On April 19, 2011, the Supreme Court decided Virginia Office for Protection and Advocacy v. Stewart, No. 09-529.

Under the Developmental Disabilities Assistance and Bill of Rights Act of 2000 and the Advocacy for Individuals with Mental Illness Act, states may receive federal funding to improve community services for people with developmental disabilities or mental illness. To get that federal funding, the state must establish a "protection and advocacy system" to protect and advocate the rights of the people it serves, and that system must be able to investigate incidents of abuse and neglect, obtain all records relating to people who may have been abused, and pursue legal action on behalf of those it protects.

The Commonwealth of Virginia created the Virginia Office for Protection and Advocacy (VOPA) as its protection and advocacy system. Virginia chose to make VOPA an independent state agency, rather than a private nonprofit, as federal law allowed it to do.

VOPA opened an investigation into the deaths of two patients and injuries to a third patient at state-run mental institutions. VOPA asked state officials in charge of the institutions to produce certain records, but the officials refused, citing a privilege created by state law. VOPA sued in federal court and asked for a declaration that the officials' refusal to produce the records violated federal law, and an injunction requiring the officials to give access to the records and refrain from interfering with VOPA's investigation in the future. The officials moved to dismiss the case on the ground that they were immune from suit in federal court under the Eleventh Amendment.

The district court denied the motion, holding that the lawsuit was proper under Ex Parte Young, which allows federal courts to award prospective relief against state officials for violations of federal law. The Fourth Circuit reversed, holding that Ex Parte Young allows only private litigants to sue state officials for prospective relief, and does not apply to lawsuits between officials of the same state.

The Supreme Court reversed, holding that the core principle of Ex Parte Young—that the Eleventh Amendment is not offended when federal courts require state officials to comply with federal law on a prospective basis—applies regardless whether the plaintiff suing the state officials is a private party or another state agency, because the intrusion on the state's sovereign interests is the same either way: the effect of the relief sought is prospective injunctive relief against state officials. The Court observed that if VOPA had been a non-profit entity, there would have been no doubt that the lawsuit was proper under Young, and concluded that the result should not change just because VOPA is a state agency.

Justice Scalia delivered the opinion of the Court, in which Justices Kennedy, Thomas, Ginsburg, Breyer, and Sotomayor joined. Chief Justice Roberts filed a dissenting opinion, in which Justice Alito joined. Justice Kagan did not participate.

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