Appleyard v. Wallace, 84-7050

• Decision Date: 08 March 1985
• Docket Number: No. 84-7050,84-7050
• Citation: 754 F.2d 955
• Parties: , Medicare&Medicaid Gu 34,536 Alma A. APPLEYARD et al., Plaintiffs, Pearl Snyder, as personal representative of Elizabeth J. Beasley, deceased, Virginia Rasch, Jackie Causey, and Ronald Pierce, as personal representative of Elizabeth Grimes, deceased, Plaintiffs-Appellants, v. George C. WALLACE, Governor of the State of Alabama, as "Single State Agency," for Administration of the Alabama Medicaid Program, et al., Defendants-Appellees.
• Court: U.S. Court of Appeals — Eleventh Circuit

Page 955

754 F.2d 955

1 Fed.R.Serv.3d 639, Medicare&Medicaid Gu 34,536

Alma A. APPLEYARD et al., Plaintiffs Pearl Snyder, as personal representative of Elizabeth J Beasley, deceased, Virginia Rasch, Jackie Causey, and Ronald Pierce, as personal representative of Elizabeth Grimes deceased, Plaintiffs-Appellants, v. George C. WALLACE, Governor of the State of Alabama, as "Single State Agency," for Administration of the Alabama Medicaid Program, et al Defendants-Appellees.

No. 84-7050.

United States Court of Appeals, Eleventh Circuit.

March 8, 1985.

Clayton Davis, Carol Wallace, Tuscaloosa, Ala., H. Floyd Sherrod, Florence, Ala., Guy M. Hicks, Supervising Atty., ADDAP, Tuscaloosa, Ala., for plaintiffs-appellants.

Robert H. Harris, Terry K. Childers, Montgomery, Ala., for defendants-appellees.

Appeal from the United States District Court for the Middle District of Alabama.

Before GODBOLD, Chief Judge, ANDERSON, Circuit Judge, and THORNBERRY ^*, Senior Circuit Judge.

THORNBERRY, Senior Circuit Judge:

The plaintiffs brought suit against the Governor of Alabama and the Commissioner of the Alabama Medicaid Agency, alleging that Alabama's Medicaid level of care admission criteria violated the Federal Social Security Act, the Civil Rights Act, and the equal protection and due process clauses of the constitution. While the action was pending in district court Alabama revised the challenged criteria. The district court subsequently denied the plaintiffs' motion for class certification and dismissed the action as moot and barred by the eleventh amendment. The plaintiffs appeal. We vacate the district court's order denying the plaintiffs' motion for class certification and dismissing the action and remand for further proceedings consistent with this opinion.

FACTS

The five named plaintiffs in this action ¹ each had been denied Medicaid nursing home benefits on the grounds that they did not meet the level of care criteria embodied in Rule 560-X-10.13, Alabama Medicaid Agency Administrative Code. Under that rule applicants for nursing home benefits were required to show that they needed medical care and associated services that could be provided only in a nursing home. The rule listed a number of criteria, each describing a particular type of such medical care or service (e.g. "tube feeding per gastrostomy"). To qualify for benefits the applicant was required to meet a specified number of the listed criteria.

The plaintiffs brought this action challenging the level of care criteria on June 24, 1983. In their complaint they alleged that the criteria violated the Social Security Act, the Civil Rights Act, and the constitution. They sought declaratory and injunctive relief and purported to represent a class consisting of "all persons in the State of Alabama who have applied for Medicaid care and treatment in nursing homes who are financially eligible for such Medicaid who have been denied Medicaid under the Alabama level of care admission criteria." The record indicates that there are approximately 1,200 members of the putative class.

While the case was pending in the district court, Alabama revised the challenged level of care criteria and began to provide Medicaid nursing home benefits to all the named plaintiffs. The challenged version of the rule was in effect from April 1982 through September 1983. The plaintiffs do not challenge the validity of the new rule. On September 26, 1983, the district court held a hearing to consider the plaintiffs' motion for class certification and the defendants' motion to dismiss. Subsequently, the district court issued its Order and Opinion, denying the plaintiffs' motion for class certification and dismissing the action.

In denying class certification the district court stated:

A review of the Medicaid admissions procedure, a process which includes opportunities for applicants to present information concerning their individual applications at both a fair hearing and a reconsideration, indicates that Medicaid eligibility decisions are based on a consideration of widely varrying medical backgrounds. The vast factual differences surrounding the medical condition of each of the named Plaintiffs prevent these Plaintiffs from having claims or defenses which would be typical of all members of the putative class.

The court also asserted that the claims of the named plaintiffs "could hardly be typical of those of the members of the purported class" since the plaintiffs were then receiving nursing home benefits.

