Guggenberger ex rel. Guggenberger v. State (198 F. Supp. 3d 973, 2016)

MEMORANDUM OPINION AND ORDER

DONOVAN W. FRANK, United States District Judge

INTRODUCTION

This matter is before the Court on the Motion to Dismiss filed by Defendants the State of Minnesota, the Minnesota Department of Human Services (“DHS”), and DHS Commissioner Emily Johnson Piper (“Commissioner Johnson Piper”) (collectively, “Defendants”). (Doc. No. 35.) For the reasons set forth below, the Court grants in part and denies in part the motion.

BACKGROUND

I. Minnesota’s Waiver Services for Individuals with Disabilities

The State of Minnesota participates in Medicaid, a health care program operated and funded jointly by individual states and the federal government. (Am. Compl. ¶ 24.) Plaintiffs allege that federal Medicaid requirements obligate Minnesota to provide various services, including treatment in institutional settings, for persons with developmental disabilities. (Id. ¶ 25.) As an alternative to providing care and treatment in institutional settings, Plaintiffs allege that Minnesota may provide Home and Community Based Waiver Services (“Waiver Services”), which encompass a variety of services and supports which Plaintiffs allege are “designed to help people with disabilities live in his or her own home and access his or her community.” (Id. ¶ 26.) Plaintiffs allege that states that choose to offer these optional Waiver Services must do so in accordance with federal law. (Id. ¶ 27.)

Defendants operate four Waiver Services programs for individuals with disabilities as part of Minnesota’s Medicaid program known as Medical Assistance (“MA”). (Id. ¶¶ 35, 36.) According to Plaintiffs, these Waiver Services programs include the Developmental Disabilities (“DD”) Waiver, the Community Alternatives for Disabled Individuals (“CADI”) Waiver, the Community Alternative Care (“CAC”) Waiver, and the Brain Injury (“BI”) Waiver. (Id. ¶ 36.) Plaintiffs allege that the State of Minnesota and DHS are responsible for administering the Medicaid Waiver Services programs. (See id. ¶ 20.) Plaintiffs allege that DHS is “an agency designated as a department of the government of the State of Minnesota,” (id. ¶ 18), and that Commissioner Johnson Piper “serves as the ‘single state agency’ responsible for the administration of the Medicaid program in Minnesota” (id. ¶ 22). Plaintiffs allege that they, along with thousands of similarly situated individuals, have been deemed eligible for these Waiver Services but have not received services due to their placement on waiting lists. (Id. ¶ 48.)

Plaintiffs allege that Minnesota “bounties act as ‘local agencies’ of the state” to aid in the administration of the Waiver Services programs. (Id. ¶ 36, 37.) Specifically, Plaintiffs allege that Defendants identify each county’s total budget to spend for each Waiver, and the counties “create individual waiver services budgets and ... manage those budgets in the aggregate, within amounts specified by Defendants as available to serve eligible persons under each waiver.” (Id. ¶¶ 38, 39.) Plaintiffs assert that both the counties and the Defendants withhold a portion of the funds available as “reserves.” (Id. ¶ 40.) Plaintiffs claim that the counties are authorized by state statute “to reserve a certain portion of the available funding for unexpected situations that might arise during the year.” (Id.) In addition, Plaintiffs allege that “Defendants also withhold funds under each Waiver to address unexpected, crisis needs.” (Id.) Plaintiffs assert that these additional reserves withheld by Defendants “eas[e] the burden on counties to handle all unexpected costs at a local level.” (Id,) Plaintiffs allege that Waiver Services funds are returned to the State’s general fund if unspent in a given year. (Id. ¶ 42; see also id. ¶ 49.) In particular, Plaintiffs assert that “[ujnspent Waiver funds are not carried over or otherwise reserved for the Waiver programs to remove people from the waitlists and pay for Waiver Services in future years.” (Id. ¶ 42.)

II. The Named Plaintiffs

The named Plaintiffs in this case are four individuals with disabilities who allege that they have been deemed eligible for Waiver Services but have not been provided such services and have instead been placed on waiting lists for three years or more. (See id. ¶¶ 59-62.) Plaintiff Kyle Guggenberger (“Guggenberger”) alleges that he was placed on a waiting list over five years ago after being found eligible for DD Waiver Services. (Id. ¶ 59. C.) Plaintiff Jay Hannon (“Hannon”) also alleges that he was placed on a waiting list approximately five years ago after being found eligible for DD Waiver Services. (Id. ¶ 60.-C.) Plaintiff Abigail Pearson (“Pearson”) alleges that she was placed on a waiting list over fourteen years ago after being found eligible for DD Waiver Services. (Id. ¶ 61.C.) Plaintiff Amber Brick (“Brick”) alleges that she was placed on a waiting list over three years ago after being found eligible for CADI Waiver Services. (Id. ¶ 62.B.) The four named Plaintiffs allege that they are between the ages of twenty-two and twenty-five and reside at home with their parents. (Id. ¶¶ 59.A, 60.A, 61.A, 62.A.)

Each of the named Plaintiffs alleges that he or she receives some services due to their disabilities. (See id. ¶¶ 59.A, 60.A, 61.A, 62.A (referencing DD Case Management Services, PCA Services, DT&H Services, employment supports, Adult Rehabilitative Mental Health Services, and job placement services).) However, each Plaintiff also alleges that he or she is in need of additional supports and services available through the DD or CADI Waivers. (See id. ¶¶ 59.A, 60.B, 61.B, 62.A.) Such services include, for example, independent housing options; services to teach the individual to live on his or her own and access the community; behavioral support services; and services aimed at developing the individual’s independent living skills in areas such as budgeting, nutrition, healthcare, and employment. (See id. ¶¶ 59.A, 59.B, 60.B, 61.B, 62.A.)

Plaintiffs allege that their placement on waiting lists and their inability to access Waiver Services causes feelings of isolation and segregation from society, and has exacerbated their disabilities. (See id. ¶¶ 59.A, 59.B, 60.A, 61.A, 62.A.) All four named Plaintiffs allege that they have not received formal updates about their progress toward moving off the waiting lists to receive Waiver Services. (Id. ¶¶ 59.C, 60.C, 61.C., 62.C.) With the exception of Pearson, Plaintiffs allege that they have not received any notice or opportunity to challenge the ongoing denial of Waiver Services. (Id. ¶¶ 59.C, 60.C, 62.C.) Pearson alleges that she received one notice which “purported to abruptly and improperly deny Waiver Services to her.” (Id. ¶ 61.D.) Pearson alleges that this notice failed to provide proper advance notice of the proposed action and did not articulate the legal basis justifying the proposed action. (Id.) Aside from this one notice, Pearson alleges that she has not otherwise received any notice or opportunity to challenge the ongoing denial of Waiver Services. (Id. ¶ 61.C.) Plaintiffs allege that the counties in which they live “routinely and repeatedly maintained reserves and failed to spend all of their available Waiver funds, while Plaintiffs remained on wait lists.” (Id. ¶ 63.)

