*1 837 from percentage depicted range and a 346 the arbitrator s award exceeded his au- (corresponding per- thority, 5.8, million dollars to 0.0 pursuant to CBA because he (cor- bonus) up ignored cent to 382 million dollars and contradicted the clear and bonus). responding to percent 6.0 243 F.3d unambiguous agreement. terms of the year, at That pre-tax operating 346. conclusion, In recognize that a dollars, causing million income was 391 goal provide is to parties arbitration parties following to submit the issue to “swift, inexpensive with and final deci operating arbitration: “if the ... income sions,” but judicial “this not vitiate go went off the chart would the bonuses of an review arbitrator’s Anheu- decision.” off chart as Id. The arbitrator well?” ser-Busch, Here, just 280 F.3d 1144. union, issued for the after award find- arbitration, parties agreed they also ing agreement “expressly provid- that the agreed “to limit the authority arbitrator’s bonuses, ed a floor for but was silent as preserven and their right challenge cap” examining and extrinsic evidence decisions when the arbitrator had reached up any ambiguity “[t]o clear created out and stray[ed] rendered decision that silence.” Id. at 347. The district court and beyond delegated his authority and award, holding this court confirmed the negotiated barred contract.” Id. engaged that “the arbitrator contract And, interpretation. although the arbitra- III. Conclusion tor was not empowered under the CBA to reasons, foregoing judgment For PRP, add to the are terms arbitrators of the district court is REVERSED. This empowered gaps to fill left contracts.” case is with instructions to REMANDED Id. at 348. VACATE the award and arbitrator the. Players argument-is Association’s judgment enter in favor US Soccer merit, Northern without Indiana Pub- Federation. apply lic here. In Service does North- Service, Indiana
ern Public the PRP chart
was “silent” as to the bonus associated operating million dollars of in- “literally
come because it ... off was chart,” 348, thereby resulting id. at in an al., individually O.B. et behalf ambiguity gap arbitrator fill class, Plaintiffs-Appellees, of a contrast, interpretation. In via contract v. discussed, silent was CBA/UPA NORWOOD, Felicia F. in her official regard sponsor print use crea- capacity as Director the Illinoi tives; it expressly the US provided Department Healthcare s “request, Soccer Federation but Services, Defendant-Appellant. quire” sponsor player pool. donation Therefore, ambiguity gap there No. 16-2049 fill,, Players arbitrator Appeals, United Court of States argument Association’s fails. Circuit. Seventh Players remaining Association’s ar- Argued September guments attempts merely additional September Decided characterize the award as fall- arbitrator’s ing authority within under the CBA/ established, already
UPA. But as we have *2 Jr., Attorney, Hugh Farley,
Robert Na- IL, Ackenhausen, perville, Shannon Marie Attorney, Yates, Attorney, LE- Thomas D. FOR HEALTH COUNSEL JUS- GAL TICE, IL, Perkins, Chicago, Martha Jane Attorney, NATIONAL HEALTH LAW PROGRAM, Carrboro, NC, for Plaintiffs- O.B., dividuals) through Appellees corrective treatment the need Burt, C.F., by Burt and Julie for which is disclosed Garland child health (Corrective Fisher, mother, screening through his J.M. services.” “treat- Kristen “EPSDT.”) S.M., acronym ment” is “T” parents, his/her provision, 1396a(a)(8), McCullough McCullough. Dan Another U.S.C. and Michele *3 requires that medical assistance “shall be Jr., Hugh Farley, Attorney, Robert promptness furnished reasonable to IL, Perkins, Naperville, At- Martha Jane eligible all individuals.” torney, HEALTH LAW NATIONAL. EPSDT treatment PROGRAM, Carrboro, NC, for Plaintiffs- One. services,” “private duty nursing 42 U.S.C. S., Appellees by SA. S. and SH. and . 1396d(a)(8), § we’ll abbreviate as which mother, through Sheila Scaro. his/her nursing”; “home it means that the child Boachie-Ansah, Attorney, Linda OF- hospital lives at home rather than in a GENERAL, FICE OF THE ATTORNEY facility medical-care and attended IL, Division, Chicago, Civil for Appeals by a nurse or series of nurses for the Defendant-Appellant. HFS, by number of hours allowed which pays nurses at rates determined WOOD, Judge, Before and Chief agency. EASTERBROOK, POSNER Circuit and Judges. approves The children whom HFS for in very poor tend to be
POSNER, Judge. Circuit health; O.B., can take the first we named appeal by This Department the Illinois representative only and so plaintiff,.as Healthcare and Services member need discuss. He is .two (“HFS”) (Norwood, the nominal defen- old, Medicaid, years approved enrolled dant-appellant, her official sued nursing, for diagnosed and director) capacity as department’s disease, Syndrome, lung with Down and grant of a challenges Judge pre- Kocoras’s Ventilator-depen- abnormalities. cardiac liminary injunction. requires us appeal breathing, digest dent for he also cannot Act, interpret provisions to of the Medicaid normally or take of the oral nutrition participant with which Med- Illinois supplements designed help people to who comply; icaid is to HFS is the difficulty digesting get to nourish- have agency charged carrying out the ment. duty compliance.
