Conrad v. Hackett

149 Misc. 2d 56, 562 N.Y.S.2d 331, 1990 N.Y. Misc. LEXIS 555
CourtNew York Supreme Court
DecidedSeptember 28, 1990
StatusPublished
Cited by2 cases

This text of 149 Misc. 2d 56 (Conrad v. Hackett) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Conrad v. Hackett, 149 Misc. 2d 56, 562 N.Y.S.2d 331, 1990 N.Y. Misc. LEXIS 555 (N.Y. Super. Ct. 1990).

Opinion

OPINION OF THE COURT

Petitioners have originated this CPLR article 78 proceeding, [58]*58as a class action, to review respondents’ determination to deny allocation of the income of an institutionalized Medicaid recipient to the maintenance needs of his noninstitutionalized spouse, based upon the latter’s available resources. The matter was initially heard at the March 19, 1990 Special Term of this court, and thereafter held in abeyance pending petitioners’ related motion for class certification. Petitioners’ motion for class certification was thereafter argued at the June 11, 1990 Special Term of this court, at which time all issues were deemed finally submitted.

The underlying facts are not in dispute. Petitioner Kenneth Conrad is 79 years old and a permanent resident of a residential health care facility. His wife, petitioner Caroline Conrad, remains in the marital residence. Mr. Conrad entered the residential health care facility in October of 1988 as a private pay patient, but became eligible for Medicaid as of March 1989. Consequently, effective April 1, 1990, the local Department of Social Services determined that Mr. Conrad must apply his entire net income of $645.81 per month toward the cost of his residential care. On the other hand, Mrs. Conrad’s minimum maintenance needs under the associated regulatory standards are $479 per month, which would appear to meet her actual regular expenses. However, her only income is $246 per month as a Social Security benefit. Nonetheless, the respondents have denied the administrative application and appeal to set aside to her "the amount needed to bring the income of the spouse * * * up to the” regulatory standards, as provided by the Department regulations at 18 NYCRR 360-4.9 (c). The basis of respondent’s determination was the availability of Mrs. Conrad’s lone bank account of approximately $10,000 as a resource for her maintenance. In this regard, the Commissioner relies upon section 360-4.3 (f) (1) (iii) (e) of the Department regulations, which states that "[i]f the spouse * * * of a person whose institutionalization places him/her in permanent absence status * * * does not have enough income and resources to meet their own needs, an amount will be deducted from the person’s income in accordance with section 360-4.9”. Resources, as opposed to income, would encompass Mrs. Conrad’s bank account (18 NYCRR 360-4.4 [a] [1], [2]).

Petitioners assert three causes of action. First, that respondents were required under the regulations to make their determination solely on the basis of Mrs. Conrad’s income, without regard to resources, as previously construed by this court in the case of Antinore v Perales (Sup Ct, