Couch v. Director, Missouri State Div. of Family Services, WD

• Decision Date: 28 August 1990
• Docket Number: No. WD,WD
• Citation: 795 S.W.2d 91
• Parties: Viola COUCH, Appellant, v. DIRECTOR, MISSOURI STATE DIVISION OF FAMILY SERVICES, Respondent. 42768.
• Court: Missouri Court of Appeals

Page 91

795 S.W.2d 91

Viola COUCH, Appellant, v. DIRECTOR, MISSOURI STATE DIVISION OF FAMILY SERVICES, Respondent.

No. WD 42768.

Missouri Court of Appeals,

Western District.

Aug. 28, 1990.

Richard N. Brown, Brookfield, for appellant.

Chantay C. Moore, Jefferson City, for respondent.

Before LOWENSTEIN, P.J., and CLARK and FENNER, JJ.

FENNER, Judge.

Appellant, Viola Couch, appeals the decision of the trial court which affirmed the decision and order of the Director of the Division of Family Services (Director) terminating her Medical Assistance Benefits.

At the time of the Director's decision, Viola Couch was an 81 year old widow. Pursuant to a Declaration of Trust, made March 28, 1987, Ms. Couch deposited $5,000 in a trust. The terms of the trust are as follows:

Comes now Viola M. Couch and establishes and declares in behalf of herself an irrevocable burial trust in satisfaction of the requirements of the Missouri Department of Social Services, Division of Family Services, for qualification of herself for title 19 support, the application for which will be processed in her behalf in due course, by conveying by check of the undersigned the sum of Five Thousand ($5,000.00) to Martha Stark, her daughter, as Trustee for the uses and purposes hereafter set forth.

The trustee shall invest the principal and earnings of this trust in maximum rate of interest bank certificates of deposit available, with all interest to be added to the principal, for the initial deposit and for any and all additions that may hereafter be made to this trust.

Upon the death [sic] the undersigned, the principal and accumulated interest of this trust shall be devoted exclusively to the funeral and burial costs of the undersigned.

Dated this 28th day of March, 1987.

/s/ Viola Couch

Viola M. Couch

On January 25, 1988, Ms. Couch applied to the Department of Social Services for Medical Assistance Benefits pursuant to Title XIX of the federal Social Security Act. At that time Ms. Couch was found eligible for Medical Assistance. On July 18, 1988, Ms. Couch reapplied for Medical Assistance and listed the $5,000 trust as one of her resources.

The Chariton County Division of Family Services (DFS), submitted to its Policy Division a Request for Interpretation of Policy or IM-14, requesting a decision as to whether the trust could be considered an available resource for purposes of determining eligibility for Medical Assistance Benefits. In making decisions regarding available resources, the Policy Division caseworkers utilize what is referred to as an Income Maintenance Manual (IMM). The Policy Division determined the trust to be an available resource to Ms. Couch and terminated her Medical Assistance.

Ms. Couch appealed that decision to the Director of Family Services. A hearing was conducted on January 12, 1989, following which the Director also found the trust to be an available resource.

Ms. Couch appealed the decision of the Director to the circuit court which affirmed the Director's decision, finding it to be supported by competent and substantial evidence.

In the present appeal, Ms. Couch presents three points. In point one, she alleges that the trial court erred in affirming the decision of the Director because said decision was based upon manuals or IMM's which are not valid rules.

Initially, it is noted, that on appeal from an administrative proceeding, it is the agency's decision that this court reviews and the inquiry is whether the decision is supported by competent and substantial evidence upon the whole record. Williams v. Missouri Dept. of Social Services, 718 S.W.2d 193, 194 (Mo.App.1986).

This court is aware, as argued by Ms. Couch, and agreed to by DFS, that the IMM does not constitute a compilation of valid rules and has no legal controlling force. Danner v. Division of Family Services, 772 S.W.2d 868, 871 (Mo.App.1989). The IMM is a publication distributed to caseworkers and to claimants for guidance in presenting and processing claims. Apparently, the IMM reflects the policies utilized by the DFS in making determinations regarding eligibility for various types of benefits, including medical assistance.

Missouri participates in the Medicaid program which has as its purpose the provision of medical assistance to needy persons whose income and resources are insufficient to meet the expenses of health care. 42 U.S.C., § 1396. Pursuant to 42 U.S.C., § 1396a, a state may design a plan to meet its needs and conditions so long as the state operates within the framework set forth by the federal government and does not run afoul of the federal policy. Mo. State Div. of Family Services v. Barclay, 705 S.W.2d 518, 521 (Mo.App.1985). To the extent that the IMM does not attempt to set forth rules and regulations, but merely states the policies and provides guidelines for DFS in making its decisions, it is not to be considered void in total as argued by Ms. Couch. There is no authority otherwise. Point I is denied.

In point two, Ms. Couch argues that the decision of the Director was in error, in that it determined the trust funds to be available to her.

The federal statute which pertains to the present appeal is 1396a(a)(17)(B) which, in pertinent part, reads as follows:

A State plan for medical assistance must--(17) ... include reasonable standards ... for determining eligibility for and the extent of medical assistance under the plan which ... (B) provide for taking into account only such income and resources as are, as determined in accordance with standards prescribed by the Secretary, available to the applicant or recipient ...

With regard to the term "available...