III. Plaintiffs’ Claims

Plaintiffs bring their claims on their own behalf and on behalf of a putative class of similarly situated individuals with disabilities in Minnesota who have been deemed eligible for Waiver Services but are currently on a waiting list for such services. (Id. ¶¶ 66, 67.A.) As of April 1, 2015, Plaintiffs allege, 3,586 individuals were on the DD Waiver waiting list, and 1,430 individuals were on the CADI Waiver waiting list. (Id. ¶ 51.) Plaintiffs allege that their continued placement on waiting lists for Waiver Services violates federal law in several respects. (See generally id.) Plaintiffs claim that Defendants have “fundamentally mismanaged” Minnesota’s Waiver Services programs, “depriv[ing] thousands of persons with disabilities of available services and supports intended to help them live independent, inclusive lives in their communities.” (Id. ¶ 1.) Plaintiffs allege that Defendants “have failed to ensure that otherwise eligible individuals are not improperly placed on wait lists for services when money is available under the Waivers to serve their needs.” (Id. ¶ 50.) According to Plaintiffs, Defendants have failed to undertake necessary administrative steps to remedy underspending by Minnesota counties. (Id.) In addition, Plaintiffs allege that Commissioner Johnson Piper does not have an effective and comprehensive plan “for ensuring that Plaintiffs and members of the Plaintiff class be provided with Waiver services within the funding appropriated by the Legislature each year, rather than placing them on wait lists, to enable them to live in the most integrated settings possible, consistent with their needs and preferences.” (Id. ¶ 99.) Plaintiffs allege that Defendants’ actions have caused them harm and have caused them to remain isolated from their communities in a discriminatory manner in violation of federal law. (Id. ¶ 2.)

In particular, Plaintiffs allege that Defendants have “improperly allow[ed] over $1 billion of funds legislatively appropriated for these critical programs to go unspent.” (Id.; see also id. ¶ 47 (providing charts identifying over $1 billion of unspent Waiver Services funds since 1995).) Plaintiffs claim that Defendants allow counties to reserve Waiver Services funds in amounts that “far exeeed[ ] what is reasonable or necessary.” (Id. ¶ 41.) To support this allegation, Plaintiffs reference multiple State reports documenting the amount of unspent reserves in Minnesota counties between 1995 and 2015. (See generally id. ¶¶ 43-47.) According to Plaintiffs, DHS has made recommendations in these reports that counties reduce their reserves, spend additional funding, and reduce their waiting lists. (See id. ¶ 43.) Specifically, one report notes that many counties “had room in their budgets to provide additional services or add more participants to programs.” (Id.) Plaintiffs allege that DHS’s most recent Waiver Services review reported that 72 out of 81 lead agencies (Minnesota counties) had unspent reserves of 4% or more in their DD Waiver budgets. (Id. ¶ 44.) pf these 72 lead agencies, 30 had reserves of 10% or more. (Id.) Plaintiffs further allege that 75 out of 81 lead agencies had unspent reserves of 4% or more in their CAC/CADI/BI Waiver budgets. (Id.) Of these, 48 had reserves of 10% or more. (Id.) Plaintiffs allege that DHS stated in a 2013 report regarding Hennepin County, “[T]here is room to add more participants via new or reuse slots or service optimization to reduce or eliminate the waiting list and enhance the quality of participant’s lives through services such as supportive [sic] employment.” (Id.) This report also stated, “Typically a 1% to 2% allocation reserve is more than adequate to manage risk for county [sic] of this size.” (Id.) Further, Plaintiffs allege that Defendants failed to spend all appropriated Waiver Services funds in the most recent state fiscal year so that allocated funds reverted to the State’s general fund. (Id. ¶ 49.) Plaintiffs allege that Defendants could have provided them with the services they seek without fundamentally altering the State’s programs or unduly burdening the State. (Id. ¶ 65.) Specifically, Plaintiffs allege that Defendants could have provided these services with unspent Waiver funds. (Id.)

According to Plaintiffs, “Defendants have failed to take administrative steps to insure [sic] that individuals on the wait lists are removed from the list and provided Waiver Services at a reasonable pace, within a reasonable amount of time.” (Id. ¶ 52.) Further, Plaintiffs allege that individuals with disabilities who are placed on waiting lists “are routinely denied advance notice of the decision not to offer them Waiver Services,” are not told whether they fall into a statutory priority group for allocating Waiver Services, and are not informed why they are placed or kept on waiting lists. (Id. ¶ 53.) Without such information, Plaintiffs allege, individuals have a limited ability to make informed choices about accepting or applying for other services. (Id. ¶ 54.) Plaintiffs also allege that individuals on waiting lists “are routinely denied the opportunity to challenge their placement on a wait list in a hearing on the merits.” (Id. ¶ 55.) Plaintiffs allege that additional funding recently allocated by the State for DD and CADI Waiver Services is “insufficient to ensure that the needs of Plaintiffs and all other individuals on wait lists are met within a reasonable time and pace, and with adequate notice of rights and due process protections.” (Id. ¶ 56, 57.) Plaintiffs also allege that Commissioner Johnson Piper has not informed individuals on waiting lists of the availability of Waiver Services as an alternative to institutional care and has denied such individuals the right to choose Waiver Services. (Id. ¶ 81.)

Plaintiffs assert the following claims against Commissioner Johnson Piper only: (1) violation of 42 U.S.C. § 1983 through failure to furnish services with reasonable promptness in violation of 42 U.S.C. § 1396a(a)(8); (2) violation of 42 U.S.C. § 1983 through failure to inform of feasible alternatives and denial of choice of Waiver Services in violation of 42 U.S.C. § 1396n(c)(2)(C); (3) violation of 42 U.S.C. § 1983 through a violation of Plaintiffs’ Due Process rights under the Fourteenth Amendment, the Medicaid Act, and its implementing regulations; and (4) violation of the Americans with Disabilities Act (“ADA”), 42 U.S.C. § 12132. (Id. ¶¶ 25-32.) Plaintiffs assert the following claim against all Defendants: violation of § 504 of the Rehabilitation Act, 29 U.S.C. § 794(a). (Id. ¶¶ 32, 33.)

Plaintiffs ask the Court to allow this action to proceed as a class action pursuant to Federal Rule of Civil Procedure 23. (See id. at Prayer for Relief ¶¶ A-D.) Plaintiffs seek declaratory, injunctive, and other relief to enforce their rights and to remedy Defendants’ violations of federal law. (See id. ¶¶ E-I.) Specifically, Plaintiffs seek a permanent injunction that requires Defendants to provide Waiver Services to Plaintiffs and similarly situated individuals “in the most integrated setting appropriate to their individual needs and preferences consistent with applicable law.” (Id. ¶ F.) Plaintiffs also seek an injunction “requiring that the Defendants fund and provide Waiver Services with reasonable promptness and at a reasonable pace” and “ordering] that such funds remain available until members of [the] plaintiff class are provided such services.” (Id. ¶ G.) Defendants move to dismiss Plaintiffs’ claims under Rules 12(b)(1) and 12(b)(6) of the Federal Rules of Civil Procedure. (See Doc. Nos. 35, 37.)

