Sanders, Paschall v. Rhodes, Kitty et al
Filing
27
ORDER denying the request for leave to proceed by plaintiff Paschall L. Sanders III. This case is DISMISSED for lack of jurisdiction. All pending motions are denied as MOOT. Signed by District Judge William M. Conley on 1/24/2014. (jef),(ps)
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
PASCHALL L. SANDERS,
Plaintiff,
OPINION AND ORDER
v.
l 3-cv-649-wmc
KITTY RHODES, Secretary, Wisconsin
Department of Health Services, et al.,
Defendants.
Plaintiff Paschall L. Sanders is currently a patient in custody of the Wisconsin
Department of Health Services ("WDHS") at the Sand Ridge Secure Treatment Center,
having been civilly committed pursuant to Wis. Stat. ch. 980.
Sanders filed this
proposed civil action for declaratory and injunctive relief, alleging that he was wrongfully
denied benefits from the state Medicare/Medicaid program. Sanders requests leave to
proceed without prepayment of the full filing fee for purposes of the federal in forma
pauperis statute. See 28 U.S.C. § l 915(a). He requests the appointment of counsel and a
special master. Having filed more than one motion for a temporary restraining order or
preliminary injunction, he seeks leave to proceed.
Before Sanders may proceed, the court is required by the federal in Jonna pauperis
statute to screen the proposed complaint and dismiss any portion that is frivolous,
malicious, fails to state a claim on which relief may be granted, or seeks money damages
from a defendant who is immune from such relief. See 28 U.S.C. § l 915(e)(2).
In
addressing any prose litigant's complaint, the court must read the allegations generously,
reviewing them under "less stringent standards than formal pleadings drafted by lawyers."
Haines v. Kerner, 404 U.S. 519, 521 (1972). Even under this lenient standard, Sanders'
request for leave to proceed must be denied and his complaint will be dismissed for
reasons set forth below.
ALLEGATIONS OF FACT
For purposes of this order, the court accepts all well-pled allegations as true and
assumes the following probative facts. 1
Sanders has a lengthy criminal record dating back to the early 1970s, including
convictions for more than one sexual assault, armed robbery, theft and escape. Following
his release from prison onto parole, Sanders absconded. Most recently, he was convicted
in Milwaukee County and sentenced to state prison for second-degree sexual assault of a
child. Anticipating his next release from the penitentiary, the State of Wisconsin filed a
petition seeking Sanders's involuntary civil commitment as a "sexually violent person"
pursuant to Wis. Stat. ch. 980. 2
In 2009, a jury found that Sanders was a sexually
violent person as defined by Wis. Stat. § 980.01 (7). Therefore, the circuit court granted
the State's petition and entered a judgment committing Sanders to the Wisconsin
1
The court has supplemented the facts with dates and procedural information about plaintiff's
underlying state court proceedings from the electronic docket available at Wisconsin Circuit
Court Access, http://wcca.wicourts.gov (last visited December 5, 2013). The court draws all other
facts from the pleadings submitted by plaintiff and the attached exhibits. See FED. R. CIV. P.
lO(c); see also Witzke v. Femal, 376 F.3d 744, 749 (7th Cir. 2004) (explaining that documents
attached to the complaint become part of the pleading, meaning that a court may consider those
documents to determine whether plaintiff has stated a valid claim).
2
"A 'sexually violent person' means a person who has been convicted of a sexually violent offense,
has been adjudicated delinquent for a sexually violent offense, or has been found not guilty of or
not responsible for a sexually violent offense by reason of insanity of mental disease, defect, or
illness, and who is dangerous because he or she suffers from a mental disorder that makes it likely
that the person will engage in one or more acts of sexual violence." Wis. Stat. § 980.01 (7).
2
Department of Health Services "for control, care and treatment" for an indefinite period
until such time that he no longer qualifies as sexually violent person. See State v. Sanders,
Milwaukee County Case No. 2004CI4.
