Gomprecht v. Gomprecht

• Decision Date: 29 June 1995
• Citation: 86 N.Y.2d 47,652 N.E.2d 936,629 N.Y.S.2d 190
• Parties: , 652 N.E.2d 936, 48 Soc.Sec.Rep.Ser. 556 In the Matter of Marilyn GOMPRECHT, Respondent, v. Gustav GOMPRECHT, Respondent, and Barbara Sabol, as Commissioner of Social Services of the City of New York, Appellant.
• Court: New York Court of Appeals Court of Appeals

Page 190

629 N.Y.S.2d 190

86 N.Y.2d 47, 652 N.E.2d 936, 48

Soc.Sec.Rep.Ser. 556

In the Matter of Marilyn GOMPRECHT, Respondent, v. Gustav GOMPRECHT, Respondent and Barbara Sabol, as Commissioner of Social Services of the City of New York, Appellant.

Court of Appeals of New York.

June 29, 1995.

[86 N.Y.2d 48] Paul A. Crotty, Corp. Counsel of New York City (Trudi Mara Schleifer and Barry P. Schwartz, of counsel), for appellant.

[652 N.E.2d 937] Epstein Becker & Green, P.C., New York City (Peter J. Strauss and Richard J. Anderson, of counsel), for Marilyn Gomprecht, respondent.

[86 N.Y.2d 49] Reynerio E. Muradaz, Brooklyn, for New York City Chapter of the Alzheimer's Disease and Related Disorders Ass'n, Inc., amicus curiae.

OPINION OF THE COURT

SMITH, Judge.

At the time of her petition for support from her husband, brought pursuant to Family Court Act § 412, petitioner's husband was institutionalized and receiving Medicaid. The issue here is whether in an action for spousal support by a community spouse against an institutionalized spouse, the Family Court is free to apply the prior standard of living or life-style standard rather than the minimum monthly needs allowance standard under Social Services Law § 366-c. We conclude that the appropriate standard is the minimum monthly needs allowance and, accordingly, reverse the order of the Appellate Division. 208 A.D.2d 452, 617 N.Y.S.2d 722.

Medicaid is a joint Federal and State program which provides medical assistance to those without sufficient resources to meet the costs of medical care. As we noted in Matter of Schachner v. Perales, 85 N.Y.2d 316, 319-320, 624 N.Y.S.2d 558, 648 N.E.2d 1321, once a person has entered a nursing home, the greater portion of his or her income is applied to his care. Because of this requirement, many spouses still living in the community became impoverished. Congress sought to ameliorate this result by passing the Medicare Catastrophic Coverage Act (MCCA) (42 U.S.C. § 1396r-5, as amended by Pub.L. 100-360, 102 U.S.Stat. 753). It permitted a State to establish a minimum monthly needs allowance for the community spouse, to be provided, if necessary, from the income received by the institutionalized spouse.

Consistent with the requirements of the MCCA, the Social Services Law provides an allowance for the non-institutionalized or community spouse, $1,764 at the time of the Family Court order ¹ (Social Services Law § 366-c[2][g]. This allowance, referred to as the community spouse monthly income allowance, is paid by the institutionalized spouse to the community spouse, but only to the extent the institutionalized spouse possesses sufficient means and the community spouse's own income is below the statutory minimum monthly needs allowance. Therefore, the institutionalized spouse's income available to help pay for his/her medical care is reduced by the amount necessary to bring the community spouse up to the minimum monthly needs allowance level. Additionally, the community spouse is entitled to retain resources totaling $60,000, excluding a home and the land on which it sits, without jeopardizing the institutionalized spouse's eligibility for Medicaid (Social Services Law § 366-c[2][d]; 42 U.S.C. § 1382b). Social Services Law § 366-c was promulgated to implement, at the State level, the Federal MCCA and "to protect the community spouse from financial disaster when the primary income-providing spouse becomes institutionalized" (Matter of Schachner v. Perales, 85 N.Y.2d 316, 323, 624 N.Y.S.2d 558, 648 N.E.2d 1321, supra ).

In October 1992, petitioner Marilyn Gomprecht filed a petition in the Family Court seeking an order of support pursuant to Family Court Act § 412 against her husband, respondent Gustav Gomprecht. Respondent was institutionalized in a nursing home from August 17, 1992 until his death on July 16, 1993. At the time of his institutionalization, respondent's income, consisting of a private pension ($4,143.64) and Social Security ($1,577.67), was $5,721.31 per month. In December 1992, respondent applied for Medicaid benefits to cover the cost of his nursing home care. This initial application for Medicaid was denied due to excess assets.

Respondent had previously transferred nearly all of his assets, totaling well over $1 million, to petitioner. These assets included two residences, an apartment in Manhattan and a house in East Hampton assessed at over $430,000, several bank accounts totaling over $9,000, as well as investments. Respondent filed a request for reconsideration of his application for Medicaid benefits. This second application for benefits was granted in April 1993.

Based on respondent's application to the New York City Human Resources Administration (HRA) for Medicaid benefits to assist in paying for his nursing home care, pursuant to Social Services Law § 363, and petitioner's own monthly income, HRA determined that petitioner, as a community spouse, was entitled to receive monthly support of only $306.71 from her institutionalized spouse. This amount would bring petitioner's total monthly income to the statutorily provided "minimum monthly needs allowance" of Social Services Law § 366-c.

A hearing was held on petitioner's October 1992 petition filed in Family Court, at which a Hearing Examiner awarded support to petitioner in the amount of $3,339.26 against respondent Gustav on the basis of petitioner's standard of living and life-style prior to her husband's institutionalization. This amount included $2,274.86 per month for household expenses, $864.30 per month for personal expenses and $200 per month for an outstanding dental bill. ² The Hearing Examiner's determination was confirmed by the Family Court which indicated that the Family Court is not bound by the statutory medical eligibility levels and has discretion to grant support where it deems appropriate based on the circumstances before it. The Appellate Division affirmed the determination...