## In the



# U n ited S ta tes Co urt o f Ap p ea ls

F o rth eS e v e n th C ir cu it

N o. 13

- 1351 M ICHAEL A MU ND S ON, b y hi s g ua r di an s El l a an d Ri ch ar d Am unds o n, e tal ., P laint if fs -App el lants , v. W I S CONS I N D EPART MENT OF H EA LT H S ERVICES, e tal ., D efend a nts-A pp ellees

.
A pp eal from the United S t ates Di strictC our t fo r the Western Di stricto f Wisc onsin
. No . 12 -cv-609 -bb c

—Barb ara B. C rab b , Ju dge
.
A RG UE D J UNE 5, 2013

— D ECI DE D J UL Y 10, 2013

Befo reE A STE RB ROOK

,Ch ie f Judge,andB AUER and H AMILTON, C ircu it Judges . E A S T E RB R OO K, Chie

f Judg e . I n 201 1 the S tat e o f W i sco nsi n deci ded to sa ve m oney by r ed u c ing the subsi d ie s f o r the W i sc o ns i n Ca r e Pr o g r am, whi cha m o ng o th erthi ng s funds d isabl ed per so ns who l i ve i n g r o up hom es. ( W i sco nsi n m ake s bl ockgr ants to or ga n izatio n s s u c h as C om m u n ity H e a l th P ar tn er sh ip , In c .,2 N o. 13

- 1351

w hich ad m inister the p r o g r am s. A lthou gh thes e intermed i a r i e s a r e r e s po ns ib l e f o r man y c ho i c e s a b o uthow to al l oca te avai l able fund s, we si m pli fy thi s o pini on by as su m i ngtha t the st at e i ts el fm ade a l l o fthe de ci si o ns . ) The c u ts , w h ich to ok effe c t in Jan u ar y 201 2, fell m o s t h ea vily on gro u p s w h os e c ar e i s m o s t c os tly . Th e p lain tiffs in th i s su i t ar e dev el o pm en ta l l y di sable d a nd b o r e th e l ar ges t cuts. Pers ons w ho had b een re cei vin g s m al l er paym ents bor e s m alle r cuts; and f orso m e ( such as thos e cl ass i fi ed by one i nter m edi ar y a s fra i l el derly) per capi ta paym ents i ncre ase d. Pl ai nti ff s conte nd that m aki ng l ar ger abso l ute cuts f or perso ns w hose car e i s m os t expensiv e vi o l at es b o ththe Re habi l i ta ti o n Acta nd the Am er i ca ns w ith Di sabi l i ti es A ct. They a l so conte nd thatr educti on in th e s ta te ’s p ay m en ts in c re as es th e ris k t h at th ey w ill be m ove d fro m gr oup hom es to i nsti tuti ons, wh i ch they say would vi ol ate bo th st atute s. Pl ai nti f f s a ske d th e d i str i ct c ourtto i ssue an i nj uncti on that w ou l d requi re W i sco nsi n to r est or e the paym ent s chedule that w as i n f or ce until20 12. A r equest f or m o ne y fr o m the s ta te na tu r al l y l ed to que st i o ns abo ut th e sc o pe o fs ta te s o ve r ei g n i m m uni tyun derthe el eve nth am endm en t. T h e di str i ct j ud ge did notse e any pr obl em with th e cl ai m bas ed on the Rehabi l i tat i on A c t, for st at es h av e w aiv ed th eir im m u n i t y as a c on d iti on o fr ecei vin g federa l fund s. S ee Sta nley v. Litsch er, 213 F. 3d 340, 3 44 (7th Cir

. 20 00)

. But the A DA does not re quir e s tat es to gi ve up thei r i m m unity in t ra de f or gr ants. T h e S up re m e Cour t has hel d that the por ti ons of the AD A thatar e no t desi gned to i m ple m ent dis ab l ed per so ns ’ c o ns ti tu ti o na l r i ght s are not bas ed o n § 5 o ftheN o. 13

- 1351 3 fourteen th am en d m en t an d t hu s can not be us ed to overri de sta tes ’ so ver ei gn i m m unity. Com pare U ni ve rsity of A labam a v. G arre tt, 5 31 U. S

