## Facts

- Two Medicaid-eligible minors with significant developmental disabilities were placed at a state-operated intermediate care facility for individuals with intellectual disabilities (ICF/MR) for short-term evaluation.
- Treating professionals concluded the facility was inappropriate for long-term placement and that community-based services were more suitable.
- One child later transferred to a private intermediate-care facility; the other remained in the state facility.
- The minors, through representatives, sued the state Medicaid agency director in his official capacity under 42 U.S.C. § 1983, alleging violations of Title XIX (Medicaid Act) and Title II of the ADA.
- Plaintiffs primarily sought access to community-based services rather than continued institutional care, asserting that the state’s policies and practices improperly kept them institutionalized.
- The defendant moved to dismiss for failure to state a claim, targeting the Medicaid Act theories related to community-based services, and separately sought a stay of ADA issues pending a different case.

## Issues

1. Whether the Medicaid Act provisions invoked by plaintiffs create individual rights enforceable under 42 U.S.C. § 1983 to obtain community-based services.
2. Whether, assuming enforceable rights, the Medicaid Act requires Ohio to provide the specific community-based services and placements demanded rather than institutional ICF/MR services.
3. Whether the ADA Title II portion of the case should be stayed pending resolution of another case addressing similar ADA integration issues.

## Decision

- The court granted the Rule 12(b)(6) motion as to plaintiffs’ Medicaid Act claims seeking community-based services and dismissed those Medicaid-based claims.
- The court denied the motion to stay proceedings on the ADA Title II claims.

## Legal Principles

- A Medicaid Act provision is enforceable via § 1983 only if it contains clear, rights-creating language conferring an individual entitlement that is sufficiently definite for judicial enforcement.
- Statutory language framed as programmatic directives to states and federal administrators, rather than individual beneficiaries, generally does not create privately enforceable rights under § 1983.
- Medicaid is a cooperative federal-state program in which states retain discretion to select and structure optional services; absent clear statutory command, courts will not treat optional community-based services as mandatory entitlements.
- A discretionary stay of ADA claims requires a persuasive showing that parallel litigation will resolve or control the issues and that delay is justified; otherwise, adjudication should proceed.

## Conclusion

The court dismissed the plaintiffs’ § 1983 claims premised on the Medicaid Act as a vehicle to compel community-based services, holding that the provisions relied upon did not create privately enforceable rights and did not obligate Ohio to provide the specific services sought, but it allowed the ADA Title II integration claims to proceed without a stay.


A.M.H. v. Hayes, No. C2-03-778, 2004 U.S. Dist. LEXIS 27387 (S.D. Ohio Sept. 30, 2004)