DEAL v. VELEZ et al, No. 1:2014cv06444 - Document 81 (D.N.J. 2018)
Court Description: OPINION. Signed by Judge Joseph H. Rodriguez on 2/20/2018. (tf, )
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DEAL v. VELEZ et al Doc. 81 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW J ERSEY CAMDEN VICINAGE PATRICE DEAL, EXECUTRIX OF THE : ESTATE OF GRACE DEAL, DECEASED, : Plaintiff, v. : J ENNIFER VELEZ, et al., Hon. J oseph H. Rodriguez Civil Action No. 14-6444 OPINION : Defendants. : This m atter is before the Court on a m otion for sum m ary judgm ent pursuant to Fed. R. Civ. P. 56 filed by the sole remaining Defendant, Charles SanFilippo, Director of Burlington County Board of Social Services. 1 The Court has reviewed the subm issions and decides the matter based on the briefs pursuant to Fed. R. Civ. P. 78(b). For the reasons stated here, Defendant SanFilippo’s motion will be granted. Background This case arises out of a series of applications for assisted living benefits m ade by or on behalf of decedent Grace Deal, which were originally denied by the State of New J ersey in conjunction with the Burlington Defendants originally nam ed but dism issed from the case are J ennifer Velez, former Comm issioner of New J ersey Department of Hum an Services (“DHS”), Meghan Davey, Director of New J ersey DHS Division of Medical Assistance and Health Services (“DMAHS”). 1 1 Dockets.Justia.com County Board of Social Services (“BCBOSS”). Although the State eventually granted Deal’s application, Plaintiff Patrice Deal, Executrix of the Estate of Grace Deal, asserts that Defendants wrongly determ ined that Grace Deal was not eligible for the Medicaid Waiver Program to cover assisted living services of $ 63,411.28 for the period from J uly 1, 20 14 to February 28, 20 15. Detailed facts regarding the application process and determ inations of benefits are fam iliar to the parties and were outlined by the Court in its March 20 , 20 17 Opinion dism issing all claim s except those asserted against Defendant SanFilippo. Relevant to the instant m otion is that on J anuary 6, 20 14, Grace Deal applied for Medicaid benefits through the Global Options Assisted Living Medicaid Waiver (“GO”) Program, the only Medicaid funded program in New J ersey that covered benefits received for assisted living facilities. On March 4, 20 14, BCBOSS, the county welfare agency, denied Deal eligibility for the GO Program because on December 13, 20 13 she had entered into a Consent Order reducing the am ount of m onthly spousal support to which she was entitled pursuant to a March 17, 20 10 settlement agreement which accom panied her Lim ited Divorce from Bed and Board from $ 20 55 to $ 1,50 0 . BCBOSS presumed that Deal’s request for the Order decreasing her m onthly support was im properly m otivated to obtain Medicaid, which had 2 a $ 2,163 m onthly incom e lim it, contrary to N.J . Adm in. Code 10 :714.10 (b)3, which prohibits disposal of assets at less than fair m arket value for five years prior to application for benefits. Plaintiff tim ely filed an adm inistrative appeal on March 12, 20 14. On J une 20 , 20 14, following a state adm inistrative hearing, the adm inistrative law judge issued an initial decision affirm ing the denial of Deal’s eligibility. On August 1, 20 14, the DMAHS issued a final agency decision affirm ing the adm inistrative law judge’s decision denying Deal GO Program eligibility. Plaintiff did not appeal that decision to the Superior Court of New J ersey, Appellate Division. Rather, on October 17, 20 14, Plaintiff filed the Com plaint in this case. Deal filed a second Medicaid application J anuary 20 , 20 15 and set up a Qualified Income Trust the next day. She alleges that in processing this second application, Defendants required her to obtain judicial m odification of her m onthly spousal support payment back to $ 20 55, which she did effective by court Order dated J une 5, 20 15. Deal passed away J une 28, 20 15. On or about J uly 22, 20 15, Deal was determ ined eligible for the Medicaid waiver program as of J une 1, 20 15, and based on undue hardship while seeking legal action to reverse the “transfer of assets,” granted her eligibility effective March 1, 20 15. 3 Plaintiff asserts violations of Deal’s statutory rights as granted by the Federal Medicaid Act, enforceable under 42 U.S.C. § 1983. The Am ended Com plaint asserts claim s for: (1) failure to establish an appropriate date of eligibility (J uly 1, 20 14) in operation of a Medicaid Assisted Living Waiver in violation of 42 U.S.C. § 1396a(a)(34); (2) denial of due process in operation of the Medicaid AL Waiver in violation of 42 U.S.C. § 1396a(a)(3) by failing to notify Deal that she was denied coverage for the tim e between the effective date of eligibility (J uly 1, 20 14) and the date in which she was enrolled; (3) failure to provide m edical assistance with reasonable prom ptness in operation of the Medicaid AL Waiver in violation of 42 U.S.C. § 1396a(a)(8); (4) denial of due process in operation of the Medicaid AL Waiver by failing to give full faith and credit to the Decem ber 13, 20 13 Superior Court Order reducing Plaintiff’s spousal support; and (5) declaratory relief directing Defendants to properly process Deal’s Medicaid application and determ ine her to be eligible for Medicaid effective J uly 1, 20 14. Sum m ary J udgment Standard “Sum m ary judgment is proper if there is no genuine issue of m aterial fact and if, viewing the facts in the light m ost favorable to the non-m