Turley v. Wilson-Coker, No. CV03 052 02 65 S (CT 6/7/2005)

• Decision Date: 07 June 2005
• Docket Number: No. CV03 052 02 65 S,CV03 052 02 65 S
• Court: Connecticut Supreme Court
• Parties: Noreen Turley v. Patricia Wilson-Coker Opinion No.: 89117

Page 1

Unpublished Opinion

Noreen Turley v. Patricia Wilson-Coker Opinion No.: 89117

No. CV03 052 02 65 S

Superior Court of Connecticut

Judicial District of New Britain at New Britain

June 7, 2005

MEMORANDUM OF DECISION

HOWARD T. OWENS, JUDGE TRIAL REFEREE.

ISSUE

Whether court-ordered child support payments may be included as available income for purposes of calculating medicaid benefits.

FACTS

This is an administrative appeal from a final decision of the department of social services brought pursuant to General Statutes §§17b-61 and 4-183. The plaintiff, Noreen Turley, appeals the defendant's determination that, for purposes of calculating medicaid benefits, the plaintiff's available income includes an amount that she was previously ordered by the Probate Court to pay for the support of her dependent child. The record reveals the following facts. The plaintiff is a disabled individual living in a long-term care facility. (Return of Record [ROR], p. 2.) She is the sole parent of a dependent child who is cared for by co-guardians. (ROR, P. 2.) In July 2002, the Probate Court issued an order directing that part of the plaintiff's monthly income be used for the support of her child. (ROR, P. 2.) In August 2002, the defendant found the plaintiff eligible for medicaid benefits and calculated the income upon which her benefits will be based by including as available income the amount previously ordered by the Probate Court to be used for her child's support. (ROR, P. 2.) The plaintiff petitioned for an administrative hearing on September 24, 2002, which began on October 29, 2002, more than 30 days after the plaintiff's request. (ROR, pp. 2-3.) After a hearing, which closed on November 27, 2002, the hearing officer upheld the defendant's determination of available income in a decision issued January 30, 2003. (ROR, pp. 1-6) The hearing officer's decision was not rendered within 60 days of the hearing. The plaintiff now brings this administrative appeal, in which she requests that the defendant be directed to calculate her available income without including the amount ordered by the court for child support.

General Statutes §17b-61(b) permits an aggrieved person to appeal from a decision rendered after a hearing, in accordance with General Statutes §4-183.¹ "It is well settled that [p]leading and proof of aggrievement are prerequisites to a trial court's jurisdiction over the subject matter of an administrative appeal . . . It is [therefore] fundamental that, in order to have standing to bring an administrative appeal, a person must be aggrieved." (Citation omitted; internal quotation marks omitted.) Harris v. Zoning Commission, 259 Conn. 402, 409, 788 A.2d 1239 (2002).

"The fundamental test for determining [classical] aggrievement encompasses a well-settled twofold determination: first, the party claiming aggrievement must successfully demonstrate a specific personal and legal interest in the subject matter of the decision, as distinguished from a general interest, such as is the concern of all the members of the community as a whole. Second, the party claiming aggrievement must successfully establish that the specific personal and legal interest has been specially and injuriously affected by the decision . . . Aggrievement is established if there is a possibility, as distinguished from a certainty, that some legally protected interest . . . has been adversely affected." (Internal quotation marks omitted.) Seymour v. Seymour, 262 Conn. 107, 110, 809 A.2d 1114 (2002).

In this case, the plaintiff's specific financial interest was negatively affected when the defendant determined that the income available to her for calculation of medicaid benefits includes money subject to a preexisting court order. The plaintiff is therefore aggrieved and the court has jurisdiction over the subject matter of this appeal.²

STANDARD OF REVIEW

"We begin by articulating the applicable standard of review in an appeal from the decision of an administrative agency. Judicial review of [an administrative agency's] action is governed by the [Uniform Administrative Procedure Act at §4-166 et seq.] . . . and the scope of that review is very restricted . . . With regard to questions of fact, it is neither the function of the trial court nor of this court to retry the case or to substitute its judgment for that of the administrative agency . . . Judicial review of the conclusions of law reached administratively is also limited. The court's ultimate duty is only to decide whether, in light of the evidence, the [agency] has acted unreasonably, arbitrarily, illegally, or in abuse of its discretion . . . Although the interpretation of statutes is ultimately a question of law . . . it is the well established practice of this court to accord great deference to the construction given [a] statute by the agency charged with its enforcement . . . Conclusions of law reached by the administrative agency must stand if the court determines that they resulted from a correct application of the law to the facts found and could reasonably and logically follow from such facts." (Citations omitted; internal quotation marks omitted.) Cadlerock Properties Joint Venture, L.P v. Commissioner of Environmental Protection, 253 Conn. 661, 668-69, 757 A.2d 1 (2000), cert. denied, 531 U.S. 1148, 121 S.Ct. 1089, 148 L.Ed.2d 963 (2001).