state’s age At nine he’d months been The Act for hospitalized respiratory defines “medical assistance” as Peoria fail- ure, including “early screening, approved di- he was periodic and while there-HFS agnostic, $19,718 monthly budget pay to- [EPSDT] and treatment services ... age up- day for ... under for to to take individuals care (to simplify ready 21” to such him-at But when he was to be we’ll refer all home. “children”), persons home-nursing home to U.S.C. sent receive the 1396d(a)(4)(B), him, § for requires prescribed to that had been his care arrange for parents to all first to that care. “mak[e] medical assistance available” had 1396a(a)(10)(A). § eligible approved agreed A had individuals. For while HFS 1396a(a)(43)(C), up budgetary it to the limit provision, pay for related parents quires “provide arrang- specified, state to for ... it had left to the nurses, they ing (directly for referral find which couldn’t do or in- son appropriate agencies, organizations, they before knew when their would be state). All it tells the hospital—and contested by the ready be released prompt is take measures hospital him to leave safe wasn’t nursing for the class mem- obtain home parents the nurses needed hired until reasonably bers, clear di- is a and that It took the him home. to take care rective. ade- year almost a to obtain staff, home-nursing only then quate been although O.B. had Remember home. O.B. sent nursing for for home which HFS approved denied it agreed pay, he was had violating the charges HFS with The suit HFS, far as so year almost because arrange by failing to statute appears, attempt made find (or even, attempting to so far as appears, left search him. That conduct- for), requisite arrange with the reasonable .apparently by parents who lacked ed nursing to for home which promptness, *4 required to knowledge experience or hire the other class acknowledges O.B. and of a the number nurses without needed Act. entitled the members are Medicaid protracted search. painfully a con- judge The district certified class permanent in The a plaintiffs seek been sisting children who have of Illinois be junction, trial will par- nursing approved for home but whose they’re to it. entitled determine whether guardians or haven’t been hire ents able ground in Judge on Kocoras was solid nursing of for to which nurses the the granting the for predicting, as basis parents guardians. or entitles the the injunction sought by plain the preliminary high likeli- that there is And convinced tiffs, prevail they likely to at trial. that are succeeding in plaintiffs’ of trial hood the far Certainly the defenses thus advanced violation, statutory the proving HFS’s primary defense by HFS are is weak. judge preliminary issued in statute “re nothing the Medicaid (which ap- is ruling the that the is that Plaintiffs quired ensure- [HFS] of in- pealing). provision essential the care from receive medical nurses would junction requires defendant Norwood HFS their But was decided homes.” HFS) (which say is to “take immediate nursing proper that home the treat was arrange directly steps and affirmative (cid:127) G.B., plaintiffs, for other named ment the agen- appropriate referral of the class. and the other members cies,' individuals, correc- organizations, nursing of in-home shift easy tive treatment to find Apparently it’s nurses not similarly to Plaintiffs and such problems as seri for children with health Medicaid-eligible situated children under of the mem ous as those O.B. other age of 21 in the of Illinois class, State who not criti for bers HFS for shift approved also in-home it took parents have been cize- for the time O.B.’s services, receiving Adding for nursing but who are them to find their child. most, approved by difficulty level the fact [those] services at the is [HFS], all, plaintiff required by maybe Act.” Medicaid injunc- Although the state that the children and the other members claims enforceable, vague exceptions tion For rare poor. too class for injunction gave eligible reasons Illinois granting order child is terms, if it, family for her income its exceeds and described stated than 42 required” poverty ... federal line no more detail” the “acts “reasonable & state, Center Medicare Med complied percent. and thus See Services, 65(d)(1) (also (d)(2), that is & CHIP FRCP but icaid Illi- nois, https://www.medicaid.gov/medicaid- nursing agencies pediatric offer chip-program-information/by-state/ most private -and insurance (visited stateproiile.html?state=illinois service, doesn’t hospitals few cover websites Sept. were the other may help parents be able find opinion). this For a cited in household nursing for their children. See American $34,506—avery persons ceiling four Pediatrics, Academy “Policy Statement: income for a of that modest household size. Financing Pediatric Health Home Dep’t of & See U.S. Health Human Ser- Care,” (2006), http:// Pediatrics 834 vices, 01/25/2016, Poverty Guidelines pediatrics.aappublications.org/content/U8/ https://aspe.hhs.gov/poverty-guidelines. 