Mikel v. Reser, 76-881C(3).

• Decision Date: 30 November 1977
• Docket Number: No. 76-881C(3).,76-881C(3).
• Citation: 440 F. Supp. 1226
• Parties: Waldine MIKEL, Individually and as next friend of Bret Mikel, Julie Mikel, Jeffrey Mikel, Alesia Mikel and Tamara Mikel, Elizabeth Smith, Individually and as next friend for Lee Smith, Velam Malone, Individually and as next friend of Barbara Malone, De Andre Smith, William Muich, and all others similarly situated, Plaintiffs, v. Phyllis RESER, Individually and as Director of Missouri Division of Family Services, Paul Nelson, Individually and as Director of St. Louis City Offices of Missouri Division of Family Services, Virginia Allen, Individually and as Director of the St. Louis County Office of Missouri Division of Family Services, Defendants.
• Court: U.S. District Court — Eastern District of Missouri

440 F. Supp. 1226

Waldine MIKEL, Individually and as next friend of Bret Mikel, Julie Mikel, Jeffrey Mikel, Alesia Mikel and Tamara Mikel, Elizabeth Smith, Individually and as next friend for Lee Smith, Velam Malone, Individually and as next friend of Barbara Malone, De Andre Smith, William Muich, and all others similarly situated, Plaintiffs, v. Phyllis RESER, Individually and as Director of Missouri Division of Family Services, Paul Nelson, Individually and as Director of St. Louis City Offices of Missouri Division of Family Services, Virginia Allen, Individually and as Director of the St. Louis County Office of Missouri Division of Family Services, Defendants.

No. 76-881C(3).

United States District Court, E. D. Missouri, E. D.

November 30, 1977.

Stuart R. Berkowitz, Shirley E. Allen, The Legal Aid Society, St. Louis, Mo., for plaintiffs.

Tom Fulkerson and Robert R. Northcutt, Legal Section, Div. of Family Services, Jefferson City, Mo., for defendants.

MEMORANDUM

NANGLE, District Judge.

Plaintiffs brought this suit pursuant to 28 U.S.C. §§ 1343 and 1331 seeking injunctive and declaratory relief. Plaintiffs, applicants for Aid to Families with Dependent Children and Medicaid or Medical Assistance benefits, contend that defendants have failed to comply with the requirements that claimants receive prompt, definitive and final administrative action within 90 days of the request for a hearing. On May 12, 1977, this Court certified a class herein pursuant to Rule 23(b)(2), Federal Rules of Civil Procedure. The class consists of all applicants for AFDC and Medicaid benefits who have applied or will apply for AFDC and/or Medicaid benefits who have been denied or will be denied these benefits, who have requested or will request hearings, and who have not received or will not receive prompt definitive and final administrative action within 90 days from the date of the request for the hearing.

This cause was tried to the Court without a jury. The case was presented by means of a stipulation of facts. Based upon the record herein, the Court makes the following findings of fact and conclusions of law:

FINDINGS OF FACT

1. Plaintiffs are citizens of the United States and residents of the state of Missouri. Defendant Ewing B. Gourley is Director of the Division of Family Services of the Department of Social Services for the state of Missouri and is responsible for the general administration of all public assistance activities for the state of Missouri. Defendant Paul Nelson is the Director of the St. Louis City Offices of the Missouri Division of Family Services, having responsibility for the administration of the AFDC and Medicaid programs in St. Louis City. Defendant Virginia Allen is the Director of the St. Louis County Office of the Missouri Division of Family Services.

2. The state of Missouri participates in a jointly funded federal-state AFDC program. 42 U.S.C. § 601 et seq.; § 208.040, R.S.Mo. (1973). The AFDC program provides funds to the state for the provision of financial assistance to families in which children have, for various reasons, been deprived of the support of a parent or parents. The state of Missouri also participates in a jointly funded federal-state Medical Assistance program. 42 U.S.C. § 1396a et seq.; § 208.151, R.S.Mo. (1973). The Medical Assistance program provides reimbursement for medical services rendered to needy individuals who are not receiving public assistance or to persons who are needy and disabled, aged or blind.

