Source: https://law.justia.com/cases/federal/appellate-courts/F3/221/1266/526272/
Timestamp: 2019-05-21 22:30:51
Document Index: 598135776

Matched Legal Cases: ['§ 1396', '§ 1396', '§ 431', '§ 1396', '§ 1983', '§ 1396', '§ 1983', '§ 1396', '§ 1983', '§ 1396', '§ 1983', '§ 1764', '§ 3', '§ 483', '§ 483', '§ 1396', '§ 1396', '§ 1396', '§ 435', '§ 435', '§ 435', '§ 435']

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, v. 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, 221 F.3d 1266 (11th Cir. 2000) :: Justia
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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, v. 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, 221 F.3d 1266 (11th Cir. 2000)
U.S. Court of Appeals for the Eleventh Circuit - 221 F.3d 1266 (11th Cir. 2000)
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.
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 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.
In March 1999, the district court granted the class certification motion. It identified as class representatives all seven of the plaintiffs named in the first amended complaint, but declined to identify as class representatives the twelve new plaintiffs added in the second amended complaint until Defendants could complete discovery.6 The court defined the class as follows: [A]ll persons with developmental disabilities who are presently receiving Home and Community-Based Waiver Services or who are eligible to receive Home and Community- Based Waiver Services, or who would receive or be eligible for Home and Community- Based Waiver Services in the future.
f. whether Defendants have violated 42 U.S.C. § 1396n and 42 U.S.C. § 1983, by funding institutional placements using Home and Community-Based Waiver Services;g. whether Defendants have violated 42 U.S.C. § 1396n(c) (2) and 42 U.S.C. § 1983, by denying Plaintiffs their freedom of choice of an appropriate Home and Community-Based Waiver program that meets their health and welfare needs;
h. whether Defendants have violated Medicaid's state-wideness requirement, 42 U.S.C. § 1396a(a) (1), and 42 U.S.C. § 1983, by failing to provide Home and Community-Based Waiver services throughout the State of Florida;
i. whether Defendants have violated Medicaid's EPSDT requirements, violated 42 U.S.C. § 1396(a) (43) (C) and 42 U.S.C. § 1983, by failing to provide needed EPSDT services directly and to ensure that there are providers who are qualified and willing to provide EPSDT services for children with developmental disabilities;
Applying the prerequisites for class certification required by Federal Rule of Civil Procedure 23(a), the district court concluded: first, that there were over 20,000 estimated class members, satisfying Rule 23(a) (1) numerosity's requirement; second, that there was sufficient commonality between the questions of law and fact posed by the class suit despite the class members' varying medical conditions, satisfying Rule 23(a) (2)'s commonality requirement; third, that there was a sufficient nexus between these common questions of law and fact and the named representatives' claims, satisfying Rule 23(a) (3)'s typicality requirement; and finally, that the named representatives satisfied Rule 23(a) (4)'s adequacy of representation requirement. The district court also concluded that class status was warranted under Rule 23(b) (2) because the class requested injunctive relief and Defendants had generally refused to act on grounds applicable to the class.
Fed. R. Civ. P. 23(f). This case is the first published opinion in this circuit, and one of the first in the nation, to address the standards to be used when evaluating a Rule 23(f) petition. Thus far, only the First and Seventh Circuits have explored this question in detail. See Waste Management Holdings, Inc. v. Mowbray, 208 F.3d 288 (1st Cir. 2000); Blair v. Equifax Check Services, Inc., 181 F.3d 832 (7th Cir. 1999). We therefore begin our discussion with background on Rule 23(f), and then set forth some guideposts for evaluating when we should permit a Rule 23(f) appeal.
A good starting point is the Committee Note accompanying Rule 23(f), which articulates the drafters' view of how courts should resolve petitions for appeal under this new rule. The Note emphasizes that "the court of appeals is given unfettered discretion whether to permit the appeal, akin to the discretion exercised by the Supreme Court in acting on a petition for certiorari.... Permission to appeal may be granted or denied on the basis of any consideration that the court of appeals finds persuasive." Id. The Note then observes that " [p]ermission [to appeal] is most likely to be granted when the certification decision turns on a novel or unsettled question of law, or when, as a practical matter, the decision on certification is likely dispositive of the litigation." Id. According to the Note:
As summarized by the First Circuit, Rule 23(f) serves two key purposes: first, to provide a "mechanism through which appellate courts, in the interests of fairness, can restore equilibrium when a doubtful class certification ruling would virtually compel a party to abandon a potentially meritorious claim or defense before trial"; and second, to "furnish [ ] an avenue, if the need is sufficiently acute, whereby the court of appeals can take earlier-than-usual cognizance of important, unsettled legal questions, thus contributing to both the orderly progress of complex litigation and the orderly development of the law." Mowbray, 208 F.3d at 293.
