Spurwink Svs., Inc. v. Maine Dep't of Health and Human Svs.

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STATE OF MAINE CUMBERLAND, ss. SUPERIOR COURT CIVIL ACTION DOCKE1~~O" ¢ F,fiC· i _11/ - '-/'i 7 CV-l?--113 r SPURWINK SERVICES, INC., Plainti H, v. ORDER MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES, 'l11d COMMISSIONER, DEPARTMENT OF HEALTH AND HUMAN SERVICES, C:l""A,l'E':~ OF MAINE" 0 TI' 'Ice C!lrnb(~~rlal1d, ss, Ci0f1( S !oJ I I' Defendants I~L:lintiff Spurwink Services, Inc., seeks judicial review of the Maine Department of Health and Human Services' decision to not adopt a rule setting a standard room and board reimbursement rate for private nonmedical institutions. The Department moves for dismissClI. BACKGROUND PI'lintiff Spurwink Services, Inc., is a privclte nonprofit mental health agency in I'v1aine. It recei ves funding for its children's residentiCl] treCltment progrLlms through privClte nonmedical institution (PNMI) funds and room and bOClrd reimbursement through the Department of J-IeCllth i1nd I-luJl1i1n Services (DHHS). In the 2009 AppropriCloons Act, the Legislature decrei1sed both stclte and federal funding in provisions that read: Initiative: Reduces funding by limiting residential lPNMI] reimbursement by rate setting and sets Cl standard room Clnd board rate. 1 P.L. 2009, Ch. 213, §§ A-31, A-32. Each provision then specifies a dollar reduction in funding to a specific fund. The Act also contained a provision mandating the adoption of a tiered PNMI rZlte. It reads: Initiative: Reduces funding for children's [PNMIs] by lldopting 5 tiers of rates and a 95% occupancy rate. This assumes providers currently reimbursed below the new tier into ,,,,hich they bll will not receive a rate increase and no cut will be made in room and bOZlrd payments. P.L. 2()()9, eh. 213, § A-32. OI-fl-IS subsequently issued new rules «(dopting a five-tiered rate schedule for PN1VII services, but did not issue rules setting a standard room ,md board rate. Spurwink requested and petitioned Df-lHS to do so, but DI-i1-IS refused. On April 20, 2()JO, Spurwink filed its complaint to obtain judici(ll review pursu(lnt to 5 M.RS. § 8058 (2009). It contends that the plain l(lnguage of the 200c) Appropric(tions Act requires DHHS to eng(lge in rulemaking to set both new I>NMI r(ltes nun (l nevv standard room and board rate. 01-1'1-1"5'5 f(lilllre Lo do so h(ls aJJegedJy cost Spurwink Cln (lllllU(l1 loss of $600,000 in reimbursements. DIIHS filed this Rule 12(b)(6) motion to dismiss on May ]2, 201 0, <1rguing that the Act docs not require it to engage in additional rulemZlking and that Spurwink's dam(lge claim is pure specul(ltion. DISCUSSION Any person who is aggrieved by "an agency's refusal or fCliJure to (ldopt Cl rule where the adoption of a rule is required by la"v" may obtain judicial review by the Superior Court in an action for declaratory judgment. 5 M.R.S. § 8058 (2009). f\ate-settlng is a form of rule-making] and the challenged room and bO(lrd I "'Rule' means the whole or any part of every regulation, standard ... or other agency statement of general applicability ... [that] implements, interprets or 2 rates directly impact plaintiff. The only question is whether the 2009 Appropriations Act requires DHHS to adopt new rules setting a standard room and board relte. Statutory interpretation is a question of law, Garrisoll City Broad., ll1c. v. York Obstetrics [1 Gyllecology, P.IL, 2009 ME 124, <J1 9,985 A.2d 465, 468, so the court !l1clY resolve this matter on the defendant's Rule 12(b)(6) motion. Heber 'ii. Lllcente-ill-Maille Village Corp., 200() ME 137, 9J 7,755 A.2d 1064,1066. The court's "primary purpose in interpreting a statute is to give effect to the intent of the Legislature." Allied Res., 111c. v. Dep't ofPllb. Safety, 2010 ME 64, <Ii 11 , _ A.2d _ (quoti ng Rich v. Dep't (~f Marille Res., 201 () ME 41, <ll 7, 994 A.2d 815,817-18) (quotations omitted). If a stcltute is ullelmbiguous, the court wi]] give the statutory language its plain meaning and look no further. Garrisoll City Broad., ll1C., 2009 MEl 24, 9[ 9, 985 A.2d at 468. If, however, the statute "is retlSOnClbly susceptible of different interpretations," Dep'l ofCorr. v. PUC, 2009 ME 40, 91 8, 968 A.2d 1047, 1050 (quoting COI//petitive EI/ergy Servs. LLC v. PllIi. Utils. COl/III/'ll, 20m ME 12, <IllS, 818 A.2dI039, 1(46) (quotations omitted), the court "will examine the legislative history as well as the context of the whole statutory scheme of which the section at issue forms a part, so that a helrmonious result, presumably the intent of the Legislature, may be achieved." Allied Res., 1I1C., 2010 ME 64, eli 21, _ A.2d at _ (quotations omitted). Spurwink contends that the Appropriations Act is plain and un<lmbiguous. It "[rleduces funding by Jinliting residential [PNMl] reimbursement by rate setting al/d sets a standard room and board rclte." r.L. 2009, eh. 213, §§ A-31, A-32 (emphasiS added). The plaintiff reads this to instruct makes specific the lay\! administered by the agency, or describes the procedures or practices of the agency." 