necessary intensive home and community based services, community residential services, and/or residential mental health services" that Defendant is mandated to provide under the EPSDT program provisions of the Medicaid Act. Cmplt. ¶ 94. Plaintiff also alleges in Count I that the failure to provide statutorily-mandated services violates 42 U.S.C. § 1983. Cmplt. ¶ 95.

In Count II, Plaintiff alleges a violation of Title II of the ADA and a violation of 42 U.S.C. § 1983. Specifically, Plaintiff alleges that J.T. is a qualified individual with a disability, the Illinois Department of Healthcare and Family Services is a public entity, and that Defendant discriminates against J.T. by failing to provide him services in the most integrated setting appropriate to his needs. Cmplt. ¶¶ 101, 102, 104. Plaintiff further alleges that "[b]y failing to provide adequate home based and community-based mental health/behavioral services, Defendant has and continues to discriminate against the Plaintiffs by unnecessarily segregating them in violation of the ADA." Cmplt. ¶ 109.

In Count III, Plaintiff alleges a violation of the Rehabilitation Act and a violation of 42 U.S.C. § 1983. Plaintiff alleges that J.T. is a qualified individual with a disability under Section 504 of the Rehabilitation Act. Cmplt. ¶ 118. Plaintiff alleges that Defendant discriminates against J.T. by failing to provide him services in the most integrated setting appropriate to his needs. Cmplt. ¶ 120. Plaintiff also alleges that the Illinois Department of Healthcare and Family Services is a recipient of federal funds under the Rehabilitation Act. Cmplt. ¶ 116.

Finally, in Count IV, Plaintiff alleges Defendant has intentionally discriminated against J.T. by "establishing a system which requires him to become institutionalized (hospitalized) in order to receive or access intensive services to address his behavioral or emotional disorders, while other persons are able to access community based services without having to become institutionalized." Cmplt. ¶ 130. Plaintiff further alleges that Defendant's actions constitute deliberate indifference because Defendant continues to administer a system that relies heavily on hospitalization despite the demonstrated advantages of community-based programs.

Cmplt. ¶ 132.

Plaintiff seeks a declaratory judgment declaring as unlawful Defendant's failure to comply with the mandates of the Medicaid Act, ADA, and Rehabilitation Act and a permanent injunction enjoining Defendant from subjecting J.T. to practices that violate his rights under the Medicaid Act, ADA, and Rehabilitation Act. The prayer for relief also seeks money damages under the Rehabilitation Act, costs, and reasonable attorney fees.

II. PROCEDURAL BACKGROUND

On August 2, 2012, Plaintiff filed the Complaint, Motion for Preliminary Injunction (d/e 2), and Motion for Temporary Restraining Order (d/e 4). On August 7, 2012, this Court entered an Agreed Order (d/e 8) providing that:

1. Defendant will seek to procure a contract, in accordance with applicable State laws, policies and procedures, for appropriate treatment and placement at a Psychiatric ...


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