DISCUSSION

I. Legal Standard

A. Fed. R. Civ. P. 12(b)(1)

A motion to dismiss under Federal Rule of Civil Procedure 12(b)(1) challenges the Court’s subject matter jurisdiction. To survive a motion to dismiss for lack of subject matter jurisdiction, the party asserting jurisdiction has the burden of proving jurisdiction. V S Ltd. P’ship v. Dep’t of Hous. & Urban Dev., 235 F.3d 1109, 1112 (8th Cir.2000) (citation omitted). “Subject-matter jurisdiction is a threshold requirement which must be assured in every federal case.” Kronholm v. F.D.I.C., 915 F.2d 1171, 1174 (8th Cir.1990).

A motion to dismiss for lack of subject matter jurisdiction may challenge a plaintiffs complaint either on its face or on the factual truthfulness of its averments. Osborn v. United States, 918 F.2d 724, 729 n. 6 (8th Cir.1990) (citations omitted). When a defendant brings a facial challenge—a challenge that, even if truthful, the facts alleged in a claim are insufficient to establish jurisdiction—a court reviews the pleadings alone, and the non-moving party receives the same protections as it would defending against a motion brought pursuant to Rule 12(b)(6). Id. (citation omitted). In a factual challenge to jurisdiction, the court may consider matters outside the pleadings, and the non-moving party does not benefit from the safeguards of Rule 12(b)(6). Id. at 728-30 n. 4 (citations omitted) (holding that on a Rule 12(b)(1) motion challenging subject-matter jurisdiction, the court “has authority to consider matters outside the pleadings”).

B. Fed. R. Civ. P. 12(b)(6)

In deciding a motion to dismiss pursuant to Rule 12(b)(6), a court assumes all facts in the complaint to be true and construes all reasonable inferences from those facts in the light most favorable to the complainant. Morton v. Becker, 793 F.2d 185, 187 (8th Cir.1986). In doing so, however, a court need not accept as true wholly conclusory allegations, Hanten v. Sch. Dist. of Riverview Gardens, 183 F.3d 799, 805 (8th Cir.1999), or legal conclusions drawn by the pleader from the facts alleged, Westcott v. City of Omaha, 901 F.2d 1486, 1488 (8th Cir.1990). A court may consider the complaint, matters of public record, orders, materials embraced by the complaint, and exhibits attached to the complaint in deciding a motion to dismiss under Rule 12(b)(6). Porous Media Corp. v. Pall Corp., 186 F.3d 1077, 1079 (8th Cir.1999).

To survive a motion to dismiss, a complaint must contain “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). Although a complaint need not contain “detailed factual allegations,” it must contain facts with enough specificity “to raise a right to relief above the speculative level.” Id. at 555, 127 S.Ct. 1955. As the United States Supreme Court reiterated, “[tjhreadbare recitals of the elements of a cause of action, supported by mere conelusory statements,” will not pass muster under Twombly. Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) (citing Twombly, 550 U.S. at 555, 127 S.Ct. 1955). In sum, this standard “calls for enough fact[s] to raise a reasonable expectation that discovery will reveal evidence of [the claim].” Twombly, 550 U.S. at 556, 127 S.Ct. 1955.

II. Justiciability

Defendants argue that Plaintiffs’ claims are not justiciable, contending that they are rendered moot by recent changes in Minnesota law or, alternatively, are not yet ripe because such changes have not yet been fully implemented. Although they do not primarily frame their arguments on standing grounds, Defendants also suggest that Plaintiffs have failed to establish standing because they purportedly fail to demonstrate that Defendants’ allegedly harmful conduct will likely occur or continue under the new statutory scheme. Because standing is an essential prerequisite to the Court’s exercise of jurisdiction, the Court will address whether Plaintiffs’ have standing to assert their claims before reaching Defendants’ ripeness and mootness arguments.

A. Standing

The party invoking federal jurisdiction bears the burden of establishing standing. Lujan v. Defenders of Wildlife, 504 U.S. 555, 561, 112 S.Ct. 2130, 119 L.Ed.2d 351 (1992). The burden corresponds with the degree of evidence required at the relevant stage of litigation. Id. “At the pleading stage ... general factual allegations of injury ... may suffice.” Id.; Iowa League of Cities v. E.P.A., 711 F.3d 844, 869 (8th Cir.2013). If a plaintiff lacks standing, a district court has no subject matter jurisdiction over the matter and must dismiss the case. Young Am. Corp. v. Affiliated Comp. Servs., Inc., 424 F.3d 840, 843 (8th Cir.2005).

Article III of the Constitution limits the power of the federal courts to deciding only actual “cases” and “controversies.” U.S. Const., art. III, § 2, cl. 1. To establish constitutional Article III standing, a plaintiff must demonstrate: (1) an injury-in-fact; (2) a causal connection between that injury and the challenged conduct; and (3) the likelihood that a favorable decision by the court will redress the alleged injury. Lujan, 504 U.S. at 560, 112 S.Ct. 2130. These constitutional requirements of standing limit federal courts to deciding only cases where the plaintiffs can show a “personal injury fairly traceable to the defendant’s allegedly unlawful conduct and likely to be redressed by the requested relief.” Allen v. Wright, 468 U.S. 737, 751, 104 S.Ct. 3315, 82 L.Ed.2d 556 (1984).

A plaintiff seeking injunctive relief must show that he “faces a threat of future or ongoing harm.” Park v. Forest Serv. of the United States, 205 F.3d 1034, 1037 (8th Cir.2000). An injury resulting from past “illegal conduct” alone is not enough to support a claim for injunctive relief. Id. Likewise, a plaintiffs speculation that a future injury may occur is not sufficient to warrant injunctive relief. Los Angeles v. Lyons, 461 U.S. 95, 111, 103 S.Ct. 1660, 75 L.Ed.2d 675 (1983). A plaintiff must show that the threat of injury is “real and immediate.” O’Shea v. Littleton, 414 U.S. 488, 496, 94 S.Ct. 669, 38 L.Ed.2d 674 (1974). In so doing, a plaintiff can show that injunctive relief “will remedy the alleged harm.” Steel Co. v. Citizens for a Better Env't 523 U.S. 83, 108, 118 S.Ct. 1003, 140 L.Ed.2d 210 (1998). With these guidelines in mind, the Court concludes that Plaintiffs have established standing to pursue their claims against Defendants.

First, Plaintiffs have sufficiently alleged an injury-in-fact. Each Plaintiff alleges that he or she is currently lacking necessary supports and services that could enable him or her to live independently in the community. Plaintiffs allege that this lack of services is presently causing specific tangible harms including feelings of societal isolation and an exacerbation of their disabilities. Plaintiffs also allege particular harms based on the lack of notice or an opportunity to challenge being denied Waiver Services. Specifically, Plaintiffs allege that their ability to make informed choices about services is impaired by the lack of notice about why they were initially placed or are kept on waiting lists.

