Madsen v. State, Dept. of Health and Welfare

• Decision Date: 05 May 1988
• Docket Number: No. 17037,17037
• Citation: 114 Idaho 182,755 P.2d 479
• Court: Idaho Court of Appeals
• Parties: , Medicare & Medicaid Guide P 37,199 John MADSEN, Plaintiff-Appellant, v. STATE of Idaho, DEPARTMENT OF HEALTH AND WELFARE, Defendant-Respondent.

Page 479

755 P.2d 479

114 Idaho 182, Medicare & Medicaid Guide P 37,199

John MADSEN, Plaintiff-Appellant, v. STATE of Idaho, DEPARTMENT OF HEALTH AND WELFARE, Defendant-Respondent.

No. 17037.

Court of Appeals of Idaho.

May 5, 1988.

Rehearing Denied May 26, 1988.

Petition for Review Denied June 28, 1988.

John Madsen, pro se. Jim Jones, Atty. Gen., Teresa A. Sobotka, Deputy Atty. Gen., Boise, for defendant-respondent.

WALTERS, Chief Judge.

This is an appeal from an order of the district court upholding a decision of the Department of Health and Welfare requiring John Madsen to contribute financially to the cost of care provided by the Department to him in his home. We affirm.

John Madsen was approved for participation in a personal care service offered through the Home and Community Based Services Program of the state Department of Health and Welfare under Title XIX of the federal Social Security Act. 42 U.S.C. § 1396n; I.C. §§ 56-201(o) and 56-209b. Federally regulated, the program is designed to permit the state to offer an array of home and community-based services for aged, blind or disabled persons receiving Medicaid benefits, as an alternative to institutionalization. See 42 C.F.R. ch. IV § 441.300. This program allowed Madsen to receive care in his own home, but required that he contribute toward the cost of his care an amount equivalent to the excess of his available income over the cost of his basic needs. Upon determining that Madsen's income was $617 per month and that the amounts allowed under the applicable regulations for the costs of his basic needs totaled $388 per month, the Medicaid Policy Section of the Department notified Madsen that his contribution would be the difference between the two sums, or $229 per month.

Contending that he was financially unable to contribute the sum of $229 per month toward the cost of his care, Madsen sought a departmental review of the determination made by the Medicaid Policy Section. See I.C. § 56-216. Following a hearing before a Department administrative hearing officer, findings of fact, conclusions of law and a decision were entered upholding the contribution determination. Madsen then petitioned the district court for judicial review of the Department's proceedings.

The district court, conducting the review under I.C. § 67-5215, ¹ upheld the administrative hearing officer's decision. Presented with the record, including a transcript of the hearing officer's proceeding, the court held there was reliable, probative and substantial evidence to support the findings of the officer and that the officer's conclusions were supported by the facts and the law. The court determined that there were no irregularities alleged with respect to the Department's procedure which would require additional proof to be taken. The court found no indication that the administrative findings, inferences, conclusions or decisions were in violation of constitutional or statutory provisions, exceeded the statutory authority of the Department, were made through an unlawful procedure, or were affected by other error of law. The court concluded that the Department's action was in full accord with the mandates of the statutes governing the personal care service program and was not in any way arbitrary or capricious or characterized by an abuse of discretion or a clearly unwarranted exercise of discretion.

On appeal from the district court's affirmance, Madsen makes the following assertions. First, he avers he suffered anguish and pain as a result of a threatening and abusive telephone call received from Jerry Nuxoll (identified during the administrative hearing as a field supervisor with the Department's Boise Office) following the hearing officer's decision. Next, he contends the district court ignored a request by him to hold two representatives or employees of the department in contempt of court because they persuaded Madsen's "personal care attendant" to leave Madsen's employ by informing the attendant that Madsen would lose his case in the district court, prior to the issuance of any decision in the case by the court. Third, he asserts the calculations regarding his living expenses "ignore reality" and "are patently ridiculous." He argues that, if he were required to pay the amount set by the Department, he would be unable to eat or to maintain a home and thus would be deprived of life without due process. Citing I.C. § 67-5215(g)(1) and (6), he submits the hearing officer's decision was "in violation of constitutional or statutory provisions" and was "arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion."

