Carolyn Simmons v. Indian Rivers Mental Health Center

652 F. App'x 809
CourtCourt of Appeals for the Eleventh Circuit
DecidedJune 13, 2016
Docket15-11658
StatusUnpublished
Cited by7 cases

This text of 652 F. App'x 809 (Carolyn Simmons v. Indian Rivers Mental Health Center) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carolyn Simmons v. Indian Rivers Mental Health Center, 652 F. App'x 809 (11th Cir. 2016).

Opinion

PER CURIAM:

Carolyn Simmons, as Administratrix of the Estate of Terri Franks, appeals the district court’s disposition of the Family and Medical Leave Act (“FMLA”) claims of Terri Franks. 1 See 29 U.S.C. § 2601, et seq. After being fired following a period of medical leave, Franks filed claims of FMLA interference and retaliation against her employer, Indian Rivers Mental *811 Health Center (“Indian Rivers”). We are asked to consider whether the district court properly applied issue preclusion to bar Franks from relitigating the reason for her termination. The district court decided that a prior state agency unemployment compensation decision should be given pre-clusive effect because the agency had found that Franks had been terminated for misconduct. We conclude on the specific facts of this case that Alabama law would not apply issue preclusion to the agency determination. Therefore, after careful consideration and with the benefit of oral argument, we reverse and remand Franks’s FMLA termination claims for trial. We affirm in all other respects.

I. BACKGROUND

A. Job Performance

Terri Franks, a Licensed Professional Counselor in the State of Alabama, was hired by Indian Rivers in 1993. Indian Rivers provides mental health and mental retardation services for individuals in several Alabama counties. In 2006, Franks was promoted to Adult Outpatient Program Manager with responsibility for intake assessment, probate matters, the Crisis Response Team and Substance Abuse Services, group and individual therapy, crisis intervention, and mental retardation services. One of her main responsibilities was to oversee, conduct and certify patient Treatment Plan Reviews (“TPRs”). The record reflects that the TPR process, established by the State Department of Mental Health and Medicaid, requires a certified reviewer to review patient treatment plans on a set schedule every 90 days for Medicaid and residential patients and once yearly for self-pay and private insurance patients. As part of the claims repayment process, the reviewer must certify that each treatment plan is medically necessary, that goals remain appropriate, that the documentation accurately reflects the treatment being provided, and that continued treatment is recommended. Franks was a certified TPR reviewer and responsible for developing the TPR form used by Indian Rivers. She also trained other staff members on the TPR process. At the request of her supervisor, Clinical Director Connie Robbins, Franks created a system for monitoring and tracking TPR due dates to ensure that Indian Rivers was in full compliance with all state and federal legal requirements. Thus, Franks was well aware of the Medicaid guidelines and the TPR process, including the importance of timely documentation and avoiding duplicate billing.

According to Robbins, Franks failed to follow through with TPRs that were due in August and September of 2006. Robbins provided Franks with a new chart to follow to remedy the situation but also added more cases to her caseload. By March and April 2007, there were numerous TPRs again waiting for Franks’s review and signature. On April 4, 2007, Robbins met with Franks about her performance and drafted a detailed memo outlining her poor management, stating, “[f]or the ‘second time now in less than a year, updating the [Adult Outreach Program] TPRs has become a crisis,” due to Franks’s failure to follow the system. Robbins told Franks that this had “resulted in a payback of greater than $40,000” to Medicaid and required work by numerous other employees to remedy the situation. 2 In a responsive memo dated April 11, 2007, Franks acknowledged having had difficulty complet *812 ing all of the TPRs but explained that Indian Rivers had “a broken system on many levels” due to human error and staffing inadequacies. Also, Franks, said she often did not receive a copy of the necessary Medicaid reports, which interfered with her ability to review the appropriate files in a timely manner. Franks offered various suggestions for how she intended to improve her performance as a manager and stated she expected to receive the Medicaid reports so she could effectively manage the TPRs. She also denied being told previously that she was responsible for a Medicaid payback of $40,000 and insisted she should not be held responsible if a payback resulted from someone receiving a benefit without her being aware of it.

B. FMLA Leave and Termination

A few days after the memo, on April 15, 2007, Franks went to the emergency room due to debilitating neck pain, and the following day she learned she needed surgery. Franks called Robbins and Rita Harless, Human Resources Director for Indian Rivers, to inform them of her condition and need for medical leave through May 1, 2007. 3 Harless informed Franks that she needed to submit her FMLA paperwork, including a physician’s certification, within 10 days. Franks picked up the paperwork on April 17 and attempted to submit some information by email the same day, but Harless was unable to access the emails due to computer problems. On April 26, Robbins documented that Franks had not yet provided her or Harless with information about the surgery. On April 27, after not being able to reach Franks by email or telephone, Harless sent her a letter, reminding her of the need to submit the required FMLA documentation and that Indian Rivers had to be able to communicate with her while she was on leave. 4 She gave Franks an additional 10 days to provide the required physician’s certification because Indian Rivers still had not received any documentation from Franks’s physician. Harless and Franks also spoke by telephone on April 27, and a recording of the conversation reflects that Harless told- Franks that management positions can be excluded from FMLA and that Franks was still “expected to function and communicate in a limited capacity” while on leave “so others can continue to keep the business going.” Franks faxed the physician’s order to Indian Rivers that day, and her physician submitted the certification forms on April 30. Franks’s FMLA leave was then approved retroactive to April 16.

On April 19, Franks sent Robbins a memo in which she complained of receiving numerous work-related telephone calls during the first few days of her medical leave. She had documented eight such telephone calls, seven from Robbins and one from another staff member, B. Johnson. Robbins’s testimony confirms that for each of her seven calls to Franks, she merely left a message concerning work-related matters, such as requesting information on the location of treatment plans and inquiring about the location of a crisis telephone *813 used by the crisis response team. 5 Robbins made one additional brief call to Franks, which was recorded. In her deposition testimony, Franks named four other staff members with whom she had spoken by telephone during her leave, but she did not state who initiated those calls or how many calls there were.

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Bluebook (online)
652 F. App'x 809, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carolyn-simmons-v-indian-rivers-mental-health-center-ca11-2016.