2/834.1ong. some, maybe many—we’re not And told many—members of the live in how doesn’t argue that HFS home nurs Illinois, poorest which is southern ing inappropriate O.B. or gion in the state and has the fewest nurses class; that, argue member of the couldn’t per Nursing, Illinois capita. See Center for appropriate because decided Survey “Registered Nurse Workforce others). (and him As far can as we (December 2014), http:// 2014” 17-18 glean record, sparse from the has nursing.illinois.gov/PDF/2015-05-04_icn_ (if did) given up searching it ever rnws2014_report.pdf; Practical “Licensed agency for children whom the' *5 Survey Report 2015” Nurse 16- Workforce deems to home nursing. entitled It’s left (March 2016), http://hursing.illinois.gov/ parents many the search to most even PDF/2016-03-09_ICN_LPN_2015_ of not competent be may whom to conduct Survey_Report_Final.pdf. timely multiple search for and effective might hospital personnel think One that (no going nurse is to nurses work 18 hours patients parents able to advise would be out). true, day, day day in and If this is O.B. to able such as where find nurses found, Judge as Kocoras HFS has violated willing provide to the care for the the Act. ceiling. payment at But children HFS’s argues that “if not nurses are no there is indication this. HFS dele- fully plaintiffs’] able to staff hours [the gates the coordination of the neces- care [presumably the is to reference the sary for children like O.B. to the Division for], agreed to pay that Plaintiffs HFS has (DSCC) of Specialized Care for Children eare at the can receive elsewhere State’s University Chicago, at see the Illinois expense.” probably The “elsewhere” means http://dscc.uic.edu/, “help[s] which children hospitals. it’s the state But that decided youth special healthcare -needs nursing right plain- that home to services and But connect resources.” as appears, children. So far tiffs’ the in no indication as there is that when be the would indefinite confine- alternative adequate nursing O.B.’s case staff is not the of O.B. and other class members ment easy within the reach the yet in The state has to HFS, hospitals. provide nursing, entitled children home that to home evidence alternatives conjunction or in itself whether nursing, hospitalization, ade- UIC, parents in search. the assists their shows, argues quate to the It children’s needs. As the or we far as are able record determine, “simply guarantee that cannot that which hospitals from HFS enough are to home will be. to care- children O.B. be nurses .available like sent homes,” nursing participate not in Plaintiffs in their which is receive home doubt- aren’t, plaintiffs asking many less But the search nurses. And because true. currentTimeframe=0 registered-nurses/? they’re asking for the guarantee; for a 22:%22Loca- 22colId% & sortModel=#% nurses, is indication that and there courts) 7D). 22,% 22:% 22asc% 22% (unless compelled by 22sort% tion% will provide many nurses to other finger .find are we told how Nor lift in O.B.’s nursing might for children situation. recruited reasonable states be having any obligation HFS denies care the children provide Indeed cost to preliminary argues members, that It to do so. should other plaintiffs and that “improperly asserts injunction [HFS] nurses. to recruit Illinois it be difficult steps provide in- take affirmative should suggest This the dis is care, identifying without nurses to be re court could trict order acknowledging many steps those caring for positions peo from moved taken, already and includes errone- steps of the transferred the homes ple and assumptions about ous what The state plaintiff of the class. members surely HFS knows requires.” Act But shortage is a argues that there nurse steps” “affirmative is im- are—that those Illinois, nothing implicitly there many steps taken claim to have plicit its it; may be can do about and this the state asking to tell it already. plaintiffs In (And shortage if true. are, asking steps what those at the rates willing to work reimbursement to substitute themselves plaintiffs HFS, agency we could order set preliminary And the HFS. shortage by raising those eliminate simply as a first cut: should understood Armstrong' Exceptional v. Child rates. something insisting, the state do — -, Center, U.S. 135 S.Ct. provide nothing than in-home rather (2015). 