SEIU HEALTHCARE PENNSYLVANIA; Melanie Zeigler; Katherine Brodala; Joanne Namey; Jon Ann Fredericks; Wendy Hoke; State Senator Timothy J. Solobay; State Senator John N. Wozniak; State Representative Michael K. Hanna; State Representative Ted Harhai; State Representative Pam Snyder, Appellants v. COMMONWEALTH of Pennsylvania; The Honorable Thomas Corbett, Governor of The Commonwealth of Pennsylvania; The Pennsylvania Department of Health; Michael Wolf, Secretary of Health, Appellees, American Federation of State, County, and Municipal Employees, Council 13, AFL-CIO, by its Trustee Ad Litem, David R. Fillman; Kelly Linko, Intervenors Federation of State Cultural and Educational Professionals, Local 2382, American Federation of Teachers Pennsylvania, AFL-CIO, by its Trustee Ad Litem, William F. Bertrand, Intervenors.
Supreme Court of Pennsylvania.
Argued March 12, 2014. Decided Nov. 20, 2014.
104 A.3d 495
tion that appellant attempted to use the assessment issue to further delay his sentencing. See N.T. Sentencing, 1/11/12, at 3-4; see also Trial Court Opinion, 4/23/12, at 3-4. This does concern the dangers of treating the assessment as a right of the accused rather than a tool of the court. Accordingly, I dissent.
Justice STEVENS joins this dissenting opinion.
Alaine S. Williams, Esq., Willig, Williams & Davidson, Philadelphia, for American Fed. of State, County and Munic. Employees, Council 13, AFL-CIO, by D. Fillman; K. Linko.
Irwin William Aronson, Esq., Harrisburg, Bruce Michael Ludwig, Esq., Philadelphia, Willig, Williams & Davidson, for Seiu Healthcare PA; Zeigler; Brodala; Namey; Fredericks; Hoke; Solobay; Wozniak; Hanna; Harhai; Snyder.
Linda Cadden Barrett, Esq., Alison Taylor, Esq., PA Office of General Counsel, Audrey F. Miner, Esq., Pennsylvania Department of Health, for Commonwealth of PA; Hon. Thomas Corbett, Gov. of Comm. of PA; PA Dept. of Health; Michael Wolf.
CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, McCAFFERY, STEVENS, JJ.
OPINION
Justice BAER.
This is a direct appeal from the Commonwealth Court‘s order dated April 25, 2013, denying a request for a preliminary injunction to prevent the closure of twenty-six State Health Centers (“Centers“) and the furloughing of approximately twenty-six nurse consultants employed by those Centers.1 For the reasons set forth herein, we discern no reasonable ground for the denial of injunctive relief, and, accordingly, reverse the order of the Commonwealth Court.
To carry out its statutory duty to protect the health of Pennsylvania citizens and determine and employ the most efficient and practical means for the prevention and suppression of disease,
In 1996, the General Assembly enacted legislation, Act 87, addressing the DOH‘s operation of the Centers and its administration of public health services. Specifically relevant here, Subsection 8 of Act 87, codified at
More than fifteen years later, in 2013, the DOH announced that, pursuant to an extensive reorganization of public health services referenced in Governor Tom Corbett‘s 2013-2014 budget, twenty-six Centers would be closed and approximately twenty-six nurse consultants would be furloughed. In re-
sponse, on April 1, 2013, a lawsuit was filed in Commonwealth Court‘s original jurisdiction by Appellants SEIU Healthcare Pennsylvania, an unincorporated labor organization, five nurses employed by the Centers and represented by SEIU, and five Pennsylvania state legislators (collectively referred to as “SEIU“), seeking injunctive and declaratory relief. Specifically, SEIU sought to prevent Appellees, the Commonwealth of Pennsylvania, Governor Corbett, the DOH, and DOH Secretary, Michael Wolf (collectively referred to as “the Executive Branch“), from closing the Centers and furloughing the nurse consultants.
SEIU alleged that the closings and furloughs violated
With the exception of the three State health centers selected for the review program established in paragraph (2)2 [currently expired], the department shall operate those public State health centers and provide at a minimum those public health services in effect as of July 1, 1995. Except as provided in paragraph (2) [currently expired], the department shall not enter into contracts with any
additional private providers that would result in the elimination of any State health center nor reduce the scope of services currently provided nor reduce the number of centers.