. 3 56 ( 20 01 ) , wi th Ten ne s s e ev. Lan e, 54 1 U.S

. 50 9 ( 2004 )

. The di str ict cour t co ncl ud ed that the pr ovi sio ns o fthe A DA thatpl ai nti ff s i nvoke do not concern t h e C onsti tuti on a nd ther ef or e a re not§5 l egi sl ati on. That left th e pos sibi l i ty ofpro specti ve re l i ef agains t state offi cials und er Ex parte Y o ung, 20 9 U.S

. 12 3 ( 1908 )

. But t h e dist ri ct c ourthel d that a n or der t o pay mon e y i s n e v e r p r o pe r under Ex par t eYoungand that the AD A ther ef or e dro ps out ofthe case . W e doubt that thi s i ssue m att er s. T h ro u ghout i ts op i ni o n, the di s t r i c tc o ur ts t r e s s e d tha tthe R e hab i l i tati on Act an d the A DA ar e s ubstanti vel y i denti calwith re spect to pla i nti f f s’ cl ai m s. S ee Jar os v. Il l i noi s D epar t m e nt of Cor r e ct i ons , 6 84 F
. 3d 6 67, 6 71 –7 2 ( 7th Ci r . 2 01 2)

. None of t h e litig an ts arg u es ot h er w ise in t h is c ou rt . Th is m ea ns th at th e Re habi l i ta ti o n Act by i ts el f aff ord s p l ai nt i f f s a n y r e l i e ft o w h i c h th e y ma y b e e n t i t l e d ; c l a i ms u n d e r th e AD A b e c o me a c a d e mi c . Ata l l e v e n t s , we r ec o r d o ur di sa g r ee m en t wi ththe di st r i ctc o ur t’ s co nc l usi on about the pr opri etyo fr el i efunder Ex par t eYoung

. Altho ug h “ Ex par te Yo ungcannotbe used to o btai n an i nj unc ti o n r equiring th e pay m en t o ffunds fr o m the St ate’s treasury, ” Virginia O ff iceforProtect ion & Adv ocacy v. Stew a rt, 13 1 S

. Ct. 16 32, 16 39 ( 201 1); see al so Ede l m an v. Jor dan , 415 U .S. 65 1 (1 97 4), ot h er form s o f re l i e fa re p os sibl e. Forexam ple , an inj uncti on m i ght r equi re the sta te to tr eatdevel opm ental l y di sabl ed pers ons no w or se than4 N o. 13

- 1351 perso ns with o therdi sabi l i ti es

— f o r e xa m pl e, b y making the s am e r educti ons acr oss the boar d. That i s n ot w hat pla i nti f f s s eek( they w oul d preferto have thei r 2011 benefi ts re sto re d), but i t would el i m i nate disc ri m i nati o n. Ora d istri ctj udg e m i g hts pel l o utthe min i m um housi ng r equi re d by federa l l aw and l eave i t t o W i sco nsi n to deter m i ne how to fulfi l i ts obl i gat i ons. That com pli ance with an i nj uncti on r equi ri ng perf or m ance, ra therthan paym ent, m ay turn o ut to be cos tl y has ne ve r b ee n a n o bj ec ti o n t o the c o m m an d t o i m pl ement f edera l l aw . S ee, e. g., A m e r i t e ch Corp. v. M cCann , 29 7 F. 3d 582, 58 7 ( 7th Ci r. 20 02)

. “In deter m in ing whether th e d octrine of Ex par t eYounga v o i ds a n El e v e nth Am e nd

m ent b arto sui t, a cour t nee d onl y c onduct a ‘ str ai ghtf or w ar d i nquir y i nto w hether[ the] co m pla i nt al l ege s a n o ng o i ngv i o l a t i o n offed e r a l l a w a nd s e e k s r e l i e fp r o per l y c hara cter i zed as pro specti ve. ’ ” Ver iz on M aryl and Inc . v. Pub l i c Se r vi ceCom m i s sio n of M aryl and, 535 U
. S. 635, 645 (2002). To the pla i nti f f s’ cl ai m s. W e sta rt w i th their c onte nti on that the r at es now i n f or ce a re to o l ow to a l l ow them to conti nue l i vi ng i n gr oup hom es w i th non- disabl ed p er so n s. If th ey m u st m ov e t o in st itu tio n s h ou sin g on ly the di sabl ed, pl ai nti ff s co nt en d , that would vi ol ate 42 U
. S

