Opinion ID: 442966
Heading Depth: 1
Heading Rank: 2

Heading: hospital for sick children

Text: 11 The district court's judgment is cryptic; it appears to hold HSC responsible for retaining Pierce Lunceford as an inpatient pending completion of EAHCA hearing procedures on two bases: either directly and independently under the statute, or under the state action doctrine, or on both grounds in combination. As the surrogate parent concedes, however, Congress addressed the EAHCA's procedural requirements only to state or local educational agencies or other public authorities established by state law to provide free public education. See 20 U.S.C. Secs. 1415(a), 1401(7)-(8), (22). HSC is not such an agency or authority. 12 The surrogate parent suggests as an appropriate statutory basis for the action against HSC, section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Sec. 794. Section 504 reads: 13 No otherwise qualified handicapped individual in the United States ... shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.... 14 Assuming arguendo HSC's amenability to this measure by reason of its receipt of Medicaid and Medicare funds, and no preclusion of appellee's resort to the legislation, 3 it remains illogical to argue that HSC discriminated against Pierce because of his handicap. 15 As stipulated, HSC's decision to discharge Pierce rested on the staff's determination that he is no longer medically appropriate for hospitalization at HSC. Stipulated Fact No. 16. Nor does there appear to be any genuine doubt that HSC's services are available only to handicapped children. HSC Brief at 21. Ten children, the hospital's records showed, were waiting for HSC beds at the time Pierce Lunceford sought the temporary restraining order, Defendant's Exhibit No. 8, Lunceford, Civ. No. 83-2132 (D.D.C. Oct. 14, 1983); each of the wait-listed children apparently fit the Rehabilitation Act's definition of handicapped individual. See 29 U.S.C. Sec. 706(7)(B). Under the circumstances, the discharge of Pierce to permit the admission of another sorely handicapped child rationally could not amount to disadvantageous treatment solely by reason of his handicap. See Southeastern Community College v. Davis, 442 U.S. 397, 411, 99 S.Ct. 2361, 2369, 60 L.Ed.2d 980 (1979) ([N]either the language, purpose, nor history of Sec. 504 reveals an intent to impose an affirmative-action obligation on all recipients of federal funds.); Monahan v. Nebraska, 687 F.2d 1164, 1170 (8th Cir.1982) (Manifestly, in order to show a violation of the Rehabilitation Act, something more than a mere failure to provide the 'free appropriate education' required by EAHCA must be shown.). 16 The district court's principal reliance in enjoining HSC, it seems, was on the notion that, as a recipient of public funding, HSC was bound by the same statutory and due process requirements as government. Lunceford, slip op. at 4. Blum v. Yaretsky, 457 U.S. 991, 102 S.Ct. 2777, 73 L.Ed.2d 534 (1982), however, rules out any state action peg for the district court's judgment against HSC. 17 In Blum, the Supreme Court considered whether state action was implicated in private nursing homes' decisions to transfer particular Medicaid patients to different facilities providing lower levels of care. The challengers claimed they did not receive adequate notice and hearings before they were transferred. Like HSC, the nursing homes received large federal financial assistance. Federal regulations required a home to establish a committee to determine, inter alia, the appropriateness of each patient's continued residence at the facility. The Supreme Court held that the nursing homes' transfer decisions were not state action. Heavy regulation by government, the High Court restated, does not by itself convert [a private facility's] action into that of the State. Id. at 1004, 102 S.Ct. at 2786 (quoting Jackson v. Metropolitan Edison Co., 419 U.S. 345, 350, 95 S.Ct. 449, 453, 42 L.Ed.2d 477 (1974)). Generally, the Court indicated, the action of a nongovernmental entity will not be held to standards limiting official action absent government coercion or significant government encouragement of the measure under inspection. Blum, 457 U.S. at 1004, 102 S.Ct. at 2786. In rejecting state action characterization of the transfer decisions in Blum, the Court emphasized that the decisions ultimately turn[ed] on [private actors'] medical judgments. Id. at 1008, 102 S.Ct. at 2788. 18 Like the nursing homes' transfer decisions, HSC's discharge decision was a medical judgment made by private parties according to professional standards that are not established by the State. Id. Blum controls this case; it leaves no room for holding HSC's decision to discharge Pierce Lunceford to strictures that the Constitution or other relevant federal law--here, the EAHCA--places only on government action. 4 Blum means that, absent any plausible statutory basis for reaching HSC here as a nonstate actor--and, as we have explained, no such basis has been shown--the case should have been dismissed to the extent that it sought relief against HSC.