In deciding an action brought under §1983, the court rejects Ohio's use of the "income first" rule and orders the Department of Human Services to change its notice procedures for amending the community spouse's resource allowance. But the court finds that provisions regarding enforcement of notice requirements are not enforceable under §1983.
Plaintiffs are two couples; the husbands reside in nursing homes and the wives reside in the community. Both wives have income that is below the minimum monthly maintenance needs allowance (MMMNA). When they applied for Medicaid on behalf of their husbands, they were informed that their resources exceeded the maximum community spouse resource allowance (CSRA). The couples sought relief under 42 U.S.C. §1983, stating that the community spouse is entitled to a revision of the CSRA if it is inadequate to raise the community spouse''s income to the MMMNA; that they were never advised by the nursing facility or the Ohio Department of Human Services that the CSRA could be revised; that the Department has failed to provide community spouses receiving resource assessments with notice of their right to a fair hearing to revise the CSRA; and that the Department has failed to take corrective action despite its awareness that nursing facilities have not been in compliance with these notice requirements. The Department contended, among other things, that it is not a "person" within the meaning of §1983; that it had adopted a reasonable interpretation of the statutory provisions at issue; and that the notice provisions do not create private enforceable rights.
The court finds that the Eleventh Amendment does not bar §1983 actions seeking prospective injunctive relief against state officials in their official capacities. The court also finds that while income cannot be transferred until Medicaid eligibility is determined, resources may be transferred before eligibility is determined. Regarding the notice provisions in the law, the court holds that they meet the test outlined in Wilder v. Virginia Hosp. Ass'n (496 U.S. 498, 508 (1990)) for creating enforceable rights under §1983. The court further holds that the Department has been failing to notify spouses of the method for computing the CSRA and orders the Department to submit a proposed notice complying with the law. However, the court rules that the statutes regarding remedial action against nursing homes failing to comply with the notice requirements do not create a "binding obligation" on the state and thus do not give plaintiffs an enforceable right under §1983.
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