Second, Plaintiffs have established the requisite causal connection between their injuries and Defendants’ conduct. Plaintiffs allege that the additional supports and services they need to integrate into the community are available through the DD or CADI Waiver programs. Plaintiffs allege that Defendants are responsible for managing and administering the Waiver Services programs under which they have been placed on long waiting lists. In particular, Plaintiffs allege that Commissioner Johnson Piper is the “single state agency” tasked with administering Minnesota’s Medicaid program including the Waiver Services programs. They allege that Defendants have mismanaged Minnesota’s Waiver Services programs and have allowed Minnesota counties to routinely underspend their allocated Waiver Services funding while Plaintiffs and others remain on waiting lists. Plaintiffs specifically allege that Commissioner Johnson Piper does not have “a comprehensive and effectively working plan for ensuring that Plaintiffs and members of the Plaintiff class be provided with Waiver Services within the funding appropriated by the Legislature each year — ” (Am. Compl. 11 99.) According to Plaintiffs, Defendants’ conduct in mismanaging the Waiver Services program has caused their ongoing harms.

Third, the Court concludes that a favorable decision by this Court would redress Plaintiffs’ injuries. Plaintiffs request a declaration from this Court that Defendants have violated their rights under the Medicaid Act, the ADA, the Rehabilitation Act, and the Fourteenth Amendment Due Process Clause. Plaintiffs allege that these violations are ongoing, and the Court’s imposition of Plaintiffs’ requested injunctive relief will remedy Plaintiffs’ injuries. See, e.g., Steel Co., 523 U.S. at 108, 118 S.Ct. 1003 (“If respondent had alleged a continuing violation ..., the injunctive relief requested would remedy that alleged harm.”). Specifically, Plaintiffs seek an injunction which would “requir[e] Defendants to provide Plaintiffs ... with Waiver Services in the most integrated setting appropriate to their individual needs and preferences consistent with applicable law.” (Am. Compl. at Prayer for Relief ¶ F.) This requested relief is directly tied to Defendants’ alleged unlawful conduct under the ADA and the Rehabilitation Act and would redress Plaintiffs’ injuries resulting from their isolation and segregation from society. In addition, Plaintiffs seek an injunction “requiring that the Defendants fund and provide Waiver Services with reasonable promptness and at a reasonable pace to members of the plaintiff class” and an order from the Court that “such funds remain available until members of [the] plaintiff class are provided such services.” (Id. ¶ G.) Such an injunction would address Plaintiffs’ Medicaid Act claims and would redress the injuries they have suffered by being placed on waiting lists for Waiver Services for many- years.

Plaintiffs have standing to pursue their claims, and the Court will therefore' address Defendants’ additional justiciability challenges.

B. Mootness

Defendants argue that Plaintiffs’ claims are moot. In support of this argument, Defendants identify multiple recent amendments to Minnesota laws governing the allocation of Waiver Services funds, effective in May 2015. First, Minnesota statutes have been amended to impose a 3% cap on the amount of allocated Waiver Services funds that counties can maintain as.reserves. See Minn. Stat. § 256B.0916, subd. 11. Second, the,newly-amended laws limit counties’ fiscal responsibility for overspending should they spend funds in excess of their individual Waiver Services allocations. See id. § 256B.0916, subd. 12. Third, there is no longer a growth limit on the CADI Waiver Program. See Laws of Minnesota, 2011, 1st Special Session, Ch, 9, art. 10, sec. 3, subd. 3(g). Finally, Defendants also argue that they are in the process of making changes to the DD and CADI Waiver Programs through the implementation of Minnesota’s Olmstead Plan, approved by this Court in the related case Jensen, et al. v. Minnesota Department of Human Services, et al., Civ. No. 09-1775 (D. Minn.). Defendants argue that Plaintiffs’ Amended Complaint focuses on the mismanagement of county reserves under prior versions of Minnesota law. Thus, Defendants argue, Plaintiffs’ claims are rendered moot by these recent changes in the law governing Waiver Services.

Plaintiffs argue that their claims are based on ongoing violations of federal law and that recent amendments to Minnesota laws do not moot their claims. Specifically, Plaintiffs point out that they are not seeking declaratory or injunctive relief with respect to the Minnesota statutes Defendants have identified. And even if Defendants enforce the new limits on county reserves, Plaintiffs argue, their Medicaid, Due Process, ADA, and Rehabilitation Act claims would still be viable, In addition, Plaintiffs point out that the goals in Minnesota’s Olmstead Plan are not binding or enforceable obligations sufficient to moot Plaintiffs’ claims. Plaintiffs note that Defendants carry a heavy burden to prove mootness and argue that they have failed to do so.

Article Ill’s case and controversy requirement prohibits federal courts from hearing disputes that are no longer live. See Allen v. Likins, 517 F.2d 532, 534 (8th Cir.1975). Because courts have no power to issue advisory opinions, a case must involve “a real and substantial controversy” as opposed to a mere academic dispute based on hypothetical facts. Id. (internal quotation marks and citation omitted); see also Deerbrook Pavilion, LLC v. Shalala, 235 F.3d 1100, 1103 (8th Cir.2000). “A case is moot when it is ‘impossible for the court to grant any effectual relief whatever.’ ” Id. (quoting Church of Scientology v. United States, 506 U.S. 9, 12, 113 S.Ct. 447, 121 L.Ed.2d 313 (1992)), The party asserting that-a case has become, moot bears “[t]he heavy burden of proving mootness.” Kennedy Bldg. Assocs. v. Viacom. Inc., 375 F.3d 731, 745 (8th Cir.2004) (internal quotation marks and citation omitted).

In order to establish mootness on the basis of a defendant’s voluntary cessation of the alleged unlawful conduct, a defendant must meet the “formidable burden of showing that it is absolutely clear the allegedly wrongful behavior could not reasonably be expected to recur.” Friends of the Earth v. Laidlaw Envtl. Servs., 528 U.S. 167, 190, 120 S.Ct. 693, 145 L.Ed.2d 610 (2000). Defendants have not clearly established, or even affirmatively alleged, that they have voluntarily discontinued the purportedly unlawful conduct that Plaintiffs challenge in this case. Although Defendants direct the Court to multiple amendments to state laws governing Waiver Services, they fail to establish that they have discontinued the challenged conduct—the routine and ongoing mismanagement of the State’s Waiver Services program. Plaintiffs allege continuing harms through them ongoing placement on waiting lists, and Defendants continue to carry the responsibility for these harms. On this basis alone, the Court could properly reject Defendants’ mootness argument.