. C. §1 21 32 an d i m pl ement i ng r egul at i o ns , whi chare com m onl y unders too d to l i m i t s tat es’ abi l i ty to re m ove disabl ed pers ons f ro m se tti ngs g ener ally acce ssibl e by the pu bl i c. W e say “l i m i t” ra ther than “pro hibi t” b ec au se al th o ug h O lm st ead v

. L
. C. , 52 7 U.S

. 58 1 ( 1999 ) , hel d that i ns ti tu ti o na l i za ti o n c anb e a f o r m o f“ di sc r i m inati o n” p ro h ibite d by § 1213 2, i t a dd ed that a s tat e m ay be ableN o. 13

- 1351 5 to j usti fy i nsti tuti onal tr eat m ent i f“the r eso urces available to the State” are lim ited. 527 U

. S. at 587. Tha t’s the s or t o fj usti fi cati on W i sco nsi n i nvoke s. The dis tr i ct c ourtdi d not re ach the m er i ts ofpl ai nti ff s’ cl ai m , how eve r, bec ause i t deem ed the sui t pr em atur e. N o ne o fth e p l a i n t i ff s h a s b e e n p l a c e d i n a n i n s t i t u t i o n. I nd eed, pl ai nti f f s do not al l ege thatan yd ev elo p m en ta lly di sabl ed per so n i n W i sc ons inha s be enmove d, i nv o l unt a r i l y , fr o m g r o up t o i ns t i t ut i o na l c a r e . P l a i nt i ff s do al l ege thatso m e o fthei r num berhave bee n re quir ed to l eave gr oup se tt ings w here theywould have prefer re d to r emai n, b utthe y d o n o t al l eg e i nabi l i tyt o fi nd a n o t h e r g r o u p h o me w i l l i n gt o a c c e pt th e l e v e l o fr e i mburs em ent that the W i sco nsi n Care Pro gr am now off er s. W isc on sin be liev es th at th e c h an ge s ith as m ad e w ill re du ce the co st ofcar e byexcl ud i ng the hi ghest -c ost pr o vi d e r s fr o m th e p r o g r a m, b u twi th o u tl a n d i n ga ny d ev elo p m en ta lly d isa b led p er so n in a n ins t i t u tio n . I f th at ’ s s o, W i sco nsi n has fulfi l l ed i ts obl i gat i ons und er f ede r all aw, no matt erho w m uchpl ainti ff s pr eferthe co m f o r t an d a m en i ti es o fthe mor e- ex pen si ve g r o up ho m es . And w heth ertha t i s so , the d is tr i ctc o ur t co nclude d, c an no t be de te r m i ne d wi th o utmor e ex per i en ce unde r the c ur re ntr at es . Pl ai nt i ff s f ea r the wo r s t, b utthe i r fe a r s ma y b e u nwa r r a nt e d. W e a gr ee w i th the di str ict c ou rtthatthi s a spect of th e su i t i s unr i pe. Ri p en ess is a matt ero ft i m i ng : the j u d icia ry sh ou ld n ot ac t p re m at u re ly or u n n ec es sa rily. If pla i nti f f s’ fear s co m e t o pass, theycan re turn t o cour t. I fthe fea r s do no t co m e to pa ss , how ev er, the r e i s no6 N o. 13