SEIU alleged in its complaint that the plain language of the first sentence of Section 1403(c)(1) requires the Common-
wealth to continue to offer the same level of public health services and operate the same number of Centers that existed on July 1, 1995, i.e., sixty. Unless and until the statute is amended, it argued, the DOH is statutorily required to operate the Centers at the current level. Consequently, SEIU contended, the plan to eliminate twenty-six Centers and furlough twenty-six nurse consultants constituted an unequivocal violation of the express terms of the statute.3
In its answer to SEIU‘s complaint, the Executive Branch denied that Section 1403(c)(1) requires the DOH to continue to operate all Centers in existence as of July 1, 1995. Rather, it argued, the focus of the provision was exclusively to prevent the closure of Centers as a result of privatization. Under the proffered modernization plan, the Executive Branch contended, the DOH was not privatizing health services, but was alternating its methodology for delivering public health services so that the services could be continued in a more efficient manner. Thus, the Executive Branch concluded, Section 1403(c)(1) was not implicated.
In addition to filing their lawsuit in the Commonwealth Court‘s original jurisdiction, SEIU also filed a motion for a temporary restraining order and preliminary injunctive relief. The Commonwealth Court denied the motion for a temporary restraining order the day after it was filed.4 Following a two-day hearing on SEIU‘s motion for preliminary injunctive relief, the Commonwealth Court, by order dated April 25, 2013, denied the request without elaboration of its rationale in its order. After SEIU filed a notice of appeal to this Court, the Commonwealth Court directed SEIU to file a
after, on May 24, 2013, the court filed a memorandum opinion in support of its denial of preliminary injunctive relief.5
Notwithstanding that an evidentiary hearing had been conducted, the Commonwealth Court set forth no findings of fact in its May 24, 2013 opinion. Initially, it observed that a preliminary injunction is intended to preserve the status quo, and prevent imminent and irreparable harm that might occur before the merits of a
Focusing exclusively on whether SEIU‘s right to relief was clear based on the legal argument that Section 1403(c)(1) precludes the Commonwealth from closing the Centers and/or decreasing the public health services offered, the Commonwealth Court opined, without further analysis, as follows:
Based on our reading of Act 87 and the arguments of counsel, we were not persuaded that the Act mandates the Department of Health to maintain staffing levels as they were on or about April 30, 1999. Stated another way, Act 87 cannot be read, in our opinion, to prevent the executive, through the Department of Health, from exercising his discretion to provide health services to the citizens of the
Commonwealth through the most effective and practicable means available.
While the Court empathizes with those individuals who may be moved from their present positions or, worse yet, furloughed, the fact remains that Act 87 does not prohibit the actions of the executive or the Department of Health and for these reasons the motion for preliminary injunctive relief was denied.
Id. at 2-3. The court did not discuss SEIU‘s plain language interpretation of Section 1403(c)(1) or review any other requisites for obtaining a preliminary injunction.
SEIU thereafter filed a direct appeal in this Court, which is now before us for disposition.6 We keep in mind that an appellate court reviews an order granting or denying a preliminary injunction for an abuse of discretion. Summit Towne Centre, Inc. v. Shoe Show of Rocky Mount, Inc., 573 Pa. 637, 828 A.2d 995, 1000 (2003). Under this highly deferential standard of review, an appellate court does not inquire into the merits of the controversy, but examines the record “to determine if there were any apparently reasonable grounds for the action of the court below.” Id., (quoting Roberts v. Board of Dirs. of Sch. Dist., 462 Pa. 464, 341 A.2d 475, 478 (1975)). “Apparently reasonable grounds” exist to support a lower court‘s denial of injunctive relief where the lower court has properly found that any one of the six “essential prerequisites” for a preliminary injunction is not satisfied. Id. at 1002.7
The six essential prerequisites that a moving party must demonstrate to obtain
follows: (1) the injunction is necessary to prevent immediate and irreparable harm that cannot be compensated adequately by damages; (2) greater injury would result from refusing the injunction than from granting it, and, concomitantly, the issuance of an injunction will not substantially harm other interested parties in the proceedings; (3) the preliminary injunction will properly restore the parties to their status as it existed immediately prior to the alleged wrongful conduct; (4) the party seeking injunctive relief has a clear right to relief and is likely to prevail on the merits; (5) the injunction is reasonably suited to abate the offending activity; and, (6) the preliminary injunction will not adversely affect the public interest. Warehime v. Warehime, 580 Pa. 201, 860 A.2d 41, 46-47 (2004) (citing Summit Towne Centre, Inc., 828 A.2d at 1001).
