Rowland v. Maher
| Decision Date | 29 August 1978 |
| Court | Connecticut Supreme Court |
| Parties | Anna ROWLAND v. Edward W. MAHER, Commissioner of the Department of Social Services of the State of Connecticut. Etta TRAVER v. Edward W. MAHER, Commissioner of the Department of Social Services of the State of Connecticut. Louise V. LUCAS v. Edward W. MAHER, Commissioner of the Department of Social Services of the State of Connecticut. Helen N. SODERBERG v. Edward W. MAHER, Commissioner of the Department of Social Services of the State of Connecticut. Madge TROULAND v. Edward W. MAHER, Commissioner of the Department of Social Services of the State of Connecticut. Anna HARBERG v. Edward W. MAHER, Commissioner of the Department of Social Services of the State of Connecticut. |
Paige J. Everin, Asst. Atty. Gen., with whom, on brief, was Carl R. Ajello, Atty. Gen., for appellant (defendant in each case).
John A. Berman, Hartford, with whom was Shelagh H. O'Neill, Hartford, for appellees (plaintiff in each case).
Before COTTER, C. J., and BOGDANSKI, LONGO, SPEZIALE and PETERS, JJ.
The underlying issue presented on appeal in each of these six companion cases is whether the action of the defendant commissioner, suspending medicaid benefits to the plaintiffs, was illegal in light of controlling federal law.
The relevant facts are the same in all six cases and are undisputed: Each of the six plaintiffs is a resident of the Elim Park Baptist Home, Inc., a nonprofit religious home for the aged in Cheshire. The home requires an entry fee of $2000 and, thereafter, residents are charged a monthly fee for room, board, and medical expenses. The plaintiffs each paid, or had paid by a relative on her behalf, the $2000 entry fee. They all qualified for and received medical assistance under the Title XIX "Medicaid" program (42 U.S.C. § 1396 et seq.) and the medicaid payments were used to meet their monthly medical expenses.
In 1975 and early 1976, medicaid payments to the plaintiffs were suspended by the commissioner of social services. The basis for the suspension was that the $2000 entry fee represented an asset transferred by the plaintiffs without reasonable consideration, and that, pursuant to General Statutes § 17-109(e), 1 the plaintiffs were not entitled to medicaid benefits until this asset was exhausted, after having been applied toward the cost of care at the appropriate rate. The plaintiffs all appealed the suspension of benefits and requested fair hearings. At each of the hearings, the fair hearing officer upheld the suspension. In support of this conclusion, the memorandum of each of the hearing officers referred to General Statutes § 17-109(e), and, in addition, alluded to the existence of a life care contract to which General Statutes § 17-116 would be applicable. 2
The plaintiffs then appealed the decisions of the fair hearing officers to the Court of Common Pleas. While the appeals were pending before that court, the United States District Court for the District of Connecticut released its decision in Buckner v. Maher, 424 F.Supp. 366 (D.Conn.1966), holding that the "transfer-of-assets" rule in § 17-109(e) of the General Statutes violates the supremacy clause by presuming that assets are available to welfare recipients which are in fact not available. On the basis of the Buckner case and of Morgan v. White, 168 Conn. 336, 362 A.2d 505 (1975), the Court of Common Pleas found that the commissioner had acted illegally in suspending medicaid payments to the plaintiffs and ordered that the plaintiffs be awarded medical assistance and that the Elim Park Baptist Home be reimbursed for any medical services advanced since the suspension which would otherwise have been paid for by the state under the medicaid program. It is from the judgments rendered in those six cases that the defendant has appealed to this court.
Subsequent to the filing of this appeal, the United States Supreme Court summarily affirmed the District Court decision in Maher v. Buckner, 434 U.S. 898, 98 S.Ct. 290, 54 L.Ed.2d 184 (1977). The defendant has consequently withdrawn the claim that the reviewing court erred in holding that because Connecticut's transfer of assets rule is inconsistent with applicable federal law, it violates the supremacy clause. The remaining claims pressed by the defendant on appeal are essentially that: (1) the plaintiff in each of the cases has a valid life care contract with the Elim Park Baptist Home and is therefore ineligible for medicaid; and (2) these life care contracts are available assets to the plaintiffs. 3
It is clear that under applicable federal law only assets Actually available to a medicaid applicant may be considered in determining eligibility. 42 U.S.C. § 1396a(a)(17)(B); 42 Fed.Reg. No. 9 at 2687-88 (Jan. 13, 1977) (revising 45 C.F.R. § 248.21); Buckner v. Maher, supra, 373 n. 12; Wilczynski v. Harder, 323 F.Supp. 509 (D.Conn.1971); Morgan v. White, supra, 168 Conn. 345, 362 A.2d 505. In its memorandum of decisions, the Court of Common Pleas acknowledged the reliance of the fair hearing officers on the life care contract statute (General Statutes § 17-116) as well as on the transfer of assets rule (§ 17-109(e)) as their grounds for sustaining the action of the commissioner. The court emphasized, however, that "even if it (the life care contract provision) did apply to the arrangement at the Elim Park Baptist Home and the court is not so convinced it would still fall before the primacy clause." We agree.
At the outset, it should be noted that the fair hearing officers should not have included the reference to the life care contract statute in their findings. The suspension of benefits by the commissioner was grounded on § 17-109(e), the transfer of assets rule, and no evidence was presented at the fair hearings that the plaintiffs had life care contracts within the meaning of § 17-116. The fair hearing officers should have confined themselves to the question of whether the commissioner's action was valid under § 17-109(e). See Morgan v. White, supra, 340 n. 4, 362 A.2d 505. Consequently, we do not decide whether the plaintiffs actually possess life care contracts with the home.
Even if the finding of a life...
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