Recently, the First Circuit adopted Blair 's Rule 23(f) taxonomy as "structurally sound" with one notable caveat. Mowbray, 208 F.3d at 294. The Mowbray court worried, we think rightly, that the third Blair category might "encourage too many disappointed litigants to file fruitless Rule 23(f) applications" since "a creative lawyer almost always will be able to argue that deciding her case would clarify some 'fundamental' issue." Id. The First Circuit then emphasized that "interlocutory appeals should be the exception, not the rule" because "many (if not most) class certification decisions turn on 'familiar and almost routine issues.' " Id. (citing Comm. Note, Fed. R. Civ. P. 23(f)). As a result, the Mowbray court concluded that "Blair 's third category should be restricted to those instances in which an appeal will permit the resolution of an unsettled legal issue that is important to the particular litigation as well as important in itself and likely to escape effective review if left hanging until the end of the case." Id.
There are also powerful case management concerns that caution against routinely granting appellate review in these circumstances. Class certification orders also are not final judgments impervious to lower court review and revision. On the contrary, Rule 23(c) (1) specifically empowers district courts to alter or amend class certification orders at any time prior to a decision on the merits. That power is critical, because the scope and contour of a class may change radically as discovery progresses and more information is gathered about the nature of the putative class members' claims.8 Indeed, Rule 23 contemplates that the class certification decision will be made prior to the close of discovery. Fed. R. Civ. P. 23(c) (1) (class status should be resolved " [a]s soon as practicable after the commencement of" the action); see also Armstrong v. Martin Marietta Corp., 138 F.3d 1374, 1389 (11th Cir. 1998) (en banc) (citing data showing that most class certification decisions are made in the early stages of the litigation). Rule 23(f) should not be a vehicle for courts of appeals to micro-manage complex class action litigation as it unfolds in the district court.
Moreover, interlocutory appellate review of a class certification decision may short-circuit the district court's ability-or at least willingness-to exercise its power to reconsider its certification decision. If a decision on class certification has been fully reviewed and affirmed on an interlocutory basis, both the parties and the district judge may feel constrained from revisiting the issue and thereby potentially triggering a new round of appellate proceedings with the inevitable delay and effort of such proceedings. This possibility is troubling, because class certification determinations are so fluid and fact-sensitive that district courts should be encouraged rather than discouraged from reassessing whether the prerequisites of Rule 23 exist and whether a class action is the most efficacious way to resolve the dispute. Quite simply, " [w]e should err, if at all, on the side of allowing the district court an opportunity to fine-tune its class certification order rather than opening the door too widely to interlocutory appellate review." Mowbray, 208 F.3d at 294 (citing Fed. R. Civ. P. 23(c) (1)) (internal citation omitted).