Acknowledging the limited standard of appellate review, SEIU contends that the Commonwealth Court‘s denial of its request for a preliminary injunction should be reversed. It submits there are no apparently reasonable grounds for the Commonwealth Court‘s denial of the preliminary injunction because the unambiguous language of Section 1403(c)(1) prohibits the conduct it seeks to enjoin. SEIU argues that the Commonwealth Court‘s interpretation of the statute, affording the Executive Branch discretion to reduce the number of Centers and the level of public health services provided, overlooks the unambiguous “shall operate” language, which mandates expressly that the DOH shall operate the number of Centers and provide the level of public health services that existed as of July 1, 1995.8 SEIU emphasizes that when the words of a statute are free from ambiguity, the letter of the statute cannot be disregarded under the pretext of pursuing its spirit.
common and approved usage,
SEIU further proffers two arguments to refute the Executive Branch‘s position that Section 1403(c)(1) prevents only the closure of Centers due to privatization, and does not preclude implementation of the planned reorganization of public health services. First, SEIU points out that if the provision was intended to curb only closures of Centers due to privatization, the second sentence of Section 1403(c)(1) would accomplish that task as it states, “the [DOH] shall not enter into contracts with any additional private providers that would result in the elimination of any State health center nor reduce the scope of services currently provided nor reduce the number of centers.”
Second, SEIU contends the interpretation of Section 1403(c)(1) proffered by the Executive Branch is contrary to language in
make recommendations to the General Assembly relating to the public and private operation of all remaining Centers.9 SEIU contends that by requiring the DOH to submit recommendations to the General Assembly regarding the operation of the Centers, the Legislature made the policy decision to reserve exclusively to itself the authority to reduce the existing Centers as part of any new plan for providing public health services in Pennsylvania.
Accordingly, SEIU concludes, the only basis for the Commonwealth Court‘s denial of the preliminary injunction, i.e., that SEIU was unlikely to prevail on the merits, was based upon an erroneous application of the law and warrants reversal. See County of Allegheny v. Commonwealth, 507 Pa. 360, 490 A.2d 402, 414 (1985) (acknowledging that the denial of a preliminary injunction can be reversed on appeal based upon the lower court‘s erroneous application of law).10
Additionally, presuming that the closing of the Centers and the elimination of the nurse consultant positions violates Section 1403(c)(1), SEIU contends that the denial of the preliminary injunction should be reversed on constitutional grounds because the Executive Branch‘s flagrant disregard of Act 87 violates
Finally, addressing the remainder of the requisites for establishing entitlement to a preliminary injunction, SEIU argues that the Executive Branch‘s violation of both a state statute and the Pennsylvania Constitution results in per se irreparable harm that cannot be compensated adequately by damages because the General Assembly already balanced the equities of the matter by enacting Section 1403(c)(1), and declaring that the Centers should not be closed and the public health services should not be decreased. See Milk Marketing Board v. United Dairy Farmers Co-op Association, 450 Pa. 497, 299 A.2d 191 (1973) (plurality) (affirming issuance of a preliminary injunction and finding irreparable harm because Petitioners violated state statute by selling milk below the minimum prices mandated by state law); Pennsylvania Public Utility Commission v. Israel, 356 Pa. 400, 52 A.2d 317 (1947) (affirming issuance of a preliminary injunction on the basis that Petitioners violated a state statute requiring taxicabs to have a certificate of public convenience); Common-
wealth ex rel. Corbett v. Snyder, 977 A.2d 28 (Pa.Cmwlth.2009) (affirming issuance of a preliminary injunction and finding that irreparable harm was presumed where there was a credible violation of the consumer protection law). It further submits that the injunctive relief requested merely restores the status quo of maintaining sixty Centers offering Pennsylvania citizens the same minimum level of public health services that has existed for years.
In response, the Executive Branch views this action as a challenge to its authority to make operational decisions regarding agency administration during difficult economic times. Emphasizing our limited standard of appellate review, it contends there are clearly “apparently reasonable grounds” supporting the Commonwealth Court‘s denial of the preliminary injunction because SEIU failed to demonstrate the prerequisites for a preliminary injunction.