The Court also concludes that the recent changes to Minnesota laws governing Waiver Services do not moot Plaintiffs’ claims. Importantly, the Court does not interpret Plaintiffs’ claims to be directed at the prior versions of these laws. Although Plaintiffs provide the Court with detailed information regarding the history of Defendants’ administration of the Waiver Services programs under the prior statutory scheme, Plaintiffs allege personal harms and direct injury caused by Defendants’ continuing conduct as of December 2016— seven months after the amendments to the relevant statutes became effective. Plaintiffs have not lodged their claims under prior versions of Minnesota statutes governing Waiver Services. Rather, Plaintiffs challenge Defendants’ current and ongoing failure to properly administer the State’s Waiver Services programs under the existing statutory regime. Cases cited by Defendants to support their mootness argument involved amendments to the specific laws at issue during the pendency of litigation. See Stevenson v. Blytheville Sch. Dist. #5, 800 F.3d 955, 964-65 (8th Cir. 2015); Phelps-Roper v. City of Manchester, Mo., 697 F.3d 678, 684, 687 (8th Cir. 2012); see also Arc of Cal. v. Douglas, 757 F.3d 975, 979, 982 (9th Cir.2014). Here, Plaintiffs do not seek declaratory or in-junctive relief with respect to the amended laws themselves, and the new laws governing Waiver Services went into effect months before Plaintiffs filed their complaint. Thus, these changes in the law do not moot Plaintiffs’ claims.

Finally, the Court concludes that Defendants’ ongoing implementation of new administrative policies under Minnesota’s Olmstead Plan does not moot Plaintiffs’ claims. A defendant’s “ ‘announcement of an intention to change or adoption of a plan to work toward lawful behavior’ is generally insufficient” to moot a case. See Rosemere Neighborhood Ass’n v. U.S. Envtl. Prot. Agency, 581 F.3d 1169, 1173 n. 3 (9th Cir.2009) (quoting 13C Charles Alan Wright et al., Federal Practice and Procedure § 3533.7 (3d ed. 2008)). In addition, a court need not “wait and see how [a] new policy work[s] out” in response to a defendant’s argument that its administrative policy moots the plaintiffs’ claims. See Gluth v. Kangas, 951 F.2d 1504, 1507 (9th Cir.1991) (rejecting an argument that the Department of Corrections’ post-litigation adoption of a new law library access policy mooted plaintiffs’ federal claim that they had been denied meaningful access to the courts). The evolving implementation of Minnesota’s Olmstead Plan approved by the Court in Jensen does not resolve Plaintiffs’ claims against the Defendants. Notwithstanding Defendants’ implementation of the Olm-stead Plan and their commitment to working toward specific goals to improve the pace of the Waiver Services waiting lists, the Court concludes that this case presents a live controversy capable of effectual relief. See Deerbrook, 235 F.3d at 1103.

C. Ripeness

In the alternative, Defendants argue that if Plaintiffs’ claims are based on current versions of Minnesota laws governing Waiver Services, they are not ripe.

As with standing and mootness, the ripeness doctrine ensures that a court’s exercise of jurisdiction meets both the constitutional requirements of Article III and prudential limitations. See Neb. Pub. Power Dist. v. MidAmerican Energy Co., 234 F.3d 1032, 1037 (8th Cir.2000). The Supreme Court has explained that:

[The ripeness doctrine’s] basic rationale is to prevent the courts, through avoidance of premature adjudication, from entangling themselves in abstract disagreements over administrative policies, and also to protect the agencies from judicial interference until an administrative decision has been formalized and its effects felt in a concrete way by the challenging parties. The problem is best seen in a twofold aspect, requiring us to evaluate both the fitness of the issues for judicial decision and the hardship to the parties of withholding court consideration.

Abbott Labs. v. Gardner, 387 U.S. 136, 148-49, 87 S.Ct. 1507, 18 L.Ed.2d 681 (1967).

Under the fitness factor, “[t]he case is more likely to be ripe if it poses a purely legal question and is not contingent on future possibilities.” Pub. Water Supply Dist. No. 10 of Cass Cty. v. City of Peculiar, Mo., 345 F.3d 570, 573 (8th Cir.2003) (citations omitted); see also Parrish v. Dayton, 761 F.3d 873, 876 (8th Cir.2014) (“A claim is not ripe for adjudication if it rests upon contingent future events that may not occur as anticipated, or indeed may not occur at all.” (quoting Texas v. United States, 523 U.S. 296, 300, 118 S.Ct. 1257, 140 L.Ed.2d 406 (1998))). Even if a dispute raises some contingencies, however, a court may properly exercise review “where an issue is largely legal in nature, may be resolved without further factual development, or where judicial resolution will largely settle the parties’ dispute.” Neb. Pub. Power, 234 F.3d at 1038 (citations omitted).

Under the hardship factor, a court may consider both financial harm and harm caused by “uncertainty-induced behavior modification in the absence of judicial review.” Iowa League of Cities v. Envtl. Prot. Agency, 711 F.3d 844, 867 (8th Cir.2013) (internal quotation marks and citations omitted). The immediacy and directness of the harm is also relevant. See Abbott Labs., 387 U.S. at 152, 87 S.Ct. 1507. The ripeness factors “are weighed on a sliding scale, but each must be satisfied ‘to at least a minimal degree.’” Iowa League of Cities, 711 F.3d at 867.

The Eighth Circuit has previously identified “the extent to which judicial intervention would interfere with administrative action” as a third relevant factor in the ripeness inquiry. Nat’l Right to Life Political Action Comm. v. Connor, 323 F.3d 684, 692-93 (8th Cir.2003). An assertion of ongoing agency action, however, will not always prevent the court’s exercise of jurisdiction. See 13B Charles Alan Wright et ah, Federal Practice & Procedure § 3532.6 (3d ed. 2016) (“[A]ny agency attempt to defeat review by the bare assertion that the agency position may some day change should be summarily rejected.”). In addition, “protracted inaction by state officials may itself be a wrong, or at least defeat any claim that a federal court should await further state developments.” Id. § 3532.3; see also Groome Resources Ltd., L.L.C. v. Parish of Jefferson, 234 F.3d 192, 199-200 (5th Cir.2000). Further, ripeness is not automatically defeated by ongoing revision or implementation of an administrative agency’s regulatory plan, see Ohio Envtl. Council v. U.S. Dist. Court, S. Dist. of Oh., E. Div., 565 F.2d 393, 397-98 (6th Cir.1977), or by the possibility of future regulatory changes, see Am. Petroleum Inst. v. U.S. Envtl. Prat. Agency, 906 F.2d 729, 739-40 (D.C.Cir.1990).

Defendants contend that Plaintiffs’ claims are not fit for judicial resolution at this time because Defendants are still in the process of implementing recent legislative changes and Minnesota’s Olm-stead Plan. Defendants assert that “[i]t is currently unknown and wholly speculative to guess how these changes will affect Plaintiffs’ specific applications for waiver services.” (Doc. No. 37 at 17.) In addition, Defendants argue that Plaintiffs’ claims are not ripe because Plaintiffs have failed to allege an immediate danger of direct injury and acknowledge that they are not currently institutionalized.

Plaintiffs disagree and contend that their claims are ripe for adjudication. First, they argue that their claims present primarily legal questions regarding Defendants’ purported violations of federal laws. Plaintiffs note, “Defendants have pointed to no missing relevant and material facts needed to create Plaintiffs’ claims, and there are no contingencies that must occur before the claims mature.” (Doc. No. 43 at 16.) Second, Plaintiffs allege that they are facing direct and sustained harms as opposed to a threat of future injury. Plaintiffs further argue that the ongoing implementation of Minnesota’s Olmstead Plan does not render their claims unripe because the plan does not legally bind the Defendants or eliminate the harms Plaintiffs are currently experiencing.