oving party, the m oving party is entitled to judgm ent as a m atter of law.” Pearson 4 v. Com ponent Tech. Corp., 247 F.3d 471, 482 n.1 (3d Cir. 20 0 1) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986)); accord Fed. R. Civ. P. 56 (a). Thus, the Court will enter sum m ary judgment in favor of a m ovant who shows that it is entitled to judgm ent as a m atter of law, and supports the showing that there is no genuine dispute as to any material fact by “citing to particular parts of m aterials in the record, including depositions, docum ents, electronically stored inform ation, affidavits or declarations, stipulations . . . adm issions, interrogatory answers, or other m aterials.” Fed. R. Civ. P. 56 (c)(1)(A). An issue is “genuine” if supported by evidence such that a reasonable jury could return a verdict in the nonmoving party’s favor. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A fact is “m aterial” if, under the governing substantive law, a dispute about the fact m ight affect the outcom e of the suit. Id. In determ ining whether a genuine issue of m aterial fact exists, the court m ust view the facts and all reasonable inferences drawn from those facts in the light m ost favorable to the nonm oving party. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986). Initially, the m oving party has the burden of dem onstrating the absence of a genuine issue of m aterial fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Once the m oving party has m et this burden, the 5 nonm oving party must identify, by affidavits or otherwise, specific facts showing that there is a genuine issue for trial. Id.; Maidenbaum v. Bally’s Park Place, Inc., 870 F. Supp. 1254, 1258 (D.N.J . 1994). Thus, to withstand a properly supported m otion for sum mary judgment, the nonm oving party m ust identify specific facts and affirm ative evidence that contradict those offered by the m oving party. Andersen, 477 U.S. at 256-57. “A nonm oving party m ay not ‘rest upon m ere allegations, general denials or . . . vague statements . . . .’” Trap Rock Indus., Inc. v. Local 825, Int’l Union of Operating Eng’rs, 982 F.2d 884, 890 (3d Cir. 1992) (quoting Quiroga v. Hasbro, Inc., 934 F.2d 497, 50 0 (3d Cir. 1991)). Indeed, the plain language of Rule 56(c) m andates the entry of sum m ary judgment, after adequate time for discovery and upon m otion, against a party who fails to m ake a showing sufficient to establish the existence of an elem ent essential to that party’s case, and on which that party will bear the burden of proof at trial. Celotex, 477 U.S. at 322. That is, the movant can support the assertion that a fact cannot be genuinely disputed by showing that “an adverse party cannot produce adm issible evidence to support the [alleged dispute of] fact.” Fed. R. Civ. P. 56(c)(1)(B); accord Fed. R. Civ. P. 56(c)(2). In deciding the m erits of a party’s m otion for sum m ary judgm ent, the court’s role is not to evaluate the evidence and decide the truth of the m atter, but to determ ine whether there is a genuine issue for trial. 6 Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986). Credibility determ inations are the province of the factfinder. Big Apple BMW, Inc. v. BMW of N. Am ., Inc., 974 F.2d 1358, 1363 (3d Cir. 1992). Discussion Defendant SanFilippo argues that, on behalf of BCBOSS, he acts as an arm of the State in the initial processing of Medicaid applications, and therefore is entitled to Eleventh Am endm ent im m unity. The Eleventh Am endm ent incorporates a general principle of sovereign im m unity that bars citizens from bringing suits for dam ages against any State in federal court. Pennhurst State Sch. & Hosp. v. Halderm an, 465 U.S. 89, 10 0 -0 1 (1984). Sovereign im m unity extends to State agencies and State officers, “as long as the state is the real party in interest.” Fitchik v. N.J . Transit Rail Operations, 873 F.2d 655, 659 (3d Cir. 1989). It does not extend to counties and m unicipalities, despite their status as political subdivision of a state. Karns v. Shanahan, 879 F.3d 50 4, 513 (3d Cir. 20 18) (citing Bolden v. Southeastern Pa. Transp. Auth., 953 F.2d 80 7, 813-14 (3d Cir. 1991)). The Court finds no precedent for Defendant’s position here and declines to apply State law im m unity to SanFilippo, a County Defendant. Next, however, the Court finds that there are no facts in the record to indicate that Defendant SanFilippo had any involvement in denying 7 Plaintiff’s eligibility for Medicaid benefits. Instead, the record reflects that Defendant SanFilippo was not involved in processing the two Medicaid applications at issue and he was not nam ed Acting Director of BCBOSS until about March 20 16. (Danks Cert. Ex. 1; SanFilippo Cert.) Vicarious liability is inapplicable to § 1983 suits. Ashcroft v. Iqbal, 556 U.S. 662, 676 (20 0 9). Accordingly, insofar as a claim has been asserted against him individually, sum mary judgment will be granted in favor of Defendant SanFilippo. Further, Plaintiff has produced no evidence at this sum m ary judgm ent stage to sustain any of her claim s of violations of the Medicaid Act or other legislation in denying coverage for assisted living services for the period from Decem ber 1, 20 14 through February 28, 20 15. Conclusion For these reasons, Defendant SanFilippo’s m otion for sum m ary judgm ent [73] will be granted. An appropriate Order will be entered. Dated: February 20 , 20 18 / s/ J oseph H. Rodriguez J OSEPH H. RODRIGUEZ U.S.D.J . 8
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