Addressing the prong requiring the moving party to demonstrate its likelihood of success on the merits, the Executive Branch contends that the lower court properly interpreted Section 1403(c)(1). As it did below, it submits that the statute only precludes the DOH from closing Centers to allow public health services to be delivered by private providers; it does not address any other reason the DOH may have for closing or consolidating Centers. In the Executive Branch‘s opinion, Section 1403(c)(1) does not prevent the DOH from altering the mechanism by which it delivers public health services, and does not mandate the maintenance of staffing levels or the size or location of the Centers. The only focus of Section 1403(c)(1), it submits, is on the provision of public, as opposed to private, health services.
The Executive Branch asserts that the DOH must be afforded wide latitude to
resources, and would continue to operate in each county that contained a Center on July 1, 1995, albeit under a different organizational structure. It asserts that the modernization plan, incorporating the closing of twenty-six Centers and the elimination of twenty-six nurse consultant positions, maintains the core clinical services the Centers previously provided, with a cost savings of over five million dollars.13
According to the Executive Branch, adoption of SEIU‘s statutory interpretation of Section 1403(c)(1) would “handcuff the [DOH‘s] ability to innovate and find new ways to combat existing and, more importantly, newly emerging public health threats.” Brief for Appellees at 13-14. By limiting where and how those services are to be performed, it asserts, the aim of providing public health services in the most effective and practical means will be frustrated.14
The Executive Branch further refutes SEIU‘s contention that the denial of the preliminary injunction should be reversed on constitutional grounds. It submits that by consolidating various Centers, the Executive Branch is neither usurping the General Assembly‘s legislative powers in violation of
trary, it maintains, the statute is still in effect because no Centers are being consolidated due to privatization, and there will be no reduction in the scope of services the DOH will be providing.15
Finally, the Executive Branch contends that SEIU failed to satisfy the remaining requisites for obtaining a preliminary injunction. Regarding the immediate and irreparable harm prong, it distinguishes case law that presumes irreparable harm where the offending activity violates statutory law, contending there is no statutory violation here because the closings did not result from the privatization of public health services. Further, the Executive Branch submits that greater injury would result from issuance of the injunction than from refusing it because it presented evidence
Having considered the parties arguments, we proceed to examine the record to determine if there were any apparently reasonable grounds supporting the Commonwealth Court‘s denial of the preliminary injunction. Summit Towne Centre, Inc., 828 A.2d at 1000. We reiterate that “apparently reasonable grounds” exist to support a lower court‘s denial of injunctive relief where the lower court has properly found that any one of the six prerequisites for a preliminary injunction is not satisfied. Id. at 1002. Because the parties’ focus in this appeal is on whether SEIU has a clear right to relief and is likely to prevail on the merits of the underlying action, we address that prong first.
I. Clear Right to Relief
To establish a clear right to relief, the party seeking an injunction need not prove the merits of the underlying
claim, but need only demonstrate that substantial legal questions must be resolved to determine the rights of the parties. Fischer v. Dep‘t of Public Welfare, 497 Pa. 267, 439 A.2d 1172 (1982). Under the facts presented, resolution of this prong is based entirely upon the statutory interpretation of Section 1403(c)(1).
As with any question of statutory interpretation, our standard of review is de novo, and our scope of review is plenary. Mercury Trucking, Inc. v. Pa. Pub. Util. Comm‘n, 618 Pa. 175, 55 A.3d 1056, 1067 (2012). In interpreting a statute, our primary goal is “to ascertain and effectuate the intention of the General Assembly.”
Contrary to the Commonwealth Court‘s determination, we find that SEIU demonstrated a clear right to relief because the unambiguous language of Section 1403(c)(1) prohibits the offending conduct sought to be prevented by the preliminary injunction, i.e., the closing of twenty-six Centers and the furlough of twenty-six nurse consultants. As noted, Section 1403(c)(1) provides:
With the exception of the three State health centers selected for the review program established in paragraph (2) [currently expired], the department shall operate those public State health centers and provide at a minimum those public health services in effect as of July 1, 1995. Except as provided in paragraph (2) [currently expired], the department shall not enter into contracts with any additional private providers that would result in the elimination of any State health center nor reduce the scope of services currently provided nor reduce the number of centers.
