United States District Court, E.D. Pennsylvania
JOHN ODI, INDIVIDUALLY AND AS THE PERSONAL REPRESENTATIVE OF THE ESTATE OF LILY ODI, DECEASED
GARY ALEXANDER, ET AL.
BARCLAY SURRICK, J.
before the Court are: (1) Defendants Gary Alexander and
Beverly Mackereth's Motion to Dismiss First Amended
Complaint (ECF No. 5); (2) Defendant Linda Robson's
Motion to Dismiss First Amended Complaint (ECF No. 12); and
(3) Defendant Jane Richards' Motion to Dismiss First
Amended Complaint (ECF No. 17). For the following reasons,
Defendants' Motions will be granted in part, and denied
in part, and Plaintiffs' request to amend the Amended
Complaint will be granted.
civil rights action, Plaintiff John Odi, individually, and on
behalf of his deceased mother, Plaintiff Lily Odi, alleges
that Ms. Odi was unlawfully denied Medicaid benefits due to
discrimination on account of race and national origin, which
ultimately resulted in Ms. Odi's death from an aggressive
form of breast cancer. Plaintiffs assert claims for
substantive and procedural due process and for equal
protection under 42 U.S.C. §§ 1981, 1983, and 1988,
42 U.S.C. § 2000d (Title VI of the Civil Rights Act),
and 42 U.S.C. § 1396a(a)(8) (Title XIX of the Social
Security Act), and the associated Medicaid Regulation, 42
C.F.R. § 435.930(b). Defendants include Gary Alexander
and Beverly Mackereth, both former Secretaries of the
Department of Public Welfare of the Commonwealth of
Pennsylvania; Linda Robson, Executive Director of the
Delaware County Assistance Office; and Jane Richards, the
District Administrator for the Darby District of the Delaware
County Assistance Office. All Defendants are sued in their
official and individual capacities.
Factual Background 
facts of this case are set forth in the First Amended
Complaint and are as follows. In May 2008, Ms. Odi lawfully
emigrated from Nigeria to the United States to live in
Pennsylvania with her son, John Odi. (Am. Compl. ¶ 28,
ECF No. 4.) On April 9, 2010, Ms. Odi obtained the status of
lawful permanent resident and was given a “green
card.” (Id. ¶ 29.) In May 2011, Ms. Odi
was diagnosed with breast cancer and subsequently applied for
emergency Medicaid through the Delaware County Assistance
Office. (Id. ¶¶ 32-33.)
is a public medical insurance program jointly funded by the
federal government and the states. (Id. ¶¶
21-27.) In Pennsylvania, DHS is the state agency that
administers Medicaid. (Id. ¶¶ 24-25.) An
individual in Pennsylvania who wishes to receive Medicaid
applies through the appropriate DHS County Assistance Office,
which screens the application and determines whether the
applicant is eligible for Medicaid. (Id.
¶¶ 25-27.) DHS and its employees, including all
Defendants, were responsible for determining whether an
individual like Ms. Odi is eligible for medical assistance.
(Id. ¶ 25.)
Odi's May 2011 application for Medicaid was approved and
she received benefits from May 2011 until May 2012.
(Id. ¶ 34.) On May 14, 2012, DHS closed Ms.
Odi's case and stopped providing her with benefits.
(Id. ¶ 35.) When DHS terminated Ms. Odi's
benefits, they failed to provide her with renewal forms or
with a redetermination notice. (Id.) In June 2012,
Ms. Odi filed a new application for Medicaid benefits as she
continued to require medical treatment for her breast cancer.
(Id. ¶ 36.) In conjunction with this
application, a letter was supplied to DHS from
Plaintiff's doctor, Dr. Jenia Jeneb-Wolcott, which
verified that Ms. Odi suffered from breast cancer. The letter
stressed the importance of Ms. Odi continuing to receive
ongoing treatment for at least five years. (Id.
5, 2012, DHS denied Ms. Odi's June 2012 Medicaid
application. (Id. ¶ 37.) DHS stated in the
denial that there was “no proof of income or letter
forms” supplied with her application. (Id.) In
fact, Ms. Odi provided these forms with her application.
(Id.) On July 27, 2012, DHS notified Ms. Odi that
more information regarding family income would be needed to
make a determination about her June 2012 application for
Medicaid benefits. (Id. ¶ 38.) On August 1,
2012, John Odi supplied DHS with the requested financial
letter. (Id. ¶ 39.)