In dismissing the action the district court held that

[i]n light of the fact that all of the named Plaintiffs are currently receiving the Medicaid benefits which they sought, this Court is of the opinion that the case at bar is now moot and must be dismissed under Article III of the United States Constitution, which confers jurisdiction only over cases and controversies.

The court also noted that any claim for retroactive benefits would be barred by the eleventh amendment under Edelman v. Jordan, 415 U.S. 651, 94 S.Ct. 1347, 39 L.Ed.2d 662 (1974).

On appeal the plaintiffs contend (1) that the district court abused its discretion in refusing to certify the class and (2) that the case is not moot or barred under the eleventh amendment since the plaintiffs have a live claim for notice relief under Quern v. Jordan, 440 U.S. 332, 99 S.Ct. 1139, 59 L.Ed.2d 358 (1979). ²

I. Class Certification

The district court refused to certify the class action, stating that "[t]he vast factual differences surrounding the medical condition of each of the named Plaintiffs prevent these Plaintiffs from having claims or defenses which would be typical of those of all members of the putative class." The plaintiffs contend that the court misapplied the typicality requirement of Rule 23(a)(3) of the Federal Rules of Civil Procedure and, thereby, abused its discretion in refusing to certify the class. We agree.

Rule 23(a) specifies four prerequisites to maintaining a suit as a class action:

One or more members of a class may sue or be sued as representative parties on behalf of all only if (1) the class is so numerous that joinder of all members is impracticable, (2) there are questions of law or fact common to the class, (3) the claims or defenses of the representative parties are typical of the claims or defenses of the class, and (4) the representative parties will fairly and adequately protect the interests of the class.

Although the considerations of subsections a(2), a(3), and a(4) tend to overlap, see De La Fuente v. Stokely-Van Camp, Inc., 713 F.2d 225 (7th Cir.1983); 7 C. Wright & A. Miller, Federal Practice and Procedure Sec. 1764 (1972), "subsection a(3) primarily directs the district court to focus on whether named representatives' claims have the same essential characteristics as the claims of the class at large." 713 F.2d at 232. Moreover, "[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." Id.; see also Penn v. San Juan Hospital, Inc., 528 F.2d 1181, 1189 (10th Cir.1975). Thus, courts have found that a strong similarity of legal theories will satisfy the typicality requirement despite substantial factual differences. See, e.g., De La Fuente, 713 F.2d at 232, Donaldson v. Pillsbury Co., 554 F.2d 825 (8th Cir.), cert. denied, 434 U.S. 856, 98 S.Ct. 177, 54 L.Ed.2d 128 (1977); Penn v. San Juan Hospital, 528 F.2d at 1189; Calkins v. Blum, 511 F.Supp. 1073, 1088 (N.D.N.Y.1981), aff'd, 675 F.2d 44 (2d Cir.1982); Wilder v. Bernstein, 499 F.Supp. 980, 992-993 (S.D.N.Y.1980).

In this case the district court was concerned by the "vast factual differences surrounding the medical condition of each of the named Plaintiffs." These factual distinctions, however, have little or no relevance to the relief requested by the plaintiffs. In their complaint the plaintiffs asked that the court (1) declare the level of care criteria invalid, (2) order reinstatement of the previous criteria pending development of new criteria (the complaint was drafted before Alabama revised the challenged criteria), (3) declare the policies and customs of the defendants invalid, and (4) enjoin the defendants from determining any member of the class to be ineligible for benefits without full compliance with applicable federal law. It does not appear that the factual differences surrounding the medical conditions of the various plaintiffs would preclude the district court from determining whether the plaintiffs are entitled to the relief they seek. The similarity of the legal theories shared by the plaintiffs and the class at large is so strong as to override whatever factual differences might exist and dictate a determination that the named plaintiffs' claims are typical of those of the members of the putative class. ³

The defendants suggest, nevertheless, that the determination of typicality in this case is controlled by our decision in Love v. Turlington, 733 F.2d 1562 (11th Cir.1984). We do not agree. In that case we held that the district court did not abuse its discretion in denying class certification on the grounds that the plaintiffs failed to meet the commonality and typicality requirements of Rule 23(a). The plaintiff challenged the constitutionality of Florida's State Student Assessment Test, a basic skills test administered to all eleventh graders in the state. The test was designed to identify students who had not mastered one or more of the minimum performance standards defined in the applicable state regulations. Although students who failed the test were targeted for remedial assistance, the determination of whether a student failing the test was ultimately eligible for a diploma was made by individual teachers on the basis of the individual student's achievements. Id. at 1564. "Each student's situation differs, and the diploma is denied each student for reasons which are unique to his...