191 L.Ed.2d The ade- nursing care for these children. nurse-shortage argument was made can then be evaluat- quacy of what prelimi- court until after the the district ed, leading to modification even perhaps *6 issued, and re- nary injunction while injunction. preliminary of the abrogation no in the state’s briefs this court peated “many steps to state’s reference The supporting and no particulars are offered in its already taken” is unsubstantiated reason to be appears evidence cited. The briefs, its to as- reference “erroneous argu- assumptions” “erroneous the state’s misunderstanding of sumptions” is a ment, which is that all law, to But we want first as we’ll show. payment quires participating of a that the state has told us note services, not the them- for medical services provide in-home it taken to “steps” has selves; requires while the statute for children with the afflic- nursing care medical “mak[e] state and hence HFS in this case. Has made involved tions plaintiffs, assistance available” for such to recruit nurses efforts active 1396a(a)(10)(A), § assis- U.S.C. “medical has, that it is no indication children? There provision just tance” either -means It hasn’t told us certainly evidence. needed “the care and services” (if any) it has ever re- many how “payment part or all of patient nursing care for provide cruited to 1396d(a). words, § In other cost.” [their] children, many or even how nurs- afflicted gets to choose argues the state (163,000, according are in Illinois es there pay provide services.or to whether for Henry Kaiser Founda- to The J. services, Facts, if it fails to tion,- though of course “Total Health Number State Nurses,” 2016, provide gap, and no one fills the April Professionally Active pay have to either. won’t http://kff.org/other/state-indicator/total- (or of) giving meanings But in two provide “medical provision ensure the services, assistance” statute need not be merely read pay for them.” meaning authorize which HFS decide oddity We note final appeal. HFS’s In govern shall in each case. fact the stat- $19,178 The willing pay state was so, because, example, ute can’t be read for month for home for nursing services O.B. plan that a for states “State medical (at requirement the estimated of 18 hours provide assistance must ... arranging of nursing per day, service equal to 540 (directly through to appro- referral per month, average hourly cost priate agencies, organizations, or individu- $35.51). would be hospitalization O.B.’s als) corrective treatment the need for $78,000 cost roughly the state a month— which is disclosed such child health four expense times nursing. 1396a(a)(43)(C) (em- screening services.” surely And HFS could scour the added). See, phases e.g., Katie A. ex rel. willing to work hour $35.51 County, Ludin v. L.A 481 F.3d (not a wage—it equates bad to an annual (9th 2007), 1158-59 Cir. and cases cited wage $71,020 year for a nurse who there; see also Centers for Medicare and year) works 2000 hours a more rapidly and Services, State Medicaid Manu- efficiently productively par- than the al, chs. https://www.cms.gov/ ents these unfortunate children. HFS Regulations-and-Guidanee/Guidance/ anomaly remark this in its briefs. Manuals/Paper-Based-Manuals-Items/ judge’s CMS021927.html?DLPage=1 grant prelimi- district & DLEn- nary injunction is tries=10 & & DLSort=0 DLSortDir=as- cending). And remember that the Medicaid Affirmed. requires provide Act the state to the re- quired services with prompt- reasonable EASTERBROOK, Judge, Circuit ness. concurring. In arguing requires that all Act I Although join opinion, I court’s contribution, is financial HFS relies language remain concerned of the Bruggeman Bruggeman ex v. Bla rel. injunction. district court’s 906, 910 (7th 2003), gojevich, 324 F.3d Cir. requires Director Nor- payment which