United States v. Secretary Florida Agency for Health Care Administration
938 F.3d 1221
11th Cir.2019Background
- In Sept. 2012 the DOJ issued a Letter of Findings after a 6‑month investigation, finding Florida’s Medicaid policies unnecessarily institutionalized hundreds of children and placed medically complex/fragile children at risk, in violation of Title II of the ADA and DOE regulations.
- DOJ sought voluntary compliance, then filed suit in July 2013 under Title II (42 U.S.C. § 12132) and implementing regulations (28 C.F.R. § 35.130(d)).
- The DOJ’s action was consolidated with a private class action alleging similar harms; Florida moved to dismiss, arguing the Attorney General lacks authority to sue under Title II.
- The district court initially denied Florida’s motion but later dismissed the DOJ’s suit for lack of standing; the Eleventh Circuit reviewed de novo whether the Attorney General (the United States) has a cause of action to enforce Title II.
- Statutory framework central to the dispute: § 12133 of Title II cross‑references § 505 of the Rehabilitation Act (29 U.S.C. § 794a), which in turn incorporates the remedial structure of Title VI (42 U.S.C. § 2000d‑1) that authorizes agency enforcement by regulation, funding termination, or “any other means authorized by law.”
- The Eleventh Circuit reversed the district court and held that the Attorney General may sue to enforce Title II, reasoning Congress incorporated the Rehabilitation Act/Title VI enforcement scheme (including federal enforcement by DOJ) into Title II and directed the AG to promulgate consistent regulations.
Issues
| Issue | Plaintiff's Argument (United States) | Defendant's Argument (Florida) | Held |
|---|---|---|---|
| 1) Does Title II authorize the Attorney General to bring enforcement suits? | §12133 cross‑references §505 of the Rehabilitation Act and thus makes available the full “remedies, procedures, and rights,” including DOJ litigation authority. | Title II grants enforcement rights only to a “person alleging discrimination”; the AG is not such a person, and titles I & III expressly name the AG while II does not. | AG has authority: Congress incorporated §505 (and thus Title VI enforcement machinery) into Title II; DOJ may sue. |
| 2) Does the cross‑referencing to the Rehabilitation Act and Title VI mean federal administrative enforcement is available under Title II? | Yes — Congress legislated against existing remedial schemes; §505/§602 provide administrative procedures and permit “any other means authorized by law,” which courts have read to include DOJ litigation. | Cross‑references do not implicitly import federal enforcement; Title II lacks the federal‑funding hook of Title VI/§504 and does not name the AG. | Yes: the Court treats the cross‑references as adopting the Rehabilitation Act/Title VI enforcement structure, including referral to DOJ. |
| 3) Do the Attorney General’s Title II regulations and prior Rehabilitation Act / Title VI regulations support DOJ enforcement? | AG was directed by Congress (42 U.S.C. §12134) to promulgate regs consistent with Rehab Act/Title VI; DOJ regs mirror those procedures and contemplate referral to the AG for litigation. | Regulatory consistency does not create a private cause of action or authorize AG suits where the statute’s text does not. | Regulations are entitled to deference and reinforce that Congress intended the administrative/agency enforcement model (including DOJ suits). |
| 4) Do federalism principles or alternate statutes (e.g., CRIPA) preclude DOJ suits against states? | Congress plainly covered states in Title II; states consented to suits by the federal government; federalism concerns do not negate the statutory enforcement scheme. | Suits against states involve sovereign interests and significant federalism costs; Congress must speak clearly to authorize such suits and Title II’s silence about the AG is telling. | Federalism does not alter result: the ADA expressly covers states and Congress indicated remedies; sovereign immunity is not a bar to suits by the United States. |
Key Cases Cited
- United States v. Georgia, 546 U.S. 151 (2006) (discusses scope of Title II and Congress’s enforcement authority)
- Barnes v. Gorman, 536 U.S. 181 (2002) (analyzes remedial structure and cross‑references to Spending Clause statutes)
- Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581 (1999) (Title II application to unnecessary institutionalization and federal role)
- Alexander v. Sandoval, 532 U.S. 275 (2001) (limits private enforcement of agency regulations promulgated under §602)
- Consolidated Rail Corp. v. Darrone, 465 U.S. 624 (1984) (discusses incorporation of agency regulations into statute)
- Marion County Sch. Dist. v. United States, 625 F.2d 607 (5th Cir. 1980) (interprets “any other means authorized by law” to include federal enforcement)
- United States v. Baylor Univ. Med. Ctr., 736 F.2d 1039 (5th Cir. 1984) (Rehabilitation Act enforcement and availability of judicial remedies)
- Pennsylvania Dep’t of Corr. v. Yeskey, 524 U.S. 206 (1998) (Title II plainly covers state institutions)
- Director, Office of Workers’ Comp. Programs v. Newport News Shipbuilding & Dry Dock Co., 514 U.S. 122 (1995) (agency standing and interpretation of “person adversely affected”)