Opinion ID: 201611
Heading Depth: 2
Heading Rank: 2

Heading: Nexus/Joint Action Test

Text: Further, Estades has failed to plead sufficient facts to justify a finding of state action under the nexus/joint action test. The complaint simply does not indicate that the state so far insinuated itself into a position of interdependence with [Appellees] that it [should be considered] a joint participant in their actions pertaining to the involuntary commitment in question. Bass, 180 F.3d at 242 (internal quotation marks omitted) (first alteration in original). The complaint does allege that: state statutes provide the mechanism for involuntary commitment; the state extensively regulates such commitment; Appellees received money derived from the state; and Appellees sought court authorization for Estades' commitment. However, even if true, none of that would justify a finding that Appellees are state actors. See, e.g., id. at 243 (The fact that the defendants . . . invoked the assistance of the courts . . . is not sufficient to show a nexus or joint effort between the defendants and the state.); Rockwell, 26 F.3d at 258 ([G]overnment regulation, even extensive regulation, and the receipt of [public] funds . . . are insufficient to [satisfy the nexus/joint action test].); Spencer v. Lee, 864 F.2d 1376, 1381 (7th Cir. 1989) (finding that a private party is not transformed into a state actor merely because the private party acted pursuant to a state statute). -13- Moreover, the complaint does not allege that the state was in any way, much less intimately, involved in the initial decision to pursue involuntary commitment,13 or in later decisions concerning the treatment Estades allegedly received while she was committed. See Perkins, 196 F.3d at 21 (finding significant the extent to which the private entity is (or is not) independent in the conduct of its day-to-day affairs); cf. Jensen v. Lane County, 222 F.3d 570, 575 (9th Cir. 2000) (The record is clear that [defendant] and the County through its employees have undertaken a complex and deeply intertwined process of evaluating and detaining individuals who are believed to be mentally ill . . . . County employees initiate the evaluation process [and] there is significant consultation . . . among . . . [private] psychiatrists and county . . . workers . . . .). On the facts alleged, we fail to see how Estades could show that a relationship existed between Appellees and the state that would justify a finding of state action under this test. In her appellate brief, seemingly in an effort to augment her nexus/joint action argument, Estades asserts that because Appellees were employed by the [state] to provide psychiatric treatment pursuant to the Plan, they are properly characterized as state actors. To support her assertion, she cites West v. Atkins, 13 It asserts that Estades' son, after consulting with Canepa, petitioned a court to authorize her commitment, and that one or more Appellees filed documents in support of the petition. -14- 487 U.S. 42 (1988), a case in which the Supreme Court held that a private physician under contract with the state to provide medical care to prison inmates was a state actor. However, her complaint cannot fairly be read to allege that any Appellee was employed by, or otherwise bound to, the state.14 Therefore, Estades' reliance on West is misplaced, see Ellison v. Garbarino, 48 F.3d 192, 197 (6th Cir. 1995) ([T]he West case does not govern [because] . . . [t]he present defendants are in no way contractually bound to the state.),15 and her employment argument fails. 14 In a single sentence, the complaint states: As participants in the . . . Plan, [Appellees] were contracted by the state. But, neither that statement nor the assertion in Estades' brief that Appellees were employed by the [state] can be squared with the facts alleged or statutes fairly referenced in the complaint. As we have stated, the complaint alleges that an instrumentality of the state, the Administration, acting in accordance with the Plan, contracted with a private health insurance carrier, Triple S, which, in turn, contracted with First Option and Canepa. A review of the statute governing the Administration's ability to enter into contracts reveals that the administration is only authorized to contract with insurers licensed to do health insurance business in Puerto Rico. 24 P.R. Laws Ann. § 7026. Thus, the complaint alleges, and the statutes referenced therein confirm, that it was only to Triple S, and not to the state, that First Option and Canepa were bound. Moreover, the complaint does not allege any facts that support the assertion that CPC Hospital or its employees were employed by the state (or, for that matter, Triple S). See Rodi v. S. New Eng. Sch. of Law, 389 F.3d 5, 10 (1st Cir. 2004) (In reviewing a complaint in an appeal from a grant of a motion to dismiss, [w]e ignore . . . bald assertions . . . [and] unsubstantiated conclusions . . . . (internal quotation marks omitted)). 15 In addition, West is distinguishable from the case at hand because in West, the defendant-physician's actions took place within a state-run prison hospital and the plaintiff-prisoner was precluded by state law from seeking treatment from a physician of his own choosing. 487 U.S. at 43-44. Here, however, the actions -15- Moreover, Estades, citing Lugar, 457 U.S. at 941, claims that Appellees should be regarded as state actors because they relied upon an unconstitutional state statut[ory scheme] to involuntarily hospitalize her. But, Lugar makes clear that even though the procedural scheme created by [a] statute . . . is the product of state action, id., a private party normally does not become a state actor merely by invoking it. See id. at 939 n.21 ([W]e do not hold today that a private party's mere invocation of state legal procedures constitutes joint participation or conspiracy with state officials satisfying the § 1983 requirement of action under color of law. The holding today . . . is limited to the particular context of prejudgment attachment. (internal quotation marks and citation omitted)); see also Spencer, 864 F.2d at 1381 (The statutes authorizing . . . private activities may or may not be constitutional; the activities themselves remain private. (internal citations omitted)).