August 21, 2012, DHS again denied Ms. Odi's application
for emergency Medicaid assistance. (Id. ¶ 40.)
In its denial letter, DHS stated that Ms. Odi was not a
“United States citizen or an alien lawfully admitted
for permanent residence” and therefore did not qualify
for benefits. (Id.) DHS's denial letter also
cited as a basis for the denial 55 Pa. Code § 149.23,
which pertains to the Aid to Families with Dependent Children
program (“AFDC”). (Id. ¶ 73.) Code
section 149.23 states that “[a] person who is not a
citizen of the United States is not eligible for AFDC unless
he is an alien lawfully admitted for permanent residence or
otherwise permanently residing in the United States under
provisions of law.” 55 Pa. Code § 149.23. Ms. Odi
had been a lawful permanent resident at the time of the
denial letter, and since 2010. She was therefore not subject
to the ineligibility requirements contained in 55 Pa. Code
§ 149.23. (Id. ¶ 42.)
Richards and her subordinates failed to review the file or
any of the documentation supplied by Ms. Odi. (Id.
¶ 43.) In response to DHS's denial letter, the
Delaware County Assistance Office was again supplied with a
copy of Ms. Odi's green card, her social security card,
and a letter from her doctor stressing the need for continued
care. (Id. ¶ 44.) The doctor's letter had
previously been provided to DHS in conjunction with the June
2012 application for benefits. (Id. ¶ 45.) All
of this information was ignored. (Id. ¶ 44.)
Richards allegedly decided that Ms. Odi's breast cancer
did not constitute an emergency. (Id. ¶ 41.)
September 20, 2012, Ms. Odi appealed the denial of her
Medicaid benefits. (Id. ¶ 56.) Despite numerous
requests to discuss the appeal informally, Plaintiffs were
not given the opportunity. (Id. ¶ 46.)
Specifically, in October 2012, Mr. Odi repeatedly requested
an opportunity to discuss the appeal, both by telephone and
in writing. (Id.) Mr. Odi was never afforded a
telephone call. (Id. ¶ 47.) Finally, in March
2013, Mr. Odi's demands were granted and DHS agreed to
provide Ms. Odi a hearing by telephone. (Id.) The
telephonic hearing on the denial of Ms. Odi's benefits
took place on April 23, 2013. (Id. ¶ 48.)
During the hearing, the Administrative Law Judge and
representatives from DHS agreed that Ms. Odi should have had
medical assistance. (Id.) Ms. Odi's benefits
were reinstated retroactively to August 1, 2012.
(Id. ¶ 59.) Notwithstanding the reinstatement,
Ms. Odi was never given a functioning “access
card” or credential that functioned to pay for the
medical services. (Id. ¶ 60.) Ms. Odi several
times attempted to use the Access Card that DHS provided to
her; however, the card did not work and was rejected by each
and every medical provider to which it was presented.
August 3, 2013, Ms. Odi was notified again that her benefits
were terminated. (Id. ¶ 62.) She timely
appealed the termination. (Id. ¶ 63.) Ms. Odi
died from untreated breast cancer on December 13, 2013.
(Id. ¶ 64.) Ms. Odi's appeal was
nevertheless pursued, ending with a settlement between her
representatives and DHS on May 27, 2015. The settlement
provided that the benefits were reinstated posthumously for
the period covering August 18, 2013 to December 13, 2013.
(Id. ¶ 65.)
August 31, 2015, Mr. Odi, on behalf of himself and the estate
of his deceased mother, Ms. Odi, filed a Complaint in this
Court against Defendants Alexander, Mackareth, Robson, and
Richards. (ECF No. 1.) An Amended Complaint was filed on
December 28, 2015. The Amended Complaint contains four
counts: Count I asserts a claim under Title VI of the 1964
Civil Rights Act, 42 U.S.C. § 2000d; Count II asserts
claims under 42 U.S.C. §§ 1983 and 1988; Count III
asserts a claim under 42 U.S.C. § 1981; and Count IV
asserts a claim under the Medicaid Statute and Regulations,
specifically 42 U.S.C. § 1396a(a)(8) and 42 C.F.R.
§ 435.930(b). All four counts are asserted against all
Defendants, both in their individual and their official
January 11, 2016, Defendants Alexander and Mackereth filed a
Motion to Dismiss for Failure to State a Claim. (ECF No. 5.)
