Wilson v. Stanton
| Decision Date | 18 August 1981 |
| Docket Number | No. 2-481A111,2-481A111 |
| Parties | Larry WILSON b/n/f Dorothy J. Wilson, Deborah Kinder b/n/f June Kinder and Gilberta Lindsey and All Others Similarly Situated, Appellants (Plaintiffs Below), v. Wayne A. STANTON, Administrator, Indiana State Department of Public Welfare, Appellee (Defendant Below). |
| Court | Indiana Appellate Court |
Scott R. Severns, William E. Marple, Legal Services Organization of Indiana, Inc., Indianapolis, for appellants.
Linley E. Pearson, Atty. Gen. of Indiana, Gary R. Brock, Deputy Atty. Gen., Indianapolis, for appellee.
Larry Wilson (Wilson), Deborah Kinder (Kinder), and Gilberta Lindsey (Lindsey) appeal the grant of summary judgment against them in their claim against Wayne A. Stanton (Stanton) as Administrator of the Indiana State Department of Public Welfare for personal allowances under Indiana's Medicaid Act, IC 12-1-7-21(b), maintaining that the trial court erred in classifying such allowances as "medical assistance" thereby not payable because of lack of federal financial participation in personal allowance programs.
We reverse.
Wilson, Kinder, and Lindsey are all institutionalized recipients of medical assistance payments under the Medicaid program. They, and the class they seek to represent, all have less than $28.50 per month personal income.
During the year including July 1, 1978 to June 30, 1979, IC 12-1-7-21(b) provided that institutionalized persons eligible for Medicaid "shall be paid a personal allowance in an amount to be established by the State Department of Public Welfare, but in no event less than twenty-eight dollars and fifty cents ($28.50) nor more than thirty-five ($35.00) monthly, which amount shall be exempt from income eligibility consideration ... and may be exclusively used by the recipient for his, or her, personal needs." It is undisputed that this language, if it is not countermanded by other law, requires that the State must pay Medicaid recipients with less than $28.50 monthly personal income enough to raise their personal income to $28.50. No such payments were made.
The plaintiffs' complaint against Stanton was filed in the Marion County Superior Court on May 23, 1979. The case was venued to the Hamilton County Superior Court on July 24. The parties' respective motions for summary judgment were heard on August 6, and summary judgment was rendered in the following manner on October 2:
FINDINGS OF FACT
2. Defendant concurs with plaintiffs that I.C. 12-1-7-21(b) ( Acts 1978, P.L. 68, Sec. 2) required defendant to provide plaintiffs with a personal allowance of not less than $28.50 per month from July 18, 1978 to July 1, 1979. The statute reads as follows (b) Persons eligible to receive medical assistance under this chapter who are not living in their own homes, but are receiving care in:
(1) hospitals;
(2) skilled nursing facilities; or
(3) intermediate care facilities;
shall be paid a personal allowance in an amount to be established by the state department of public welfare, but in no event less than twenty-eight dollars and fifty cents ($28.50) nor more than thirty-five dollars ($35) monthly, which amount shall be exempt from income eligibility consideration by the state department of public welfare and may be exclusively used by the recipient for his, or her, personal needs.
3. In answer to interrogatories, the defendant states that $4,795,040.13 reverted to the State of Indiana unspent from the Medicaid Program. Yet, no personal allowance payments were made.
4. Defendant contends that the Indiana Legislature did not intend for Medicaid funds to be available for payment of the personal allowance in the absence of federal financial participation Defendant's contention is based on the definition of medical assistance found at I.C. 12-1-7-14.9(b). That definition reads as follows:
(b) Such medical assistance includes, subject to the provisions of sections 15.7 and 16 of this chapter, the following:
(1) in-patient hospital services;
(2) licensed nursing home services;
(3) physician's services
(4) out-patient hospital or clinic services;
(5) home health care services;
(6) private duty nursing services;
(7) physical therapy and related services;
(8) dental services performed or prescribed by a licensed dentist;
(9) prescribed laboratory and X-ray services;
(10) prescribed drugs and services when dispensed by licensed pharmacists and when dispensed by legally authorized practitioners;
(11) eye glasses, and prosthetic devices;
(12) optometric services;
(13) diagnostic, screening, preventive and rehabilitative services;
(14) podiatry services;
(15) any other medical care or remedial care recognized under state law;
(16) family planning services except the performance of abortions; and
(17) nonmedical nursing care given in accordance with the tenents (sic) and practice of a recognized church or religious denomination to any individual qualified for assistance under this chapter who depends upon healing by prayer and spiritual means alone in accordance with the tenets and practices of his church or religious denomination.