called “Medicaid ... wood to “take immediate and affirmative scheme, state-provided not a scheme for steps to arrange directly refer *7 medical assistance.” At that time the stat ral to appropriate agencies, organizations, defined “medical ute assistance” as individuals, corrective treatment of in- “payment part or all of the of’ costs n nursing home shift services to Plaintiffs 1396d(a) enumerated care. 42 U.S.C. and; similarly Medicaid-eligi such situated (2009). Congress amended this defini in age ble children' under the 21 the tion Protection the Patient and Afforda of Illinois ap State who also have been in response Bruggeman ble Care Act services, proved for nursing in-home shift the decisions that it. followed And as but not receiving who are in-home shift explained Washington in A.H.R. v. State nursing approved by services at the Authority, 2016 level Health Care WL Defendant, (W.D. 7, 2016) (internal required by the *12 Jan. Wash. omitted), steps, quotation by doing particular? this Act.” What The in marks “Congress clarify junction say. does not P. that where Yet Fed. R. Civ. intended 65(d)(1)(C) Act that provision the refers the tells us an must services, participating required a is “describe in State reasonable detail'.. the act judge to expect the tors. required.” This in Nor should restrained acts Department ought to do. the any The know supply detail. what
junction does not not know what may itself injunctions Department has Supreme Court reversed suffice; See, so committed to the idea will is e.g., Schmidt like this one. that read pay is offer to Lessard, all it need do 473, 94 38 that 414 U.S. S.Ct. v. may have (1974). that never tried services L.Ed.2d approach. other Some, sug- opinion court’s the district declaratory judgment would Perhaps a .thought particulars gests judge that the starting point, a but the produce been better unnecessary goal the is have because complaining about the Department is not get children a defined result: injunction rather than declara- use of an for them. authorized Since do All court can tory judgment. a district Department of .Healthcare end, judge require as this is in a knows situation desired Services 65(d) re- pro- trying. Rule the means to start implied, must know defendant detail, not more detail quires duce that end. “reasonable” circumstances. possible than under the is Depart- If non-sequitur. That as the sent the May Department judge Last nurses, shortage of ment there is a asserts options it could with a list of some letter then the end cannot be achieved without Department As as the starts pursue. long from other de- taking care medical away list, this or takes some working through judge persons, the district did serying step prospect that seems to have a rationing nursing care suggest success, injunc- complied it has Act or the Medicaid either question It of the tion. would be out equitable use of appropriate court’s Department district court to hold the Raising rates powers. reimbursement ap- trying one or more contempt might supply nurses to induce additional As poorly. long turn out proaches that services, Armstrong Exceptional but v. detail-free, injunction is the most — Center, -, S.Ct. Child U.S. Department can is that the judge demand (2015), 1378, 191 holds that L.Ed.2d 471 if something—and the first one or two judges change cannot rates reimbursement fails, try something somethings else. private judge Yet if the cannot suits. Illinois, money, pay more command judge keep should tabs The district may possible not be achieve the end adjust injunc- happening judge thought required Department If the appropriate. tion as statute. be about the right supply turns out to nurses, judge also must ensure injunction in of this a ease kind persons, competing of other the interests steps designed specify should those resources, class for with the scarce (other promised pay- raising than rates De- adequately protected. Not unless the ment) Department take that the must spe- far more partment defies command *8 plaintiff order find nurses cific than the issued so far would be one counsel, class—-if, believe, class there .as consider, (or sensible) taking permissible prob- principal are found. steps. punitive injunction is drafting such an one lem my colleagues do not know mention: expect will work. We shouldn’t knowledge; lawyers
counsel to- have this not professional administra- healthcare