Cathleen Murray v. Charles Auslander

Procedural entryThis page is a short order in Cathleen Murray v. Charles Auslander. Read the opinion of the Court — 244 F.3d 807
Court of Appeals for the Eleventh Circuit·Decided March 13, 2001·No. 00-11955·Published

Opinion

[PUBLISH]

IN THE UNITED STATES COURT OF APPEALS FILED

FOR THE ELEVENTH CIRCUIT U.S. COURT OF APPEALS _______________________ ELEVENTH CIRCUIT MAR 13 2001

No. 00-11955 THOMAS K. KAHN _______________________ CLERK

D. C. Docket No. 98-01066 CV-WDF CATHLEEN MURRAY, SHELLY WILSON, et al., Plaintiffs-Appellees,

versus

CHARLES AUSLANDER, Acting Administrator of DFCS District 11, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, by the highest ranking official, et al.,

Defendants-Appellants.

Appeal from the United States District Court for the Southern District of Florida

(March 13, 2001)

Before WILSON, KRAVITCH and COX, Circuit Judges.

KRAVITCH, Circuit Judge:

The State of Florida and several Florida officials (collectively the “Defendants”) appeal the district court’s order certifying a plaintiff class of developmentally disabled persons who have been denied services for which they are eligible under Florida’s Home and Community Based Waiver Program. Defendants contend: (1) that every named plaintiff either lacked standing or possessed moot claims at the time of certification; (2) that the named plaintiffs lack commonality and typicality of claims; (3) that the class definition is overly broad; and (4) that the plaintiffs’ class is subsumed in the certified class of another lawsuit. After careful consideration, we vacate the class certification order and remand for further proceedings not inconsistent with this opinion.

I. BACKGROUND

Plaintiffs are developmentally disabled individuals participating in the Medicaid program under Florida’s Home and Community Based Waiver Program (“Waiver Program”).1 On May 12, 1998, Plaintiffs filed a class action lawsuit in

1 Medicaid is a federal-state program “through which the federal government furnishes financial assistance to the states so that the states may provide necessary medical, rehabilitation, and other services to low-income persons.” Prado-Steiman v. Bush, 221 F.3d 1266, 1268 (11th Cir. 2000); see Medicaid Act, Title XIX of the Social Security Act, 42 U.S.C. § 1396, et seq. Because Florida participates in the Medicaid program, it is obligated to provide Medicaid services to all of Florida’s Medicaid-eligible and developmentally disabled persons either in an Intermediate Care Facility for the Developmentally Disabled (“ICF/DD”) or through the Waiver Program. See 42 U.S.C. § 1396n. Under the Waiver Program, the Secretary of Health and

federal court, challenging the manner in which Defendants administer the Waiver Program. Plaintiffs allege violations of Title XIX of the Social Security Act, § 1396n (c)(2)(A); the Fourteenth Amendment to the United States Constitution; and the Americans with Disabilities Act (“ADA”), 42 U.S.C. § 12101, et seq. Specifically, Plaintiffs contend that, contrary to federal law, Defendants routinely deny needed Home and Community Based Waiver (“HCBW”) services to Medicaid-eligible, developmentally disabled individuals based on funding concerns rather than medical necessity concerns.2 According to the plaintiffs, Defendants have implemented a policy which “caps” the amount that Florida will spend on services for a particular individual regardless of changes in that individual’s condition or needs. Plaintiffs assert that the “cap” used by Defendants equals the cost of an individual’s HCBW services as of the day he or she entered the Waiver Program. Consequently, participants of the Waiver Program allegedly are forced to select between certain needed HCBW services despite their admitted eligibility for all such services. Plaintiffs seek

Human Services (“Secretary”) may “grant a waiver to a state under which approved costs of home- and community–based services are reimbursed for eligible individuals who otherwise would require care in an ICF/DD facility, but who instead elect to remain in their homes.” Prado-Steiman, 221 F.3d at 1268; see § 42 U.S.C. 1396n(c)). Florida has chosen to participate in the Waiver Program.

2 Federal law allows Medicaid plans to apply a “medical necessity” test to all applicants.

See Prado-Steiman, 221 F.3d at 1268; see also 42 CFR § 440.230(d).

declaratory and injunctive relief which would require Defendants to provide all necessary HCBW services for participants of the Waiver Program whom Defendants already have deemed eligible to receive such services. Plaintiffs also seek compensatory damages under the ADA.

On May 13, 1998, the day after Plaintiffs filed this class action, another group of developmentally disabled individuals filed a class action in which they also challenged Florida’s administration of the Waiver Program. See Prado- Steiman v. Bush, No. 98-06496 (S.D. Fla. Mar. 30, 1999), vacated by Prado- Steiman v. Bush, 221 F.3d 1266 (11th Cir. 2000). The district court certified the Prado-Steiman class in March 1999, but this court vacated the certification order and remanded for further proceedings. See Prado-Steiman, 221 F.3d at 1283.

On February 22, 2000, the district court in the instant case certified the following class under Fed. R. Civ. P. 23(b)(2):

All developmentally disabled individuals participating in the Home and Community-Based Waiver who are not receiving needed services under the Waiver for which they are qualified and eligible.

Defendants sought an interlocutory appeal of the class certification decision under Rule 23(f) and we granted permission to appeal.

II. DISCUSSION

A.

We review orders granting class certification for abuse of discretion. Prado-

Steiman, 221 F.3d at 1278. In order to obtain class certification, plaintiffs first must satisfy the prerequisites of numerosity, commonality, typicality, and adequacy of representation specified in Rule 23(a).3 General Tele. Co. of the Southwest v. Falcon, 457 U.S. 147, 156 (1982). Here, the district court found that the named plaintiffs met all four prerequisites. Defendants disagree, arguing that the class lacks commonality and typicality of claims because none of the named plaintiffs demonstrated that they have Article III standing and that they possessed claims that were not moot at the time of certification.

Prado-Steiman v. Bush involved a similar challenge to the district court’s class certification order. In that case, the defendants argued that the class did not satisfy the commonality and typicality requirements because plaintiffs made no showing that at least one of the named plaintiffs possessed individual standing to raise each class claim. 221 F.3d at 1277. Addressing the defendants’ objection,

3 In addition, plaintiffs have to demonstrate that one of the three conditions of Rule 23(b), subsections (1), (2), or (3) apply: “that either (1) prosecution by separate actions would create a risk of inconsistent results; (2) the defendant has acted in ways generally applicable to the class, making declaratory or injunctive relief appropriate; or (3) common questions of law or fact predominate over individual issues.” Moore v. American Fed’n of Television and Radio Artists, 216 F.3d 1236, 1241 (11th Cir. 2000). The district court found that the plaintiffs’ action met the threshold requirements of Rule 23(b)(2) because Plaintiffs alleged that Defendants refused to provide services to Medicaid eligible individuals on grounds generally applicable to the class.

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