Second, a court should consider whether the petitioner has shown a substantial weakness in the class certification decision, such that the decision likely constitutes an abuse of discretion. Ordinarily, the appropriateness of allowing a Rule 23(f) appeal should turn on more than the outcome of a preliminary debate about the merits of the district court's ruling. Interlocutory review may be appropriate when it promises to spare the parties and the district court the expense and burden of litigating the matter to final judgment only to have it inevitably reversed by this Court on an appeal after final judgment. Such a situation may exist, for example, when the district court expressly applies the incorrect Rule 23 standard or overlooks directly controlling precedent. Cf. Rutstein v. Avis Rent-A-Car Sys., Inc., 211 F.3d 1228, 1234-35 (11th Cir. 2000) (granting Rule 23(f) petition and reversing order granting class certification where in light of a prior Eleventh Circuit opinion "we do not see how plaintiffs can maintain a class action under Rule 23(b) (3) in the instant case"). In that situation, interlocutory review may be warranted even if none of the other factors supports granting the Rule 23(f) petition.9 Typically, however, class certification decisions require the application of broad and flexible legal standards to unique and complex sets of facts that do not fit squarely within prior precedent. Due to the highly fact-sensitive nature of this inquiry, district courts are given wide latitude to decide whether and how to certify a class, and appellate scrutiny of such decisions is limited at any stage. Accordingly, merely demonstrating that the district court's ruling is questionable generally will be insufficient to support a Rule 23(f) petition in the absence of other factors supporting immediate review. See Armstrong, 138 F.3d at 1386 ("class certification decisions are left to the sound discretion of the district court, and in most cases the certification order can be effectively reviewed on appeal after final judgment") (internal citation omitted).10
Third, a court should consider whether the appeal will permit the resolution of an unsettled legal issue that is "important to the particular litigation as well as important in itself." Mowbray, 208 F.3d at 294. Such an issue might be one that is of moment yet is "likely to escape effective review if left hanging until the end of the case." Id. Alternatively, the issue might be one as to which an appellate ruling sooner rather than later will substantially assist the bench and bar, as may be the case when an issue is arising simultaneously in related actions involving the same or similarly-situated parties or is one that seems likely to arise repeatedly in the future. The fact that the lawsuit involves a governmental entity, or has a strong public interest component, may also lend the issue particular importance and urgency. Moreover, interlocutory review under Rule 23(f) seems more appropriate if the unsettled issue relates specifically to the requirements of Rule 23 or the mechanics of certifying a class, given that one of the primary justifications for Rule 23(f) was a concern over the perceived lack of a substantial body of case law addressing the Rule 23 standards. See Blair, 181 F.3d at 835. We reiterate, however, that a class certification decision which "turns on case-specific matters of fact and district court discretion," Comm. Note, Fed. R. Civ. P. 23-as most certification decisions indisputably do-generally will not be appropriate for interlocutory review.
Fourth, a court should consider the nature and status of the litigation before the district court. Some cases plainly will be in a better pre-trial posture for interlocutory appellate review than others. As noted above, the propriety of granting or denying a class, as well as the proper scope of any class that has been granted, may change significantly as new facts are uncovered through discovery. Similarly, a limited or insufficient record may adversely affect the appellate court's ability to evaluate fully and fairly the class certification decision. Moreover, a district court's ruling on dispositive motions or a motion to add new class representatives, parties, or claims may significantly redefine the issues in the case and thereby affect the scope of or need for a class. Accordingly, the decision on a Rule 23(f) petition may take into account such considerations as the status of discovery, the pendency of relevant motions, and the length of time the matter already has been pending. In certain circumstances the court may also consider the current impact on the parties of rulings by the district court that, while not themselves subject to Rule 23(f) review, nevertheless are inextricably tied to the class certification decision. Cf. Jackson v. Motel 6 Multipurpose, Inc., 130 F.3d 999, 1007-08 (11th Cir. 1997) (reviewing petitions for writ of mandamus that challenged class certification decision as well as district court's order allowing highly prejudicial advertising and mass mailings to putative class members), reh'g denied, 167 F.3d 542 (1998).
We reiterate, however, that interlocutory appeals are inherently "disruptive, time-consuming, and expensive," Mowbray, 208 F.3d at 294, and consequently are generally disfavored. Piecemeal appellate review has a deleterious effect on judicial administration. It increases the workload of the appellate courts, to the detriment of litigants and judges. It requires the appellate courts to consider issues that may be rendered moot if the appealing party ultimately prevails in or settles the case. It undermines the district court's ability to manage the action. And it creates opportunities for abuse by litigants seeking to delay resolution of a case by raising with the appellate court objections to the scope of an order that should have been raised first with the district court itself. Most of these concerns are, if anything, even more compelling in the class action context, especially given the district court's broad authority under Rule 23(c) (1) to monitor and if necessary reconsider its class certification decision as discovery unfolds and the action progresses to trial.
Defendants' objection that Plaintiffs have not as yet demonstrated that a named class representative possesses individual or associational standing to bring each of the class's subclaims is of greater moment. But although we agree that at least one named representative must have standing to bring each class subclaim, see infra Part III, this argument should have been raised squarely with the district court rather than for the first time in a Rule 23(f) petition.13 Outside the Rule 23(f)context, issues of standing are normally not available for review on interlocutory appeal. See Summit Medical Assocs. v. Pryor, 180 F.3d 1326, 1334 (11th Cir. 1999).
Extensive interlocutory review of Defendants' standing objection seems particularly inappropriate given the circumstances of this case. First, the factual record is not fully developed-making resolution of individual standing claims impossible. Second, even if Defendants' argument were completely correct, at worst several new named representatives would have to be added to the class or several of the class subclaims would have to be amended or dropped. Simply put, Defendants' standing argument does not end the case; and given the fluid nature of class certification rulings and the ability of the district court to alter or amend the certified class at any point prior to a ruling on the merits, see Fed. R. Civ. P. 23(c) (1), we believe such standing challenges are best raised initially with the district court rather than as the predicate for an appeal under Rule 23(f).
We review orders granting class certification for abuse of discretion. See Kendrick v. Jefferson County Bd. of Educ., 932 F.2d 910, 914 (11th Cir. 1991) (citing Walker v. Jim Dandy Co., 747 F.2d 1360, 1363 (11th Cir. 1984)). Fed. R. Civ. P. 23(a) requires, as a condition precedent to class certification, that four prerequisites be met. The Rule states:
Id. These four requirements commonly are referred to as the prerequisites of numerosity, commonality, typicality, and adequacy of representation, see General Telephone Co. of Southwest v. Falcon, 457 U.S. 147, 156, 102 S. Ct. 2364, 2370, 72 L. Ed. 2d 740 (1982); Appleyard v. Wallace, 754 F.2d 955, 958 (11th Cir. 1985), and they are designed to effectively limit class claims to those " 'fairly encompassed' " by the named plaintiffs' individual claims, Falcon, 457 U.S. at 156, 102 S. Ct. at 2370 (citation omitted). In this case, Defendants argue that the certified class does not satisfy the commonality and typicality requirements because there are several classwide legal claims for which no named plaintiff possesses Article III standing.
In many ways, the commonality and typicality requirements of Rule 23(a) overlap. Both requirements focus on whether a sufficient nexus exists between the legal claims of the named class representatives and those of individual class members to warrant class certification. See Washington v. Brown & Williamson Tobacco Corp., 959 F.2d 1566, 1569 n. 8 (11th Cir. 1992) (citing Falcon, 457 U.S. at 157 n. 13, 102 S. Ct. at 2370 n. 13); Appleyard, 754 F.2d at 958 (citing De La Fuente v. Stokely-Van Camp, Inc., 713 F.2d 225 (7th Cir. 1983)); see also 7 C. Wright & A. Miller, Federal Practice and Procedure § 1764 (1972). Traditionally, commonality refers to the group characteristics of the class as a whole and typicality refers to the individual characteristics of the named plaintiff in relation to the class. See Baby Neal v. Casey, 43 F.3d 48, 56 (3rd Cir. 1994). These requirements "serve as guideposts for determining whether under the particular circumstances maintenance of a class action is economical and whether the named plaintiff's claim and the class claims are so interrelated that the interests of the class members will be fairly and adequately protected in their absence." Falcon, 457 U.S. at 157 n. 13, 102 S. Ct. 2364.14
As the Supreme Court has explained, " [w]e have repeatedly held that a class representative must be part of the class and possess the same interest and suffer the same injury as the class members." Falcon, 457 U.S. at 156, 102 S. Ct. at 2370 (citing East Texas Motor Freight Sys. v. Rodriguez, 431 U.S. 395, 403, 97 S. Ct. 1891, 1896, 52 L. Ed. 2d 453 (1977)) (internal quotation marks omitted); see also Blum v. Yaretsky, 457 U.S. 991, 999, 102 S. Ct. 2777, 2783, 73 L. Ed. 2d 534 (1982) (explaining that " [i]t is not enough that the conduct of which the plaintiff complains will injure someone. The complaining party must also show that he is within the class of persons who will be concretely affected. Nor does a plaintiff who has been subject to injurious conduct of one kind possess by virtue of that injury the necessary stake in litigating conduct of another kind, although similar, to which he has not been subject."). This rule makes especially good sense when we consider that one of the core purposes of conducting typicality review is to ensure that "the named plaintiffs have incentives that align with those of absent class members so as to assure that the absentees' interests will be fairly represented." Baby Neal, 43 F.3d at 57; see also 1 Newberg & Conte, Newberg on Class Actions, § 3.13 (3d ed.1992).
Thus, it is well-settled that prior to the certification of a class, and technically speaking before undertaking any formal typicality or commonality review, the district court must determine that at least one named class representative has Article III standing to raise each class subclaim. " [A]ny analysis of class certification must begin with the issue of standing." Griffin v. Dugger, 823 F.2d 1476, 1482 (11th Cir. 1987); see also Brown v. Sibley, 650 F.2d 760, 771 (5th Cir. Unit A, July 1981) (stating that the "constitutional threshold [of standing] must be met before any consideration of the typicality of claims or commonality of issues required for procedural reasons by Fed. R. Civ. P. 23"). "Only after the court determines the issues for which the named plaintiffs have standing should it address the question whether the named plaintiffs have representative capacity, as defined by Rule 23(a), to assert the rights of others." Griffin, 823 F.2d at 1482. It is not enough that a named plaintiff can establish a case or controversy between himself and the defendant by virtue of having standing as to one of many claims he wishes to assert. Rather, "each claim must be analyzed separately, and a claim cannot be asserted on behalf of a class unless at least one named plaintiff has suffered the injury that gives rise to that claim." Id. at 1483.
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).
Although the Waiver Act excuses states from satisfying all of the Medicaid Act's requirements, see 42 U.S.C. § 1396n(c) (3), it does not authorize the Secretary to waive any sections of the Medicaid Act governing the health, safety, or welfare of Medicaid recipients. Moreover, the Secretary may not grant a waiver unless a state provides assurances that its waiver plan includes "necessary safeguards" to protect the health and welfare of individuals provided services under the waiver. 42 U.S.C. § 1396n(c) (2) (A).
In Doe v. Chiles, we held that a "federal right to reasonably prompt provision of assistance under section 1396a(a) (8) of the Medicaid Act" exists, and "that this right is enforceable under section 1983." 136 F.3d 709, 719 (11th Cir. 1998). Under section 1396a(a) (8), " [a] State plan for medical assistance must ... provide that all individuals wishing to make application for medical assistance under the plan shall have opportunity to do so, and that such assistance shall be furnished with reasonable promptness to all eligible individuals." 42 U.S.C. § 1396a(a) (8). A corresponding federal regulation requires that the responsible state agency " [f]urnish Medicaid promptly to recipients without any delay caused by the agency's administrative procedures," and " [c]ontinue to furnish Medicaid regularly to all eligible individuals until they are found to be ineligible." 42 C.F.R. § 435.930(a)-(b) (1996).
Federal Medicaid regulations provide that a state "must establish time standards for determining eligibility and inform the applicant of what they are." 42 C.F.R. § 435.911(a) (1996). These periods are not to exceed " [n]inety days for applicants who apply for Medicaid on the basis of disability" or " [f]orty-five days for all other applicants." 42 C.F.R. § 435.911(a) (1)-(2) (1996). In addition, the state "must not use the time standard" as "a waiting period." 42 C.F.R. § 435.911(e) (1) (1996).
The more the alleged error arises out of a mistake of law (as opposed to an improper application of the law to the facts), the more the case may be susceptible to interlocutory review, simply because such an error is more readily reviewable by this Court and does not require us to base our determination on an evolving factual record that may already have become incomplete. See SunAmerica Corp. v. Sun Life Assur. Co., 77 F.3d 1325, 1333 (11th Cir. 1996) (court necessarily abuses its discretion if it "has applied an incorrect legal standard"); see also Pickett v. Iowa Beef Processors, 209 F.3d 1276, 1279 (11th Cir. 2000) (granting Rule 23(f) petition and applying de novo standard to reverse district court's interpretation of the adequacy-of-representation test of Rule 23(a) (4)).
Neither of these requirements requires that "all putative class members share identical claims." Baby Neal, 43 F.3d at 56. Previously, we have explained that these requirements may be satisfied even if some factual differences exist between the claims of the named representatives and the claims of the class at large. See Appleyard, 754 F.2d at 958 (" ' [t]he typicality requirement may be satisfied even if there are factual distinctions between the claims of the named plaintiffs and those of other class members' ") (quoting De La Fuente, 713 F.2d at 232). However, we do require that the named representatives' claims share " 'the same essential characteristics as the claims of the class at large.' " Appleyard, 754 F.2d at 958 (quoting De La Fuente, 713 F.2d at 232) (emphasis added). In making this determination, we have concluded that "a strong similarity of legal theories will satisfy the typicality requirement despite substantial factual differences." Appleyard, 754 F.2d at 958; see also Kornberg v. Carnival Cruise Lines, Inc., 741 F.2d 1332, 1337 (11th Cir. 1984) (stating that "a sufficient nexus is established if the claims or defenses of the class and the class representative arise from the same event or pattern or practice and are based on the same legal theory").