The Court concludes that this case is ripe for review. The issues before the Court are primarily legal, and future factual developments will not meaningfully enhance the Court’s ability to undertake review of the legal issues raised by Plaintiffs’ claims. Further, the hardship to Plaintiffs of withholding judicial review is concrete. Plaintiffs do not allege or speculate that they face a threat of future harm; Plaintiffs allege that they are harmed currently on an ongoing basis every day that they are denied essential Waiver Services based on Defendants’ purported mismanagement and administration. N ot’ivithstanding Defendants’ argument that their implementation of new statutes and Minnesota’s Olm-stead Plan make this case unripe, the Court concludes that delaying resolution of Plaintiffs’ claims is unwarranted.

Further, awaiting additional developments will not sharpen the Court’s analysis of Plaintiffs’ claims and will only exacerbate the direct and ongoing harms Plaintiffs allege they are facing. Unless and until Plaintiffs’ are removed from the waiting lists for Waiver Services, their legal claims challenging Defendants’ ongoing administration of the Waiver Services programs will remain viable and unresolved. Although Defendants emphasize that Minnesota’s new statutory scheme may somehow affect Plaintiffs’ applications for Waiver Services, the Court’s analysis of Plaintiffs’ current claims will not benefit from waiting to see what might happen a| a future time. In short, the Court “in al| likelihood ‘will be in no better position later than [it is] now to confront’” the legal issues presented. Johnson v. Stuart, 702 F.2d 193, 197 (9th Cir.1983) (quoting Regional Rail Reorganization Act Cases, 419 U.S. 102, 145, 95 S.Ct. 335, 42 L.Ed.2d 320 (1974)); cf. Neb. Pub. Power, 234 F.3d at 1039 (“Were we to withhold adjudication, [the parties] would perforce return here shortly, making precisely the same arguments, with nary a scintilla of additional relevant evidence.”).

The Court concludes that Plaintiffs’ claims are justiciable. Plaintiffs have established standing to pursue their claims, and the claims are neither moot nor unripe for judicial resolution.

III. Sovereign Immunity

The Court next considers Defendants’ argument that Plaintiffs’ claims and requested relief are barred by sovereign immunity. The Eleventh Amendment provides that states and their agencies are immune from suit in federal court, unless the state has consented to be sued,' or Congress has abrogated the state’s immunity by some express statutory provision. See Will v. Mich. Dep’t. of State Police, 491 U.S. 58, 66-67, 109 S.Ct. 2304, 105 L.Ed.2d 45 (1989); Egerdahl v. Hibbing Cmty. Coll., 72 F.3d 615, 619 (8th Cir. 1995). The Supreme Court has identified a longstanding exception to Eleventh Amendment sovereign immunity, permitting suits against state officers that seek prospective injunctive relief to enforce compliance with federal law. See Ex parte Young, 209 U.S. 123, 28 S.Ct. 441, 52 L.Ed. 714 (1908). Plaintiffs have asserted all of their claims against Commissioner Johnson Piper, and have only asserted their Rehabilitation Act claim against the State of Minnesota and DHS. The Court will first analyze the extent to which Ex parte Young applies to Plaintiffs’ claims against Commissioner Johnson Piper before analyzing whether the State of Minnesota is immune from Plaintiffs’ claims under § 504 of the Rehabilitation Act.

A. Claims for Injunctive Relief Against the Commissioner

Defendants argue that Plaintiffs’ claims are barred by sovereign immunity principles established under the Eleventh Amendment. While acknowledging that individuals may properly seek prospective relief against state officials under Ex parte Young, Defendants argue that Plaintiffs seek relief that is barred because the monetary consequences to the State are not merely ancillary but are the primary purpose of Plaintiffs’ claims. Defendants contend, “Plaintiffs do not seek an order merely requiring Defendants to comply with federal law, ... they seek an order compelling Defendants to fund waiver services and keep funding available.” (Doc. No. 45 at 3.) Defendants also raise general federalism concerns, arguing that Plaintiffs are asking the Court to “interfere with Defendants’ right to manage state funding by requiring the state to indefinitely continue its participation in a voluntary medical assistance program,” (Doc. No. 37 at 8), and by overriding State decisions regarding how to spend its limited funds. Defendants further argue that remedying Plaintiffs’ claims would implicate separation-of-powers concerns due to improper judicial interference with federal Medicaid statutes enacted by Congress and administered by the Secretary of the Department of Health and Human Services (“HHS”).

Plaintiffs argue that their claims against Commissioner Johnson Piper may proceed notwithstanding the Eleventh Amendment because Plaintiffs properly seek prospective injunctive and declaratory relief under Ex parte Young. Plaintiffs also argue that any fiscal consequences to the State are ancillary to their request for injunctive relief and are thus proper. Further, Plaintiffs acknowledge that Defendants’ participation in Medicaid is voluntary but emphasize that such voluntary participation necessitates compliance with federal statutes and regulations governing the Medicaid program. In response to Defendants’ federalism and separation of powers arguments, Plaintiffs argue that they are not seeking to override the State’s funding decisions. Specifically, Plaintiffs note that “[njowhere in Plaintiffs’ Amended Complaint ... is any demand that the State use non-Waiver Services funds to pay for Waiver Services.” (Doc. No. 43 at 21.) Rather, Plaintiffs explain, “Plaintiffs ask only that the State spend legislatively appropriated Waiver Services funds on Waiver Services for individuals already deemed eligible for such services.” (Id.) Plaintiffs also argue that Defendants waived sovereign immunity when they agreed to create and implement Minnesota’s Olmstead Plan which commits to reducing Waiver Services waiting lists.

The exception to sovereign immunity established in Ex parte Young is an “[e]xtremely important” and “substantial” limitation on state sovereign immunity “accepted as necessary to ‘permit federal courts to vindicate federal rights.’” Denke v. S.D. Dep’t of Soc. Servs., 829 F.2d 688, 689 (8th Cir.1987); Va. Office for Prot. & Advocacy v. Stewart, 563 U.S. 247, 131 S.Ct. 1632, 1638, 179 L.Ed.2d 675 (2011) (citation omitted). Specifically, “the power of federal courts to enjoin ‘continuing violation[s] of federal law [is] necessary to vindicate the federal interest in assuring the supremacy of that law.’ ” Fond du Lac Band of Chippewa Indians v. Carlson, 68 F.3d 253, 255 (8th Cir.1995) (quoting Green v. Mansour, 474 U.S. 64, 68, 106 S.Ct. 423, 88 L.Ed.2d 371 (1985)). The Ex parte Young exception to sovereign immunity permits federal courts to grant prospective relief against state officials in order to enjoin their future compliance with federal law. Edelman v. Jordan, 415 U.S. 651, 664, 94 S.Ct. 1347, 39 L.Ed.2d 662 (1974). However, a federal court may not impose retroactive relief that requires state officials “to use state funds to make reparation for the past.” Id. at 665, 94 S.Ct. 1347.