In his pending complaint, Sanders contends that he was wrongfully denied
"medical assistance" benefits from the state Medicare/Medicaid program. In 2012, the
Juneau County Department of Human Services denied Sanders's application for benefits
after conducting an in-person hearing at the Sand Ridge Secure Treatment Center. The
Department of Health Services, Division of Hearings and Appeals affirmed that decision
on July 23, 2012, concluding that Sanders could not qualify for benefits while civilly
committed to Sand Ridge because he met the definition of an "inmate of a public
institution." Wis. Stat. § 49.47(6)(c); see also 42 C.F.R. §§ 435.1009-.1010 (excluding
inmates of a public institution from eligibility for Medicaid benefits). Sanders filed more
than one motion for rehearing with the Wisconsin Department of Health Services. After
his last request for rehearing was denied on September 12, 2012, Sanders pursued relief
through the administrative grievance process at Sand Ridge.
Sanders notes that individuals confined in "institutions for mental disease"
pursuant to the Wisconsin Mental Health Act are eligible for benefits. 3 Arguing that
Sand Ridge qualifies as an institution for mental disease, Sanders contends that the
Wisconsin Department of Health Services wrongfully denied his application for benefits.
3
Sanders mentions the Winnebago Mental Health Institute, the Mendota Mental Health
Institute in Madison, and several psychiatric hospitals in Green Bay, Milwaukee and Waukesha
as facilities that are defined or recognized as "institutions for mental disease" by the Wisconsin
Medicare Eligibility Handbook at § 27.1.1, 27.1.2 and 27.11. (Dkt. # 2, Exhibits). One of his
claims is that Sand Ridge, which houses sexually violent persons pursuant to Wis. Stat. ch. 980,
should be recognized as an institution for mental disease.
3
In particular, he claims that the adverse decision constitutes illegal discrimination that
violates Title II of the Americans with Disabilities Act, the Rehabilitation Act, and the
Fourteenth Amendment Equal Protection Clause. He seeks declaratory and injunctive
relief in the form of a judgment overturning the adverse decision by the Wisconsin
Department of Health Services and finding him eligible to receive the applied for
benefits. 4
OPINION
Liberally construed, Sanders challenges an adverse decision by the Wisconsin
Department of Human Services, denying his application for medical assistance or
Medicaid benefits.
Judicial review of adverse decisions by this state agency typically
must be sought in the state circuit court in the county where the applicant resides. See,
e.g., Hedlund v. Wisconsin Dep't of Health Servs., 2011 WI App 153, 337 Wis. 2d 634, 807
N.W.2d 672 (appeal from a circuit court's decision affirming an administrative law
judge's denial of medical assistance benefits); Berger v. Wisconsin Dep't of Health Servs.,
2011 WI App 121, 337 Wis. 2d 89, 803 N.W.2d 867 (unpublished) (same).
By contrast, federal judicial review of adverse benefits determinations is available
only from a final administrative decision by the Commissioner of the United States
Department of Health and Human Services. See 42 U.S.C. §§ 405(g), 1395ii; Heckler v.
4
In addition to the relief sought in his complaint, Sanders seeks a temporary restraining order or
preliminary injunction to enjoin the defendants from subjecting him to restrictive conditions of
confinement and charging him "out-of-pocket fees" for goods and services such as cable television,
"personal care products," eyeglasses and other items that would otherwise be paid for with
Medicaid benefits. (Dkts. # 20, # 21).
4
.
..
Ringer, 466 U.S. 602, 617 (1984); see also 2 HARVEY L. McCORMICK, MEDICARE AND
MEDICAID CLAIMS AND PROCEDURES §§ 18.1-18.2 (4th ed. 2005). Because the adverse
decision that Sanders challenges does not meet the criteria for federal review, his
complaint concerning that decision must be dismissed for lack of subject matter
jurisdiction.
ORDER
IT IS ORDERED that:
1. The request for leave to proceed by plaintiff Paschall L. Sanders III is
DENIED and this case is DISMISSED for lack of jurisdiction.
2. All pending motions are denied as MOOT.
Entered thisJ. t-/ th day of January, 2014.
BY THE COURT:
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