Barela v. Beye
| Decision Date | 21 March 1996 |
| Docket Number | No. 94CA1500,94CA1500 |
| Citation | 916 P.2d 668 |
| Parties | Horace BARELA and others similarly situated, Plaintiffs-Appellees, v. Karen BEYE, in her official capacity as Executive Director, and the Colorado Department of Social Services, Defendants-Appellants. . I |
| Court | Colorado Court of Appeals |
Larsen and Snow, Catherine N. Snow, Roger B. Larsen, Colorado Springs; Colorado Coalition of Legal Services Programs, D. Karen Erickson, for Plaintiffs-Appellees.
Gale A. Norton, Attorney General, Stephen K. ErkenBrack, Chief Deputy Attorney General, Timothy M. Tymkovich, Solicitor General, Wade Livingston, First Assistant Attorney General, Denver, for Defendants-Appellants.
Opinion by Judge METZGER.
In this action for review of an administrative agency decision and for declaratory and injunctive relief, defendants, Karen Beye, in her official capacity as Executive Director, and the Colorado Department of Social Services (the Department) appeal the summary judgment and preliminary injunction issued in favor of class action plaintiffs, Horace Barela and others similarly situated. Specifically, defendants challenge the trial court's conclusion that the enabling legislation for the Home Care Allowance (HCA) program unlawfully delegated legislative authority to the Department and that the Department had promulgated a rule that both exceeded its statutory authority and was arbitrary and capricious. We reverse and remand for further proceedings.
Plaintiff Horace Barela is a 68-year-old Colorado resident who suffers from blindness, asthma, and hypertension. He has only one kidney. Because of his condition, Barela is incapable of providing for many of his basic needs. Instead, he relies on the services of a non-professional care provider who assists him in his home. Barela compensates this care provider with funds he receives under the HCA program. Without the services of this care provider, Barela would be unable to function independently and would likely require institutionalization.
HCA was designed to provide supplemental assistance to adults who qualify for Old Age Pension, Aid to the Needy Disabled, or Aid to the Blind. Its purpose is to assist such individuals in obtaining unskilled services in their homes, thus allowing them to function outside of an institutional setting.
HCA is a state program and receives no federal funds. Persistent budgetary constraints in recent years have impaired the Department's ability to provide aid to all of the persons who need it.
At its inception, HCA was administered by the Colorado Department of Social Services. Effective July 1994, the Department was restructured and renamed as the Department of Human Services. See §§ 26-1-105 and 26-1-105.5, C.R.S. (1995 Cum.Supp.). At that time, the responsibility for administering HCA was transferred to the newly-created Medical Services Board of the Colorado Department of Health Care Policy and Financing. See § 25.5-1-105(1), C.R.S. (1995 Cum.Supp.).
In 1991, the General Assembly amended the HCA enabling legislation by enacting Colo.Sess.Laws 1991, ch. 17, § 26-1-111(2) at 80-81 (2d Extraordinary Session). That statute has been repealed and reenacted by Colo.Sess.Laws 1993, ch. 230, § 26-2-122.3(1)(b) at 1114-15; amended by Colo.Sess.Laws 1994, ch. 268, § 26-2-122.3(1)(b) at 1562-63; amended by Colo.Sess.Laws 1995, ch. 196, § 26-2-122.3(1)(b); and the present version is codified as § 26-2-122.3(1)(b), C.R.S. (1995 Cum.Supp.).
At the time relevant to this dispute, the statute, § 26-1-111(2), provided in pertinent part:
The state department, under the supervision of the executive director, shall:
....