Plaintiffs filed a Response to Defendants' Motion to
Dismiss on February 1, 2016. (ECF No. 7.) On May 24, 2016,
Defendants Richards and Robson filed a Motion to Dismiss for
Failure to State a Claim. (ECF No. 12.) On November 7, 2016,
Richards individually filed a Motion to Dismiss for Failure
to State a Claim. (ECF No. 17.) On November 18, 2016,
Plaintiffs filed a Response to Richards' Motion to
Dismiss. (ECF No. 18.) On November 28, 2016, Richards filed a
Reply to Plaintiffs' Response to her Motion to Dismiss.
(ECF No. 19.)
Federal Rule of Civil Procedure 8(a)(2), “[a] pleading
that states a claim for relief must contain a short and plain
statement of the claim showing that the pleader is entitled
to relief.” Rule 12(b)(6) provides for the dismissal of
a complaint, in whole or in part, for failure to state a
claim upon which relief can be granted. A motion under Rule
12(b)(6), therefore, tests the sufficiency of the complaint
against the pleading requirements of Rule 8(a). “To
survive a motion to dismiss, a complaint must contain
sufficient factual matter, accepted as true, to ‘state
a claim to relief that is plausible on its face.'”
Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting
Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570
is plausible “when the Plaintiffs pleads factual
content that allows the court to draw the reasonable
inference that the defendant is liable for the misconduct
alleged.” Id. A complaint that merely alleges
entitlement to relief, without alleging facts that show
entitlement, must be dismissed. See Fowler v. UPMC
Shadyside, 578 F.3d 203, 211 (3d Cir. 2009). Courts need
not accept “[t]hreadbare recitals of the elements of a
cause of action, supported by mere conclusory statements . .
. .” Iqbal, 556 U.S. at 678. “While
legal conclusions can provide the framework of a complaint,
they must be supported by factual allegations.”
Id. at 679. This ‘“does not impose a
probability requirement at the pleading stage, ' but
instead ‘simply calls for enough facts to raise a
reasonable expectation that discovery will reveal evidence
of' the necessary element.” Phillips v. Cnty.
of Allegheny, 515 F.3d 224, 234 (3d Cir. 2008) (quoting
Twombly, 550 U.S. at 556).
determining whether dismissal of the complaint is
appropriate, courts use a two-part analysis. Fowler,
578 F.3d at 210. First, courts separate the factual and legal
elements of the claim and accept all of the complaint's
well-pleaded facts as true. Id. at 210-11. Next,
courts determine whether the facts alleged in the complaint
are sufficient to show that the Plaintiffs have a
“‘plausible claim for relief.'”
Id. at 211 (quoting Iqbal, 556 U.S. at
679). Given the nature of the two-part analysis,
“‘[d]etermining whether a complaint states a
plausible claim for relief will . . . be a context-specific
task that requires the reviewing court to draw on its
judicial experience and common sense.'”
McTernan v. City of York, 577 F.3d 521, 530 (3d Cir.
2009) (quoting Iqbal, 556 U.S. at 679).
assert due process and equal protection claims under Section
2000d of the Civil Rights Act (Count I), under Section 1983
of the Civil Rights Act (Count II), and under Section 1981 of
the Civil Rights Act (Count III). Plaintiffs also assert
claims under Section 1396a(a)(8) of the Medicaid Act, and
Section 435.930(b) of the Medicaid Regulations (Count IV).
Defendants seek dismissal of all claims asserted against them
by Plaintiffs. We address the counts in turn.
Section 1983 (Count II)
argue that Plaintiffs' claims under Section 1983 are
barred by the two-year statute of limitations. Defendants
contend that even if the claims are timely, sovereign
immunity under the Eleventh Amendment requires dismissal of
the claims asserted against Defendants in their official
capacities. Finally, Defendants contend that Plaintiffs have
failed to allege facts sufficient to state due process and
equal protection claims under Section 1983.
Statute of Limitations
parties do not dispute that the claims are governed by a
two-year statute of limitations. The original Complaint was
filed on August 1, 2015. Defendants argue that
Plaintiffs' claims are untimely because the alleged civil
rights violations occurred more than two years prior to
August 1, 2015. Plaintiffs respond that the claims did not
accrue until December 13, 2013, the day that Ms. Odi died.
Plaintiffs further contend that even if the date of Ms.
Odi's death is not the relevant ...