5 M.RS. § 8002(9) (2009). 3 DHHS to both engage in rate setting for PNMl reinlbursements and adopt a rule setting a standard room and board rate. DHHS advances a different interpretation of the statutory ltlnguage. It starts by noting that the statutory rules of construction make "rt]he words 'and' ,11ld 'or' ... convertible as the sense of a statute may require." 1 M.R.5. § 71(2) (200l)). The Act's usc of the word "and" is thus not necessarily conjunctive. DHHS clIso notes that provision in question docs not include the words "sheill" or "must," whose presence would "indicate a mandatory duty, action or requirement." 1 M.R.5. § 7'1 (9-A) (2009). The DHHS interprets the ](lnguelge "Initiative: Reduces funding by limiting residential [PNMI] reimbursement by rate setting and sets a standclrd room and board rate" as ,:l!l instruction to achieve the mandated savings by cutting the total amount spent on PNMI reimbursement and room and board together. The Dep,utment achieved the required savings when it adopted the five-tier PNMJ reirnbursement system nlelndl1ted in P.L. 2009, eh. 213, § A-32, so it does not need to alter the room and board rate. Both parties' interpretations of the plain stcltutory language are reasonelble, so the language is ambiguous. "When statutory terms arc l1mbiguous, /the court will] defer to the agency's interprctcltion of a statute that is within its area of expertise unless" it contradicts the plain legislative language or is unreelsonable in context of the legislative history and statutory scheme as a whole. Allicd Res., 1I1C., 20ID ME 64, ~121,_ A.2d at._ (citing Me. Ass 'II (:f HCI7/t/1 P/nlls v. SlIpcrilltcndcnt of 1115.,2007 ME 69, <j[ 32,923 A.2d 918, 927; Cobb v. Bd. OrCol/llsc/illS Prof'/s Liccllsl/rc, 2006 ME 48, <]I 13,896 A.2d 271, 275). DHHS's interpretation does not run afoul of the statute's plain language or its evident 4 purpose. The 2009 Appropriations Act crafts a budget and drastically reduces government spending. DHHS's interpretation fits this purpose. Spunvink argues that DHHS's reading will result in an inequitable distribution of funds among PNJ\/Ils and deviate sharply from past practice, results the Legislature intended to avoid by making DHHS cldjust its room imd bOurd fund in tandem vvith itsPNMI reimbursement rCltes. Even if the court could consider DIII-IS's ptlst and appi1rently informal practice of bulclncing the two types of disbursements to ensure uniform funding among PNMJs, there is no evidence thut the Legislature had this prclcticc in mind when it rutified the contested sentences together with thousands of others in the 2U09 Appropriutions Act. DHHS's interpretcltion of the Act is reasonable, and the court grants its motion to dismiss. The entry is: Public Lenv 2009, eh. 213, §§ A-31, A-32 does not require the Department to set a stundard room und board rate when it was able to uchievc the mandated savings solely through PNMJ rate setting. Since the statute does not require the Depurtment to adopt a rule, the plaintiff's section 8058 action is dismissed. DATE: -¥'i, 'l.01 0 5 UTN:AOCSsr -2010-0038938 CASE #:PORSC-CV-2010-00170 01 0000007985 GREGORY, JANE -------'-------------------------­ 6 STATE HOUSE STATION AUGUSTA ME 04333-0006 F DEPARTMENT OF HEALTH AND HUMAN SERVICES DEF 05/12/2010 RTND --------------- 02 0000002671 LEIGHTON, CHRISTOPHER - - - - . . . . : -__- : . . . . _ - - - - - - - - - - - - - - - - - - - - ­ 6 STATE HOUSE STATION AUGUSTA ME 04333-0006 F DEPARTMENT OF HEALTH AND HUMAN SERVICES DEF RTND 05/12/2010 ------------'---'---­ 03 0000000299 STEVENS, GRAYDON -'--~----:;,;~-.::....:....:;;,~:....;;.:~--------------------53 EXCHANGE ST PO BOX 597 PORTLAND ME 04112-0597 F SPURWINK SERVICES INC PL RTND 04/20/2010 -'---------=-----'---'---=-..:....----=...........;;,.

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