(o)(I) Promulgate rules and regulations concerning the state home care allowance program. Said program provides payments, subject to available appropriations, to functionally impaired persons who are, or who would be but for their income, eligible to receive old age pension ... aid to the needy disabled ... or aid to the blind.... To be eligible for a home care allowance, a person's monthly gross income shall be less than the applicable monthly grant standard for the old age pension, aid to the needy disabled, or aid to the blind programs, plus the person's authorized monthly home care allowance grant as determined in accordance with rules promulgated pursuant to this paragraph (o). The payments allow recipients who are in need of long-term care to purchase community-based services as defined in section 26-4-507(2)(c). Such services may include, but need not be limited to, the supervision of self-administered medications, assistance with activities of daily living as defined in section 26-4-507(2)(a), and assistance with instrumental activities of daily living as defined in section 26-4-507(2)(g). The rules adopted by the state department shall specify, in accordance with the provisions of this section, the services available under the program and shall address eligibility criteria for the home care allowance program which shall be in addition to the eligibility criteria for the old age pension, aid to the needy disabled, or aid to the blind programs. In addition, the rules shall specifically provide for a determination as to the persons's functional impairment, the person's unmet need for paid care, and shall address amounts awarded to persons eligible for home care allowance. The rules shall require that eligibility be determined through the use of a comprehensive and uniform client assessment instrument as defined in section 26-4-507. The state board may adjust income eligibility criteria, the functional impairment standard, or the amounts awarded to eligible persons or may limit or suspend enrollments as necessary to manage the home care allowance program within the funds appropriated by the general assembly.... (emphasis added)
Pursuant to this statute, the Department promulgated Department of Social Services Rule 7.101.4, 12 Code Colo. Reg. 2509-2 (Rule 7.101.4), which provided in pertinent part:
A. Definition
The Home Care Allowance (HCA) is a special allowance for the purpose of securing services to an individual in his/her home, based on the caseworker's assessment. The Home Care Allowance is a non-entitlement program designed to serve those clients with the lowest functional abilities and the greatest need for paid care. Eligibility for and authorization amounts of the Home Care Allowance are subject to available appropriations.
B. Eligibility
Eligibility for the Home Care Allowance program shall be based on financial need, the client's functional capacity score, the client's need for paid care score and the available appropriations.
....
3. Effective June 7, 1991, in order to be eligible for the Home Care Allowance program each applicant or client must meet the minimum client functional capacity score of 21 points in the following areas and shall score a minimum of one (1) point on the need for paid care assessment in the following areas:
a. Activities of daily living--includes transfers, bladder care, bowel care, mobility, dressing, bathing, hygiene, eating;
b. Basic instrumental activities of daily living--includes meal preparation, housework, laundry, and shopping;
c. Supportive services--includes medicine management, appointment management, money management, accessing resources, and telephoning.
4. The need for paid care score shall be based on the frequency of the client's or applicant's need for paid care as follows:
Frequency of Need Need for Paid
for paid care Care Score
No need for paid care 0
Up to and including once a week 1
More than once a week and up to seven days a week 2
At least two times per day 3
5. Each applicant or client meeting the minimum requirements for the HCA program shall be assigned an authorized amount of Home Care Allowance based on his/her need for paid care score as follows:
Need for Paid Authorized Home Care
Care Score Allowance Amount per Month
1"23 Up to--$108
24"37 Up to--$222
38 and over Up to--$330
In promulgating this rule, the Department chose to assess an individual's "unmet need for paid care" by measuring the frequency with which that individual required services. This means that the amount of benefits an HCA recipient receives is based on the number of times the recipient needs services rather than upon the amount of time required to provide those services.
On May 13, 1992, the Department reevaluated Barela's eligibility for HCA, using the new formula. This reevaluation resulted in the reduction of Barela's monthly benefits from $309 to $202.
Barela challenged the reduction of his HCA benefits and a hearing was convened before an Administrative Law Judge (ALJ) to determine if the Department had erred. The ALJ issued an initial decision affirming the reduction. After Barela objected to this decision, the Department issued a final decision which also affirmed the reduction.
Thereafter, Barela sought judicial review of the Department's decision pursuant to § 24-4-106, C.R.S. (1988 Repl.Vol. 10A).
Based on a stipulation by the parties, the trial court certified the case as a class action under C.R.C.P. 23(a) & (b)(2), with the plaintiff class consisting of:
All persons in the State of Colorado with regard to whom Home Care Allowance has been or will be denied, reduced, or terminated as a result of the February 7, 1992 publication of the "frequency" regulations at 12 [Code Colo.Reg.] 2509-2, § 7.101.4(B)(3) and (4) and the "payment range" regulation at 12 [Code Colo.Reg.] 2509-2, § 7.101.4(B)(5).
On cross-motions for summary judgment, the trial court ruled that § 26-1-111(2)(o)(I) was unconstitutional, insofar as it delegated legislative authority to the Department, and that Rule 7.101.4 exceeded the Department's statutory authorization and was arbitrary and capricious. The trial court then issued a preliminary injunction to prevent the Department from implementing Rule 7.101.4.
Resolving an initial issue, we conclude that we do have subject matter jurisdiction over...
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