I

We turn first to Madsen's recitation concerning the allegedly abusive and threatening telephone call. We cannot ascertain from Madsen's argument whether he believes any error occurred with respect to that claim in the proceeding below, or whether Madsen simply wished to inform us of the existence of the claim, as background. It appears that Madsen presented the claim to the district court in his initial pleading which also sought judicial review of the Department's administrative proceeding relating to the contribution to his in-home care service. He prayed for an award of a specified sum as damages for mental and physical suffering caused by the telephone call.

Evidently, a duplicate copy of the pleading was made and the clerk of the district court opened two files--one for the damage action based on the alleged telephone call, the other for a judicial review of the Department's administrative action. Separate docket numbers were assigned to the files. The judicial review case was given district court number 90075 and now appears as the appeal in this case, our number 17037. The other file was assigned number 90076 in district court and resulted in appeals to the Supreme Court in cases numbered 16996 and 17121. Consequently, both cases in district court proceeded separate and apart from each other. Because the action for damages remains as the subject of another case, or cases, on appeal, we need make no determination relative to the damage action in this opinion. We limit our concern in this case only to a review of the district court's decision upholding the Department's administrative action.

II

We turn next to Madsen's claim that the district court "ignored" a request by Madsen to hold certain persons (a caseworker and a nurse) in contempt of court for persuading Madsen's personal care attendant to leave Madsen's employ in anticipation that Madsen would "lose" his case in the district court. This request was raised by a motion filed with the district court after the court had entered its decision and order on review of the administrative process.

The record before us does not show the district court acted on Madsen's motion--explaining, perhaps, Madsen's impression that the motion was "ignored." However, the record does disclose that Madsen's motion to hold the nurse and caseworker in contempt of court was filed simultaneously with his notice of appeal from the order of the district court upholding the administrative decision of the Department. The filing of a notice of appeal divests the district court of jurisdiction to proceed further with an action, except in certain particular respects specifically delineated in Idaho's appellate rule 13. Madsen's contempt motion does not appear to fall within any of the subject matters stated in that rule. ² Thus, it is understandable that the district court did not act on Madsen's motion, causing Madsen to misperceive that the court "ignored" the motion by inaction. Because Madsen's notice of appeal deprived the court of authority to proceed on the motion filed by Madsen, we hold no error occurred as a result of the court's inaction.

III

We turn finally to the real crux of this appeal. Madsen contends that the Department's calculations regarding his living expenses ignore reality and are "ridiculous." He argues that requiring him to contribute to his care is arbitrary, capricious, an abuse of discretion, and would deprive him of life without due process. In light of the evidence presented to the administrative hearing officer in this case we find no merit to Madsen's contentions. ³

Mr. Forbes, the alternative care coordinator with the Medical Policy Section of the Department's Bureau of Medical Assistance, testified before the hearing officer. Forbes related that Madsen's medical condition ⁴ qualified him for nursing home care under the Medicaid program. As an alternative to institutional placement, Madsen was approved for participation in the personal care services program. Forbes explained that eligibility in the latter program required the participant to financially contribute to his care. The amount of contribution depended upon the participant's income after deducting amounts allocated to the participant's needs, under the Department's rules. Forbes presented a copy of a letter he had written to Madsen, informing him of his eligibility and the requirement of contribution, as a participant in the personal care services program. The letter disclosed that "Due to federal program requirements, your continued eligibility for Idaho Medicaid and Personal Care Services is dependent on the payment of these monies to the Department." [Emphasis in original.] Madsen admitted receiving the letter.

Jerry Nuxoll, the eligibility supervisor with the Boise Field Office of the Department, also testified. He explained that Madsen's level of income (apparently as well as his medical condition) qualified Madsen for nursing home care. With respect to the personal care service, he stated "If it were not for this program we would not be able to help Mr. Madsen in any way unless he were in a nursing home." Nuxoll explained the process of arriving at the participant's contribution to the cost of medical care each month. He related, "[W]hat you do particularly is set up a...