The clear and unambiguous language of the first sentence of this provision has two
Section 1403(c)(1) prohibits only the closing of Centers due to privatization of health services, then the first sentence of the statute would be rendered meaningless in contravention of the canons of statutory construction. See
Notwithstanding that the portions of the statute implementing the privatization pilot program have expired, the General Assembly has never seen fit to eliminate the mandate that the DOH operate the same number of Centers and provide the same level of public health services that existed in July of 1995. This Court may not disregard the language of the statute when it is facially clear. See
We conclude that by enacting Section 1403(c)(1), the General Assembly established the requisite number of Centers and the minimum level of public health services, and reserved to itself, not the Executive Branch, the ability to alter that system.18 While the Executive Branch
Appellees at 13-14, this Court‘s adoption of SEIU‘s position constitutes strict adherence to the mandate of the General Assembly as expressed in Section 1403(c)(1). The statute makes clear that if a radical restructuring of the provision of public health services is to occur in this Commonwealth, the General Assembly, and not the Executive Branch, must make the necessary determination. Accordingly, we conclude that the Commonwealth Court‘s interpretation of Section 1403(c)(1) is erroneous as a matter of law, thereby invalidating its holding that SEIU was unlikely to succeed on the merits of its underlying action.19
II. Immediate and Irreparable Harm
Having concluded that SEIU has a clear right to relief and is likely to succeed on the merits, we next examine whether it demonstrated that “an injunction is necessary to prevent immediate and irreparable harm that cannot be adequately compensated by damages.” Summit Towne Centre, Inc., 828 A.2d at 1001. This inquiry is facilitated by case law holding that where the offending conduct sought to be restrained through a preliminary injunction violates a statutory mandate, irreparable injury will have been established. See Commonwealth v. Coward, 489 Pa. 327, 414 A.2d 91, 98-99 (1980) (holding that where a statute prescribes certain activity, the court need only make a finding that the illegal activity occurred to conclude that there was irreparable injury for purposes of issuing a preliminary injunction); Pennsylvania Public Utility Commission v. Israel, 356 Pa. 400, 52 A.2d 317, 321 (1947) (holding that when the Legislature declares certain conduct to be unlawful, it is tantamount to calling it injurious to the public, and to continue such unlawful conduct constitutes irreparable injury for purposes of seeking injunctive
relief); Commonwealth ex rel. Corbett v. Snyder, 977 A.2d 28 (Pa.Cmwlth.2009) (affirming issuance of a preliminary injunction and finding that irreparable harm was presumed where there was a credible violation of the state consumer protection statute).
It is undisputed that the Executive Branch proposes to close more than one-third of the existing sixty Centers and to furlough twenty-six nurse consulting positions. Even absent factual findings by the Commonwealth Court regarding the pros and cons of the Executive Branch‘s proposal, it is clear that such action will reduce the number of Centers and the level of public health services in direct contravention
III. Greater Harm from Refusing Injunction
We must next examine whether SEIU has demonstrated that “greater injury would result from refusing an injunction than from granting it, and, concomitantly, that issuance of an injunction will not substantially harm other interested parties in the proceedings.” Summit Towne Centre, Inc., 828 A.2d at 1001. Similar to our discussion on the irreparable injury prong, we conclude that greater injury would result from refusing an injunction than granting it; moreover, we can discern no harm in maintaining the status quo which has existed since at least 1995, in conformity with the clear legislative mandate. Any policy arguments that the modernization plan is more practical and cost-effective than the existing structure for delivering public health services should be addressed to the General Assembly, and are not for our Court to decide in this appeal from the denial of interim relief.
IV. Restoration of Status Quo
Our inquiry next turns to whether SEIU has shown that “a preliminary injunction will properly restore the parties to their status as it existed immediately prior to the alleged wrongful conduct.” Id. Stated differently, “[t]he rele-
vant standard requires that an injunction must address the status quo as it existed between the parties before the event that gave rise to the lawsuit, not to the situation as it existed after the alleged wrongful act but before entry of the injunction.” Ambrogi v. Reber, 932 A.2d 969, 979 (Pa.Super.2007). We conclude that SEIU satisfied this requisite because the grant of the requested injunctive relief will restore the parties to their status as it existed before the DOH attempted to close the twenty-six Centers and eliminate the twenty-six nurse consultant positions.