3. The Missouri Division of Family Services, pursuant to federal and state laws and regulations, operates an administrative appeal process for claimants who disagree with state agency decisions regarding their AFDC and Medicaid cases. The appeals process is commenced by an oral or written request for a fair hearing by the claimant or his or her representative. A hearing is then scheduled and held before an impartial hearing officer or referee who makes a recommendation to the Director of the Division of Family Services who then makes a decision. The decision is put in written form, signed, dated and forwarded to the county office, the claimant and his or her representative.

4. On December 29, 1975, plaintiff Waldine Mikel made an application for AFDC and Medicaid benefits, at an office of the Missouri Division of Family Services in St. Louis County, for herself and her six children. On March 15, 1976, the application was denied. On March 24, 1976, a hearing was requested and on April 13, 1976 a hearing was held. The hearing was left open for further medical information and a reevaluation of the father's disability. A determination was made on August 10, 1976, presumably by the hearing officer, that the father was unemployable. On November 15, 1976, defendant Gourley issued a decision in which he stated that "the action of the County to reject the Aid to Dependent Children application due to the employability of the father in the home is reversed". Accordingly, defendant Gourley ordered the County

. . . to take a reapplication retroactive to the date of the original application and if the claimant is eligible on all other points of eligibility retroactive benefits will be granted per Manual instructions.

A new application was taken on February 14, 1977, together with an application for Aid to Dependent Children-Unemployed Fathers by Robert Mikel. Mr. Mikel's application for AFDC-UF was approved. Plaintiff's application was rejected because the same household may not receive both AFDC and AFDC-UF. Mr. Mikel has received retroactive benefits back to the date of plaintiff's original application dated December 29, 1975 in the amount of $1,918.00 by check dated March 4, 1977. The Mikel family will continue to receive AFDC-UF and Medicaid benefits until found ineligible and so notified pursuant to 45 C.F.R. § 205.10 et seq.

5. Plaintiff Elizabeth Smith applied for AFDC and Medicaid benefits on January 15, 1976 for herself and her two children. On January 29, 1976, these benefits were denied by the Missouri Division of Family Services in St. Louis County. On March 5, 1976, a hearing was requested and on April 2, 1976 a hearing was held. On February 27, 1976, plaintiff Smith again made an application for AFDC and Medicaid benefits. This was denied on April 27, 1976 on the same basis that her January 15, 1976 application had been denied. On July 9, 1976, defendant Gourley issued a decision reversing the rejection of the application and further stating "if the Claimant is eligible on all other points of eligibility, and using the consolidated standard, the Claimant will be approved for Aid to Dependent Children benefits retroactive to the date of application". On September 1, 1976, plaintiff again reapplied for AFDC and Medicaid benefits. This application was rejected on September 28, 1976 for "failure to cooperate" in providing her new address. On October 4, 1976, plaintiff Smith reapplied for AFDC and Medicaid benefits and was approved for retroactive benefits on October 12, 1976. Plaintiff Smith was approved for benefits of $100.00 per month on October 12, 1976 and is presently receiving benefits.

6. Plaintiff Malone made application for AFDC and Medicaid benefits for herself and her two minor children on November 25, 1975 at the Missouri Division of Family Services Office located at 4236 Lindell Boulevard in the City of St. Louis. On January 21, 1976, she was sent a letter informing her that she was ineligible for the benefits due to excessive income. In late January, 1976, plaintiff Malone requested a fair hearing which was held on March 1, 1976. On April 29, 1976, defendant Gourley issued his opinion reversing the agency decision and instructing the agency "to take an Aid to Dependent Children application, back date, and approve same if otherwise eligible". On May 4, 1976, plaintiff Malone made an application for benefits and this application was denied on May 18, 1976 on the same grounds for the denial of the November 25, 1975 application. On June 4, 1976, plaintiff made another application for benefits; this application was withdrawn on June 23, 1976. On August 4, 1976, plaintiff reapplied for benefits and this application was approved on August 24, 1976. Plaintiff Malone received a retroactive benefit of $945.00 in September 1976 for the months of November, 1975 through May, 1976. Plaintiff Malone is currently...