However, medical assistance, under this subsection does not include any services for which federal participation is not available. (emphasis added by trial court)
5. Federal financial participation was not available for the payment of the personal allowance.
6. The single issue before the Court is whether or not the personal allowance described in I.C. 12-1-7-21(b) ( Acts 1978, P.L. 68, SEC. 2) constituted "medical assistance" as defined in I.C. 12-1-7-14.9(b) and was, therefore, dependant (sic) on federal financial participation.
3. Upon careful reading of I.C. 12-1-7-14.9(b) in particular and all of the sections of Title 12, Article 1, Chapter 7 of the Indiana Code pertaining to medical assistance and disabled persons, it is this Court's interpretation that the definition of "medical assistance" found in I.C. 12-1-7-14.9(b) was intended to be broad enough to encompass all payments 4. Therefore, defendant was prohibited from making personal allowance payments when federal financial participation was not available just as he would have been prohibited from making any other payment in regard of medical assistance, remedial care, or personal disability under Indiana Code, Title 12, Article 1, Chapter 7, without federal financial participation.
described under Chapter 7 pursuant to medical need, remedial care, and personal disability. From the face of I.C. 12-1-7-21(b) ( Acts 1978, P.L. 68, SEC. 2) it is clear that the personal allowance was such a payment.
It is therefore ORDERED, ADJUDGED, and DECREED that Summary Judgment be entered in favor of defendant and against plaintiffs.
/s/ Donald E. Foulke
/s/ Donald E. Foulke, Judge
Hearing was also held on the plaintiffs' motion for certification of their class action under T.R. 23(B)(2); but summary judgment was rendered before the class was certified. The class remains uncertified.
On appeal, the plaintiffs present two issues:
1. Does the restriction on medical assistance payments apply to the personal allowance program under IC 12-1-7-21(b) (Burns 1979 Supp.)?
Because we remand for further proceedings, we need not reach the second issue.
Because there is no factual controversy whatsoever, our decision is a question of law, purely a technical question of statutory construction.
In construing statutes, it is our aim to give effect to as much of the language of the statute as possible, White v. White, (1975) 167 Ind.App. 459, 338 N.E.2d 749, and to recognize the plain and ordinary meaning of the words used, if possible. IC 1-1-4-1(1). It is not to be presumed that the legislature intends its enactments to have no effect. State ex rel. Boger v. Daviess Cir. Ct., (1960), 240 Ind. 198, 163 N.E.2d 250. Social legislation in particular will be construed liberally to effect its purpose. Renwanz v. Review Board of Indiana Employment Security Division, (1971) 148 Ind.App. 540, 267 N.E.2d 844.
The definition of "medical assistance", IC 12-1-7-14.9(a)-(c) covers more than a page and half of Burns Indiana Statutes. "Medical assistance" is defined as "payment to or on behalf of part or all of the cost of medical or remedial services" for seven classes of beneficiaries who are then described. IC 12-1-7-14.9(a).
The kinds of medical services covered by Medicaid are then enumerated in subsection (b):
(b) Such medical assistance includes, subject to the provisions of sections 15.7 and 16 of this chapter, the following:
(1) In-patient hospital services;
(2) Licensed nursing home services;
(3) Physician's services;
(4) Out-patient hospital or clinic services;
(5) Home health care services;
(6) Private duty nursing services;
(7) Physical therapy and related services;
(8) Dental services performed or prescribed by a licensed dentist;
(9) Prescribed laboratory and X-ray services;
(10) Prescribed drugs and services when dispensed by licensed pharmacists and when dispensed by legally authorized practitioners;
(11) Eye glasses, and prosthetic devices;
(12) Optometric services;
(13) Diagnostic, screening, preventive and rehabilitative services;
(14) Podiatry services;
(15) Any other medical care or remedial care recognized under state law;
(16) Family planning services except the performance of abortions; and (17) Nonmedical nursing care given in accordance with the tenets and practice of a recognized church or religious denomination to any individual qualified for assistance under this chapter who depends upon healing by prayer and spiritual means alone in accordance with the tenets and practices of his church or religious denomination.
By its terms, the enumerated list is not exclusive; subsection (b...
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