- 1351 l ega l i nj ury, and an o p in i on t oday w oul d be a dvis or y. W i sco nsi n m ai ntai ns that i t has safeguar ds i n pla ce that w i l l pre vent any pl ain ti fffro m being tr ansfer re d to ani ns ti tu ti o n. The c o m pl ai ntd oes no t g i ve a s uffi ci en t re as on to th in k t h at th es e w ill fail. By co nt r ast, p l ai nt i ff s’ c o nt en ti o n tha t th eya r e be i ng tr ea ted worse than perso ns with o therdi sabi l i ti es is ripe. I f W iscons in b u y s t h e b e s t a v a il able care f orper sons w i th vi suali m pai rm ents, but pays o nl y f or m edi ocr e ca re f orthe devel opm ental l y d isabl ed, then pla i nti f f s hav e a theo ryo fdi scr i m i nati on e ven though allof t h e m r e m ain in group hom es. T he district cou rt st o pp ed h er e, ho wev er, c o nc l udi ngi n r el i an ce o n Grza n v. Char t e r H o spit al , 10 4 F
. 3d 116 ( 7th Ci r. 19 97) , thatdi scr i m i na ti o n a m o ngdi sabl ed per so ns ne ve r v i o l at es the A D A or th e R eh ab ilita tio n A c t. Se e a lso , e.g., M al l e t tv. Wi s co ns i n Divi s i on of Voc at i onal Re hab i l i t at i on , 1 3 0 F
. 3d 12 45 (7t h C ir. 19 97 ); EE O C v. CNA Ins ura nc eCos

. , 96 F.3 d 10 39 , 104 4 (7 th C ir. 19 96 ). Grza n hel d that a d isabl ed pers on ca n show fo rbi dd en di scr i m i nati on only by com p arison w ith a non -disab led person

. Plaintiff s concede thatGrzan do o m s th i s as pec t o fthe ir su itb ut as k u s t o m od ify or ov er ru le G rz an in li g hto fthe S upr eme Co ur t’ s l at erde ci si o n i n O l m s t e ad

. They o b s e r v e tha ta ft er O lm s t e ad se ver alappel l ate co urts have concl ud ed that disc ri m i nation am ong perso ns with d iffer en t d isa b ilitie s ca n st at e a go od c laim . Se e , e .g., H enrietta D . v. B lo o m berg, 331 F.3d 261 , 274 (2d Cir. 2003); C
. O
. v. P ortl and PublicScho ols , 67 9 F
. 3d 1162 , 11 69 ( 9th C ir. 20 12 ); Jo hn son v. KM a rt C o rp . , 27 3 F
. 3d 10 35, 10 53–5 4 (11th Cir. 2001).N o. 13

- 1351 7 O l m s t e ad i nd eed super sedes G rz an , f ortwo r eas ons. Fi rs t, the Ju sti ces obs er ved thattheyhave al l owed i ntra
c las s c laim s o f d i s c r i m in at ion
. O l m s t e ad g i ve s as a n e xam ple O ’C o nn o r v. C o nso lid a ted C o in C a t e rers Co rp . , 51 7 U
. S. 30 8, 31 2 ( 1996 ) , wh i ch co ncl ud ed that disc ri m i n atio n ag ai ns t o l derpe r so ns wi th i n the c l as s o f allpe r so ns pr o te ct ed bythe Age Di sc r i m i nation i n Empl o y m en t A ct

— s a y , f a v o r i ng 45 y e a r o l ds o v e r 6 0 y e a r o l ds

— c ou ld vi ola te t hat s tatute. O l m s t e ad, 52 7 U.S

. at59 8 n. 10. S ec o nd, a nd mor e i m portan t, the Co ur t he l d tha t th e w or d “dis cri m i nati on” as used i n §12 132 i ncl ud es not o nl y di spa r at e tr ea tmentof com par ab l y s i tu at ed per so ns but al so und ue i nsti tutio n al i zati on o fdi sabl ed pers ons, no m a tter ho w an yo ne else is treated

. 52 7 U.S

. at59 7–60 3. Grza n th o u g h tth a t“ d i s c r i mi n a t i o n ” r e q u i r e s a c o mpar i so n t o the t r ea tmentof so m eo ne o ut si de th e prot ecte d cl ass ; O l m s t e ad hol ds otherwis e. This i s a s f aras pl ai nti ff s g et, however, bec ause they ha ve n ot offered any com p arison grou p or an y stan d ard by w hich “w orse treatm en t” cou ld be ide nt ified. Before the c hange m ade i n 201 1, devel opm en tal l y di sabl ed perso ns r ecei ved gr eat ersubsi die s than any ot her subc at eg or y oft h e d isa b led . Th e 2 01 1 re vis ion s c u t t h eir subsi dy, but pla i nti ff s do not conte nd that t h ey are now tr eat ed w o rsethan som e o therse t o fdi sabl ed pers ons. Suppose i t co sts a t l eas t $ 50, 000 a y earto pro vi de f or ca r e o fa d evel o pm en ta l l y di sabl ed per so n i n a g r o up hom e a nd m or e ( say, $7 5, 000) to pay f orto p-qual i ty gr oup car e. Su pp ose thati t co sts o nl y $ 40, 000 a y earto provi de f orcar e of a bl i nd per son i n a g ro up hom e. Fi nal l y,8 N o. 13