DISCUSSION

I

"Our analysis begins with an overview of the medicaid program. The program, which was established in 1965 as Title XIX of the Social Security Act and is codified at 42 U.S.C. §1396 et seq. (medicaid act), is a joint federal-state venture providing financial assistance to persons whose income and resources are inadequate to meet the costs of, among other things, medically necessary nursing facility . . . The federal government shares the costs of medicaid with those states that elect to participate in the program, and, in return, the states are required to comply with requirements imposed by the medicaid act and by the secretary of the Department of Health and Human Services . . . Specifically, participating states are required to develop a plan, approved by the secretary of health and human services, containing reasonable standards . . . for determining eligibility for and the extent of medical assistance to be provided." (Citations omitted; internal quotation marks omitted.) Ahern v. Thomas, 248 Conn. 708, 713, 733 A.2d 756 (1999).

"Connecticut has elected to participate in the medicaid program and has assigned to the department [of social services] the task of administering the program . . . The department, as part of its uniform policy manual, has promulgated regulations governing the administration of Connecticut's medicaid system. See General Statutes §17b-260." (Citations omitted; internal quotation marks omitted.) Burinskas v. Dept. of Social Services, 240 Conn. 141, 148, 691 A.2d 586 (1997).

"In determining an individual's eligibility for medicaid benefits, the commissioner may take into account only such income and resources as are, as determined in accordance with standards prescribed by the Secretary [of health and human services], available to the applicant or recipient . . . (Emphasis added.) 42 U.S.C. §1396a(a)(17)(B)." (Internal quotation marks omitted.) Clark v. Commissioner, 209 Conn. 390, 397, 551 A.2d 729 (1988). "The Secretary's regulations require that an 'agency must reduce its payment to an institution, for services provided to an individual . . . by the amount that remains after deducting the amounts specified in paragraph (c) of this section, from the individual's income.' (Emphasis added.) 42 C.F.R. §435.832(a). Paragraph (c) specifically lists only four amounts an agency may deduct from a 'medically needy' applicant's total income: (1) a personal needs allowance; (2) an at-home spousal allowance; (3) an at-home family allowance; and (4) medical or remedial expenses not paid by third parties. 42 C.F.R. §435.832(c)." Clark v. Commissioner, supra, 209 Conn. 398.³

Connecticut's regulations governing its administration of the medicaid program are found in the defendant's Uniform Policy Manual, including section 5035.20, which applies the federal regulations for determination of benefits for applicants who do not have a spouse living in the community. The state regulation allows a deduction of income for residents of long-term care facilities to pay for the support of a family member at home in an amount sufficient to bring the family member's income to a specific level, based on the size of the family.⁴

The plaintiff raises three grounds on appeal. First, the plaintiff asserts that the defendant illegally determined that the plaintiff's available income includes the amount that she was previously ordered by the Probate Court to pay for her son's support. The plaintiff asserts that the decision violates the defendant's regulations and statutory authority, is clearly erroneous, is arbitrary, capricious or an abuse of discretion. Second, the plaintiff contends that because the defendant failed to schedule a hearing by the statutory deadline, the plaintiff should prevail on the merits. Finally, the plaintiff similarly contends that she should prevail on the merits because the defendant failed to issue its decision by the statutory deadline.

In support of her first ground for appeal, that the defendant's determination of her available income was illegal, the plaintiff makes two primary arguments. First, the plaintiff argues that inclusion of the income subject to the child support order denies proper legal effect to a valid Probate Court order.⁵ The Supreme Court in Clark v. Commissioner, supra, 209 Conn. 390, considered and rejected a nearly identical argument. In Clark, the plaintiff appealed the inclusion in available income of an amount that the Probate Court previously ordered be paid for the support of an at-home spouse. The court rejected the plaintiff's argument that inclusion of the...