The line between proper relief under Ex parte Young and relief prohibited by the Eleventh Amendment can sometimes be difficult to draw. See id. at 667, 94 S.Ct. 1347. However, the Supreme Court has clarified that “a court need only conduct a straightforward inquiry into whether [the] complaint alleges an ongoing violation of federal law and seeks relief properly characterized as prospective” to determine whether Ex parte Young applies. Verizon Md. Inc. v. Pub. Serv. Comm’n of Md., 535 U.S. 635, 645, 122 S.Ct. 1753, 152 L.Ed.2d 871 (2002) (internal quotation marks and citation omitted); see also Gibson v. Ark. Dep’t of Corr., 265 F.3d 718, 720 (8th Cir. 2001).

If the relief sought is prospective in nature, it is proper “notwithstanding a direct and substantial impact on the state treasury.” Milliken v. Bradley, 433 U.S. 267, 289, 97 S.Ct. 2749, 53 L.Ed.2d 745 (1977) (finding an injunctive relief order to be proper despite its explicit requirement that the state bear one half of the cost of developing a comprehensive educational program); see also Papasan v. Attain, 478 U.S. 265, 281-82, 106 S.Ct. 2932, 92 L.Ed.2d 209 (1986) (declining to dismiss on Eleventh Amendment grounds plaintiffs’ claim challenging the state’s unequal allocation of resources to state school districts, even though remedying the disparity “might require the expenditure of state funds”). As the Supreme Court explained in Edelman v. Jordan,

State officials, in order to shape their official conduct to the mandate of the Court’s decrees, would more likely have to spend money from the state treasury than if they had been left free to pursue their previous course of conduct. Such an ancillary effect on the state treasury is a permissible and often an inevitable consequence of the principle announced in Ex parte Young.

Edelman, 415 U.S. at 668, 94 S.Ct. 1347. Thus, to determine whether Ex parte Young applies to override Eleventh Amendment sovereign immunity, the Court must focus not on the impact of the requested relief on the state treasury, but on whether the relief sought is fundamentally prospective or retrospective in nature. See Mo. Child Care Ass’n v. Cross, 294 F.3d 1034, 1042 (8th Cir.2002); see also Antrican ex rel. Antrican v. Odom, 290 F.3d 178, 186 (4th Cir.2002); Lewis v. New Mexico Dep’t of Health, 261 F.3d 970, 977 (10th Cir.2001).

The Court concludes that Plaintiffs’ claims against Commissioner Johnson Piper fall within the scope of the Ex parte Young exception to sovereign immunity. To remedy ongoing violations of federal laws, including the Medicaid Act, the ADA, the Rehabilitation Act, and the Due Process Clause of the Fourteenth Amendment, Plaintiffs seek injunctive relief that would operate prospectively against the Commissioner to affect her conduct in the future. Specifically, Plaintiffs seek a permanent injunction that requires Defendants to provide Plaintiffs with Waiver Services “in the most integrated setting appropriate to their individual needs and preferences consistent with applicable law.” (Am. Compl. at Prayer for Relief ¶ F.) Plaintiffs also seek an injunction “requiring that the Defendants fund and provide Waiver Services with reasonable promptness and at a reasonable pace” and “order[ing] that such funds remain available until members of [the] plaintiff class are provided such services.” (Id. ¶ G.) Because Plaintiffs seek only prospective injunctive relief, their claims against Commissioner Johnson Piper fall squarely under the Ex parte Young exception to sovereign immunity. See Boulet v. Cellucci, 107 F.Supp.2d 61, 74 (D.Mass. 2000) (“[T]he plaintiffs request an order that the defendants grant the requested services with reasonable promptness—an order affecting prospective action only.”).

Although the relief Plaintiffs seek relates to and will likely involve the expenditure of funds, it is not the type of retroactive monetary relief barred by the Eleventh Amendment. Specifically, Plaintiffs’ requested relief will not be “measured in terms of a monetary loss resulting from a past breach of a legal duty on the part of the defendant state officials.” Edelman, 415 U.S. at 668, 94 S.Ct. 1347. Plaintiffs do not request retroactive relief “to ... compensate] ... for conduct and consequences completed in the past,” Milliken, 433 U.S. at 290 n. 21, 97 S.Ct. 2749, or to “bestow an award for accrued monetary liability,” Papasan, 478 at 282, 106 S.Ct. 2932. Rather, Plaintiffs seek “relief that serves directly to bring an end to a present violation of federal law” which is ongoing and causing Plaintiffs continuing harms. Id. at 278, 97 S.Ct. 2749. If Plaintiffs requested to be made whole through financial compensation for the past months or years in which they were placed on the Waiver Services waiting lists, such relief would be barred by the Eleventh Amendment. However, Plaintiffs make no such request. Therefore, the Court may properly award prospective in-junctive relief to remedy Plaintiffs’ harms. Any impact upon the State’s treasury -will be ancillary to such relief and is therefore permissible under the Eleventh Amendment. See Mo. Child Care Ass’n, 294 F.3d at 1042; see also Boulet, 107 F.Supp.2d at 74.

Defendants also assert that Plaintiffs’ claims implicate state sovereignty concerns and are barred by principles of federalism. Even if a claim would otherwise be proper under Ex parte Young, a suit may be prohibited under the Eleventh Amendment where “the suit and the remedy it seeks ‘implicate[ ] special sovereignty interests.’” See Union Elec. Co. v. Mo. Dep’t of Conservation, 366 F.3d 655, 658 (8th Cir.2004) (quoting Idaho v. Coeur d’Alene Tribe of Idaho, 521 U.S. 261, 281, 117 S.Ct. 2028, 138 L.Ed.2d 438 (1997)). Although Defendants have not specifically invoked the “special sovereignty interests” exception to Ex parte Young, the Court interprets their arguments to be directed at similar concerns. First, Defendants assert that Plaintiffs improperly request the Court to order Defendants to continue participating in Medicaid indefinitely. Second, Defendants argue that Plaintiffs’ requested relief would infringe state sovereignty by dictating how the State should spend its limited funds.

The Court disagrees with Defendants. First, as Defendants assert and Plaintiffs admit, Defendants’ participation in Medicaid and its provision of any Waiver Services is voluntary. This Court cannot order the State to fund such services if the legislature chooses to abandon its participation in Medicaid or its provision of Waiver Services. See Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 29, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981). However, because Defendants have chosen to provide these services in the State of Minnesota, them participation must comply with federal law. Mo. Child Care Ass’n, 294 F.3d at 1036 (“[0]nee a state agrees to take the funds offered through [a federal program created pursuant to the Spending Clause], the state is bound to ‘comply with federally imposed conditions.’” (quoting Pennhurst, 451 U.S. at 17, 101 S.Ct. 1531)).