- 1351 supp ose thatunti l 20 11 W i sco nsi n w as payi ng $7 5, 000 a year f o r e ac h de ve l o pm en ta l l y di sabl ed per so n a nd $40, 000 a y ear for ea ch bl i nd per son, but that i n 201 1 the pay m ents w er e cut to $50, 000 an d $ 40 ,00 0 f orthes e gr oups. A l though o ne gr oup l ost m oney and the othe r did not, thi s would notbe disc ri m in at i onag a instthe dev elopment al l y di sabl ed; i t woul d i ns te ad be the e nd ofdi scr i m i nati onin f

avorof the de v e l o pme nt a l l y di s a b l e d. I fcar e f ordysl exi a co sts o nl y $ 5, 000 a y earfo r seve ra l ye ar s , th en n ot h in g a fte r tr ain in g is c om p let ed , i t w ou ld am ount t o “dis cri m i nati on” to provi de gr eat erpaym ents f ordy slexi cs than f orthe devel opm ental l y di sabl ed. Bu t pla i nti f f s do not say that the am ount p ro vi ded f o r the i r c a r e i s b e l o w wha tWi s c o ns i n pr o v i des f o r s o me o t he r di s a b i l i t y tha ti s l e s s e xp e ns i ve t o c o pe w i th. They do not eve n saythatthey a re r ecei vi ng a l ow erpe r ce nt ag e o fthe c o sto fthe i r c ar e th anpe r so ns w i th o therki nd s o fdi sabi l i ti es do. I nstea d, pla i nti f f s’ theor y i s that anyr educti on that lea ve s th em u n ab le to re m ain in gr ou p h om es t h a t t h eir physi ci ans o r othe r provi ders thi nk the o pti m alpl acem en t fo r th em is forb id d en “d i sc rim in at ion .” T h at is un t e n a b l e , u n l e s s th e s t a t e i s p r o v i d i n go th e r g r o u ps ofdi sabl ed pers ons w i th wh ate vercar e, i n w hatev er location, th eir p hy sicians m ost favor, and pl a in tiffs do no t co nt en d thi s. Pl ai nt i ff s te l l us no t hi ngabo ut w hat k i nd o fcar e p er sons w i th o therdi sabi l i ti es re c ei ve i n W i sco nsi n. Thei r sol e a rg um ent i s that W i sc o ns i n r edu ce d the i r o wn su bs idi es . Apar t f r o m the possibi l i ty ( w hic h is unri pe) that the r educti on m ay l eadN o. 13

- 1351 9
to und ue i nsti tuti onal i zat ion , thi s i s no t a theo ryo f “dis cri m i nati on” a t all

. I t i s a cl ai m o fabs ol ute e nti tl em en t. Pe r ha ps su cha c l ai m c o ul d b e m ad e u nd erthe M edi cai d A ct ( a princi pal so urce of fund s f orthe W i sconsi n Care Pro gr am ) , but pla i nti ff s t ol d the di str i ct cour t, and r epeate d a t or al ar gum ent on appe al, that th eya r e no t co nt en di ngtha t W i scons i n h as v i o l at ed th e d u t i e s i ta s s u me d w h e n j o i n i n gth e Me d i c a i d p r o g r a m. I n s um, p l a i nt i f f s ’ c o nt e nt i o n tha tWi s c o ns i n’ s de c i si on w ill l ea d to th eir ins tit u tio n aliz at ion is u n rip e, an d th eir c o n t e n t i o n th a tWi s c o n s i n h a s d i s c r i mi na t e d i n s o me othe r w ay f ou n d er s fo r l ack ofa useful theo ryo f“di sc r i mi na t i o n. ” T he j ud g men to fthe di s t r i c tc o ur ta c c o r di ng l y i s a f fi r med

.

7- 10- 13