Defendant's Statement of Undisputed Material Facts in Opposition to Motion for Partial Summary Judgment

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- SENT +BY NHelLP ! ® s 12:0) ey 62400757811 

DANIEL E. LUNGREN, Attorney General 
of the State of California 

CHARLTON G. HOLLAND, III 
Assistant Attorney General 

STEPHANIE WALD 
Supervising Deputy Attorney General 

HARLAN E VAN WE y 
Deputy Attorney General 

2101 Webster Street, 12th Floor 
Qakland, California 94612-3049 
Telephone: (415) 464-1173 

Attorneys for Defendant 

UNITED STATES DISTRICT COURT 

NORTHERN DISTRICT OF CALIFORNIA 

No. C 90 3620 EFL 

DEFENDANT'S STATEMENT OF 
UNDISPUTED MATERIAL 
FACTS IN OPPOSITION TO 
MOTION FOR PARTIAL 
SUMMARY JUDGMENT 

Date: June 21, 1991 
Time: 10:00 AM 

ERIKA MATTHEWS AND JALISA 
MATTHEWS, by their guardian ad litem Lisa 
Matthews, and PEOPLE UNITED FOR A 
BETTER OAKLAND, On Behalf of 
Themselves and All Others Similarly Situated, 

Plaintiffs, 

Y. 

MOLLY COYE, M.D., Director, California 
Department of Health Services, 

Defendant. 

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Pursuant to Local Rule 220-7, Defendant hereby submits the following 

statement of undisputed material facts in opposition to Plaintiffs’ motion for summary 

judgment: 

1. In 1963, Congress enacted Title XIX of the Social Security Act, 42 

U.S.C. §§ 1396-13960, establishing a cooperative federal-state medical assistance | 

program designed to provide necessary medical services to poor people. Known ‘as 

"Medicaid," the program is administered by the state and federal governments, subject 

to mandatory federal statutory and regulatory guidelines. 

Proof: Complaint 1 16; Answer 1 9. 

2 At the federal level, the Medicaid program is implemented by the       TR pec MRE SL MEE eam LL. ood. mai Emam... Alama Ld an  



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US. Department of Health and Human Services’ Health Care Financing Administration 

(HCFA), HCFA issues mandatory, controlling guidelines to the statés through 

regulations and the State Medicaid Manual. 

| Proof: - Complaint § 20; Answer 1 12. 

3 The State Medicaid Manual] is controlling. 

Proof: Range Depo., at 34-35, 46 (Exh. J); Gregory Depo., at 62-64 

(Exh. K). 

4, Federal Medicaid law requires states, including California, to 

provide a range of "mandatory" health care benefits to poor persons, including Early 

and Periodic Screening, Diagnostic, and Treatment (EPSDT) services to children under 

age 21. Lead blood screenings are a mandatory part of the EPSDT program for 

children ages 1 through 5, 42 U.S.C. § 1396d(r)(1); State Medicaid Manual § 
5123201 

Proof: Complaint 1 20; Answer § 12. 

5. The State of California has elected to participate in the Medicaid 

program and established the California Medical Assistance Program, commonly called 

"Medi-Cal." In California, the EPSDT Program is also referred to as the Child Health 

and Disability Prevent (CHDP) Program. i | 

Proof: Complaint § 16; Answer f 9. 

6. Defendant Molly Coye, M.D. is the duly appointed Director of the 

State Department of Health Services (DHS). DHS is the state agency responsible for 

administration of the Medi-Cal EPSDT/CHDP Program. Defendant Coye's duties 

include supervision and control of the Medi-Cal program so as to secure full 

compliance with the governing laws. 

Proof: Complaint q 12; Answer 1 7. 

7 The decision of whether or not to physically test a Medicaid/Medi- 

Cal participant child’s blood for the presence of elevated lead levels is a medical 

decision to be made by the examining physician based upon age and risk factors, 42 

PEEIS OFainF ANC 110 Ir Imm 1 =r JAA) FA mem    



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~ SENT BY NHelLP @ yi 12:03 - 4 Uy 62400757813 

U.S.C. § 1396d(r)(1)(B)(iv); State Medicaid Manual § 5123.2.D.1; Gregory Dec. at 1 

4, 8 and 9. 

8. The American Academy of Pediatrics recognizes that mandatory 

blood lead level testing may not be appropriate in all circumstances. Gregory Dec. 11 

Sand? 

DATED: June 7, 1991 Respectfully submitted, 

DANIEL E. LUNGREN, Attorney General 
of State of California 

al 
E. VAN a 

Deputy Attorney General 

Attorneys for Defendant 

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