Second, Plaintiffs do not ask the Court to dictate expenditures from the State treasury. Rather, the relief they seek centers on the administration, use, and oversight of funds that the State legislature independently decides to allocate for Waiver Services. The Court may properly order Defendants to properly administer the funds the State has allocated to provide Waiver Services for individuals with disabilities. Such an order would not “ha[ve] the effect of dictating state or local budget priorities,” see Horne v. Flores, 557 U.S. 433, 448, 129 S.Ct. 2579, 174 L.Ed.2d 406 (2009), but would simply require Defendants to comply with federal laws within the budget previously established by the State.

Finally, the Court concludes that no special sovereignty interests are implicated by the relief Plaintiffs seek. “A state’s interest in administering a welfare program at least partially funded by the federal government is not such a core sovereign interest as to preclude the application of Ex parte Young.” J.B. ex rel. Hart v. Valdez, 186 F.3d 1280, 1287 (10th Cir.1999); see also Antrican, 290 F.3d at 189 (finding no special sovereignty interests in a § 1983 Medicaid case because it “involve[d] a federally designed healthcare program in which the federal government has invited the States to participate if they agree to certain federally established conditions”); Lewis v. N.M. Dep’t of Health, 94 F.Supp.2d 1217, 1232 (D.N.M.2000) (“[T]hough states certainly have a special interest in administering their own social services programs, when they accept federal funding for a program they cannot escape suit against state officials for failure to comply with federal law governing that program under Ex parte Young,”). As noted above, Defendants have elected to participate in Medicaid and must therefore comply with its requirements. Any sovereignty interests the State retains in administering Minnesota’s Waiver Services programs under Medicaid must be exercised in compliance with federal law.

Defendants’ last contention is that remedying Plaintiffs’ claims would raise federal separation-of-powers concerns due to congressionally-approved limits on Waiver Services and the HHS Secretary’s administration of the Medicaid Act. Without prematurely delving into the merits of Plaintiffs’ Medicaid Act claims, the Court concludes that these separation-of-powers concerns do not preclude the Court’s exercise of jurisdiction over Plaintiffs’ claims. Multiple federal appellate courts have permitted plaintiffs to pursue claims seeking prospective injunctive relief to remedy ongoing violations of the Medicaid Act. See Westside Mothers v. Haveman, 289 F.3d 852, 861 (6th Cir.2002); J.B. ex ret. Hart, 186 F.3d at 1286-87; Doe v. Chiles, 136 F.3d 709, 720 (11th Cir.1998). Indeed, the Tenth Circuit has specifically found prospective injunctive relief to be proper in order to remedy alleged violations of 42 U.S.C. § 1396a(a)(8)’s reasonable promptness requirement. See Lewis, 261 F.3d at 977-78.

The Court concludes that Plaintiffs’ claims against Commissioner Johnson Piper may proceed because Plaintiffs properly seek prospective injunctive relief under the Ex parte Young exception to sovereign immunity to enjoin ongoing violations of federal law. That their requested relief may have an ancillary effect upon the State treasury is no bar to their claims, and the Court’s imposition of the requested relief would not improperly interfere with state sovereignty.

B. Rehabilitation Act Claim Against all Defendants

Defendants argue that under both Ex parte Young and controlling Eighth Circuit caselaw governing Congress’s abrogation of state sovereign immunity under the Rehabilitation Act, the State of Minnesota is not a proper party to Plaintiffs’ complaint. Specifically, Defendants assert that Minnesota’s acceptance of federal Medicaid funds only effectuates a waiver of sovereign immunity with respect to the individual agency that receives the funds.

Plaintiffs contend that both DHS and the State of Minnesota are proper parties to their Rehabilitation Act claim. Because Congress has abrogated state immunity under § 504 of the Rehabilitation Act, Plaintiffs argue, the State of Minnesota has waived its sovereign immunity with respect to such claims by accepting federal funds to administer the State’s Medicaid program.

As noted above, express Congressional abrogation may override the sovereign immunity afforded to states and their agencies under the Eleventh Amendment. See Will, 491 U.S. at 66-67, 109 S.Ct. 2304; Egerdahl, 72 F.3d at 619. With respect to the Rehabilitation Act, Congress has enacted the following provision to abrogate state sovereign immunity: “A State shall not be immune under the Eleventh Amendment of the Constitution of the United States from suit in Federal court for a violation of section 504 of the Rehabilitation Act of 1973 ...42 U.S.C. § 2000d-7(a)(l). Applying this provision to a Rehabilitation Act claim against State of Arkansas, the Eighth Circuit has explained that “[t]he Rehabilitation Act requires States that accept federal funds to waive their Eleventh Amendment immunity to suits brought in federal court for violations of Section 504.” Jim C. v. United States, 235 F.3d 1079, 1081 (8th Cir.2000). However, because the definition of a “program or activity” covered under the Rehabilitation Act does not include a state itself, the state’s waiver of sovereign immunity is limited to the state agency that accepts or distributes the federal funds. See id. at 1080-81 (construing 29 U.S.C. § 794(b)). In other words, “[t]he acceptance of funds by one state agency ... leaves unaffected both other state agencies and the State as a whole.” Id. at 1081; see also Doe v. Nebraska, 345 F.3d 593, 598 (8th Cir.2003) (“[T]his waiver of sovereign immunity is limited and applies only to the individual agency that receives the federal funds”). This is true even if the state itself is the entity that “applie[s] for and receive[s] federal grants” to be used by a specific agency. See Doe, 345 F.3d at 599-600.

Plaintiffs allege that the State of Minnesota has elected to participate in Medicaid, a health care program jointly funded by the federal government and the State. (Am. Compl. ¶ 24.) Plaintiffs further allege that Commissioner Johnson Piper, the DHS Commissioner, “serves as the ‘single state agency’ responsible for the administration of the Medicaid program in Minnesota.” {Id. ¶ 22.) Plaintiffs also allege that the “State of Minnesota and DHS, an agency of the State of Minnesota, are responsible for developing and implementing the Medicaid Waiver Services to eligible individuals.” {Id. ¶ 20.)

The Court concludes that the State of Minnesota has waived its Eleventh Amendment sovereign immunity for claims under § 504 of the Rehabilitation Act by accepting federal funds and participating in Medicaid. However, Minnesota’s waiver of sovereign immunity for such claims is limited to DHS, the agency that accepts and distributes federal Medicaid funds through the State’s MA program. Therefore, the Court agrees with Defendants that the State of Minnesota is not a proper party to this action and should be dismissed.

Furthermore, the Court concludes that allowing this claim to proceed against both Commissioner Johnson Piper in her official capacity and DHS is redundant. “An official-capacity suit is merely another way of pleading an action directly against the public entity itself.” Roberts v. Dillon, 15 F.3d 113, 115 (8th Cir.1994). Therefore, “any naming of [the public entity] in the heading of the complaint [is] ... redundant” to a suit against an official in her official capacity. See id.; see also Veatch v. Bartels Lutheran Home, 627 F.3d 1254, 1257 (8th Cir.2010) (affirming a district court’s dismissal of a claim against a police sergeant in his official capacity “as redundant of the claim against the City”). This is particularly true here where Minnesota statutes specifically identify the Commissioner of DHS herself as the “state agency” responsible for administering th