Carla Frew v. Thomas Suehs
780 F.3d 320
| 5th Cir. | 2015Background
- Plaintiffs represent a Texas EPSDT class challenging Medicaid implementation under a 1996 consent decree.
- CAO 637-8 was issued in 2007 to address pharmacists’ understanding of EPSDT and the 72-hour emergency prescription policy.
- Plaintiffs moved in 2012 to enforce CAO 637-8; Defendants sought Rule 60(b)(5) relief to dissolve CAO 637-8 and Decree ¶¶ 124–30.
- District court found Defendants substantially complied with CAO 637-8 and Decree ¶¶ 124–30 and dissolved them, granting relief under Rule 60(b)(5) first clause.
- Appellate court affirmed, holding Decree interpretation proper and that substantial compliance justified dissolution; No explicit effectiveness metric required by Decree.
- In conclusion, the case centers on whether the Decree and CAO 637-8 should be dissolved when discrete action items were completed rather than achieving stated health outcomes.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Rule 60(b)(5) relief applicable? | Frew III governs; Decree’s goals require ongoing oversight. | Rule 60(b)(5) third clause not invoked; first clause satisfied. | Relief granted under Rule 60(b)(5) first clause; dissolution affirmed. |
| Contract interpretation of Decree as whole? | Broad results-oriented interpretation needed. | Decree governs specific actions; roadmap suffices. | Decree interpreted as a roadmap; no extra results-based standard required. |
| Was substantial compliance proven for CAO 637-8 bullets 6 and 10? | Defendants failed to meet intensive, targeted training and ombudsman training. | Defendants completed discrete actions; substantial compliance established. | Court properly found substantial compliance; dissolution affirmed. |
| Should analysis weigh overall Decree purpose vs. discrete actions? | Need evaluation of impact on EPSDT access and outcomes. | Goal is to implement the roadmap; no outcome metric required. | Outcome-based assessment not required; adherence to action items suffices. |
Key Cases Cited
- Frew ex rel. Frew v. Hawkins, 540 U.S. 431 (Supreme Court 2004) (standard for modifying institutional reform decrees under Rule 60(b)(5))
- Rufo v. Inmates of Suffolk County Jail, 502 U.S. 367 (Supreme Court 1992) (flexible standard for modification of consent decrees)
- Jeff D. v. Otter, 643 F.3d 278 (9th Cir. 2011) (comparison on-goal consideration in termination of decrees; distinguishable facts)
- Horne v. Flores, 557 U.S. 433 (Supreme Court 2009) (Rule 60(b)(5) relief discussed; no automatic cessation of obligations)