V. Reasonably Suited to Abate Offending Activity
We must also determine whether the injunction SEIU seeks is “reasonably suited to abate the offending activity.” Summit Towne Centre, Inc., 828 A.2d at 1001. Our issuance of a preliminary injunction instructing the Commonwealth to cease reducing the number of Centers, reestablish Centers in counties in which they have been unlawfully closed, cease reducing the level of public health services, and restore the level of public health services to that which existed on July 1, 1995, is reasonably tailored to abate the Executive Branch‘s offending conduct.
VI. Not Contrary to Public Interest
Finally, we must inquire whether SEIU has demonstrated that “a preliminary injunction will not adversely affect the public interest.” Id. SEIU has satisfied this final requisite for injunctive relief. As noted, when the Legislature declares particular conduct to be unlawful, it is tantamount to categorizing it as injurious to the public. Pennsylvania Public Utility Commission v. Israel, 52 A.2d at 321. Furthermore, the maintenance of the status quo will protect, rather than harm the public, as it will assure that the minimum health care services mandated by the Legislature will continue to be available to the recipients of those services.
VII. Conclusion
We conclude that SEIU satisfied the stringent criteria for the grant of a preliminary injunction, and can identify no
reasonable
Former Justice McCAFFERY did not participate in the decision of this case.
Chief Justice CASTILLE and Justices SAYLOR, TODD and STEVENS join the opinion.
Justice EAKIN files a dissenting opinion.
Justice EAKIN, dissenting.
As I believe SEIU has failed to demonstrate a clear right to relief, I respectfully dissent. Section 1403(c)(1) provides:
With the exception of the three State health centers selected for the review program established in paragraph (2) [ (expired)], the department shall operate those public State health centers and provide at a minimum those public health services in effect as of July 1, 1995. Except as provided in paragraph (2) [ (expired)], the department shall not enter into contracts with any additional private providers that would result in the elimination of any State health center nor reduce the scope of services currently provided nor reduce the number of centers.
services (again the two are separately enumerated); it does nothing to imply there cannot be changes in the centers by the department itself, so long as services are maintained.
That is, in addition to requiring the maintenance of service levels, what this section focuses on is the continued operation of health centers by the state, as opposed to private companies. It does not say the department cannot close or modify a center—it says the department cannot do so by means of contracts with private providers. It does not say the department cannot substitute a mobile unit for a fixed location. It does not set a minimum number of buildings or employees that must be maintained—it says only that the department must provide the public health services available as of July 1, 1995. Clearly, this section was concerned with the preservation of available public health services, not the perpetual insulation of employees from the normal changes that every other employee faces. If the centers are sacrosanct, so are the landlords. But times change, and it cannot be that the legislature meant to lock the state into a series of locations in perpetuity. There will always be demographic shifts, lease expirations, building closures, employee furloughs and transfers, and the advances of technology and treatment options that make change inevitable. It would be absolutely silly to require the department to maintain exactly the same building as a center, forever tying the taxpayers’ support to a location that has become an albatross. Why would the legislature demand such fealty to a “center” when its goal is service? The
This reading is supported by various aspects of the statutory language. The first sentence addresses the department‘s obligations. It mandates the department continue its operation of state health centers except those covered by the privatization pilot program and maintain, at minimum, the current level of health services. The language is devoid of a specific number of centers that must be operated or language
stating the specific number then in existence must be maintained. Moreover, given the exception of three health centers yet to be selected for the privatization pilot program,1 the legislature showed no intent to set a definitive number of health centers that the department must operate, nor did it require the department to operate centers within specific counties. As a matter of fact, had the legislature intended to do so with this language, the magic number would be 57, not 60, and the continued presence of health centers in Dauphin, Butler, and Berks Counties would not be required. The only portion of the sentence that sets a minimum standard concerns the public health services available, not the number, employment, or location of centers providing them.
The second sentence concerns actions from which the department must refrain, specifically, entering into additional contracts, aside from those employed in the privatization pilot program, with private providers that would result in reduction of the scope of services or number of centers then available. Here we find the only reference to maintaining the number of health centers, and such is only protected from privatization measures. The statute makes no mention of reducing the number of centers for other reasons.2 Compare this to the scope of public health services, which is protected from reduction both by a set minimum level in the first sentence and from privatization in the second.
Accordingly, I would affirm the preliminary injunction denial, finding SEIU is not clearly entitled to relief as the Commonwealth‘s proposed closures do not blatantly violate