Wolf Prado-Steiman v. Jeb Bush

221 F.3d 1266
CourtCourt of Appeals for the Eleventh Circuit
DecidedAugust 11, 2000
Docket99-11034
StatusPublished
Cited by1 cases

This text of 221 F.3d 1266 (Wolf Prado-Steiman v. Jeb Bush) 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
Wolf Prado-Steiman v. Jeb Bush, 221 F.3d 1266 (11th Cir. 2000).

Opinion

[PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT FILED ________________________ U.S. COURT OF APPEALS ELEVENTH CIRCUIT AUGUST 11, 2000 No. 99-11034 THOMAS K. KAHN ________________________ CLERK

D. C. Docket No. 98-06496-CV-WDF

WOLF PRADO-STEIMAN, by and through his mother and next friend Laura Prado, M.C., by and through his mother and next friend, et al., Plaintiffs-Appellees, versus

JEB BUSH, in his official capacity as Governor and Chief Executive of the State of Florida, KATHLEEN KEARNEY, in her official capacity as Secretary, Department of Children and Families, et al., Defendants-Appellants.

________________________

Appeal from the United States District Court for the Southern District of Florida _________________________ (August 11, 2000)

Before EDMONDSON and MARCUS, Circuit Judges, and STROM*, District Judge. MARCUS, Circuit Judge:

* Honorable Lyle E. Strom, U.S. District Judge for the District of Nebraska, sitting by designation. This is an interlocutory appeal from a class certification order. It also marks

our first opportunity to explicate the circumstances in which a court of appeals

should exercise its discretion to accept such an appeal under Federal Rule of Civil

Procedure 23(f).

Defendants, Governor Jeb Bush and other named state officials, appeal the

district court’s order certifying a broad class of developmentally-disabled persons

eligible for Florida’s Home and Community Based Waiver Program, which

provides Medicaid-related services in home- and community-based settings to

individuals who meet certain level-of-care requirements. All parties agree that

some kind of class or classes should be certified, but Defendants contend that the

single class certified by the district court was too broad. Defendants specifically

assert that Plaintiffs have not demonstrated that the claims of the named class

representatives possess the requisite typicality with the claims of the class at large

as required by Fed. R. Civ. P. 23(a). We agree and vacate the class certification

order. On remand, the district court must ensure that at least one of the named

class representatives possesses the requisite individual or associational standing to

bring each of the class’s legal claims.

2 I.

A.

The named plaintiffs are individuals with developmental disabilities who

meet the level-of-care requirements of an intermediate care facility for individuals

with developmental disabilities (“ICF/DD”) under the Medicaid Act, Title XIX of

the Social Security Act, 42 U.S.C. § 1396, et seq.1 Medicaid is a cooperative

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. At present, the federal

government pays for about 55% of the cost of Medicaid services in Florida. State

participation in Medicaid is voluntary, but participating states must comply with

1 Under the ICF/DD program:

Each client must receive a continuous active treatment program, which includes aggressive, consistent implementation of a program of specialized and generic training, treatment, health services and related services . . ., that is directed toward –

(i) The acquisition of the behaviors necessary for the client to function with as much self determination and independence as possible; and

(ii) The prevention or deceleration of regression or loss of current optimal functional status.

42 C.F.R. § 483.440(a)(1)(i)-(ii) (1996). The ICF/DD program is restricted to individuals with sufficiently severe mental retardation and related conditions. It is not designed for “generally independent clients who are able to function with little supervision or in the absence of a continuous active treatment program.” 42 C.F.R. § 483.440(a)(2) (1996).

3 certain requirements imposed by the Act as well as regulations promulgated by the

Secretary of Health and Human Services (“Secretary”). Those provisions allow

state Medicaid plans to apply a “medical necessity” test to all applicants to ensure

that applicants receive medical services in order of need. However, state plans are

required to provide “an opportunity for a fair hearing before the State agency to

any individual whose claim for medical assistance under the plan is denied or is not

acted upon with reasonable promptness.” 42 U.S.C. § 1396(a)(3); see also 42

C.F.R. § 431.200, et seq.

Under the Home and Community Based Services Waiver Act, Title XIX of

the Social Security Act, 42 U.S.C. § 1396n(c), Congress has authorized certain

persons with developmental disabilities to receive Medicaid services in a

community setting rather than in an institutional facility. The Act empowers the

Secretary to 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. 42 U.S.C. § 1396n(c). To qualify for a waiver, a state must develop

alternative regulatory schemes aimed at lowering the cost of medical assistance

4 while still maintaining the same level of care.2 Florida has chosen to participate in

the Medicaid Home and Community Based Waiver Program.3

B.

On May 13, 1998, two of the named plaintiffs, Wolf Prado-Steiman and

Marlon Christie, filed a class action lawsuit alleging that various Florida state

officials in their official capacity, including the Governor and the Secretary of the

Department of Children and Families, have acted unlawfully in their governance of

Florida’s Home and Community Based Medicaid Waiver Program. Plaintiffs

allege violations of the American with Disabilities Act, 42 U.S.C. § 12101, et seq.;

Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; Title XIX of the

Social Security Act, 42 U.S.C. §§ 1396a, et seq., 1396n, et seq., and 42 C.F.R. §

431.200; the Due Process Clause; and 42 U.S.C. § 1983. Specifically, Plaintiffs

contend that, contrary to federal law, state officials routinely deny or provide

without reasonable promptness critical “Home and Community Based Waiver”

2 Although the Waiver Act excuses states from satisfying all of the Medicaid Act’s requirements, see 42 U.S.C. § 1396n

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Alhassid v. Bank of America, N.A.
307 F.R.D. 684 (S.D. Florida, 2015)

Cite This Page — Counsel Stack

Bluebook (online)
221 F.3d 1266, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wolf-prado-steiman-v-jeb-bush-ca11-2000.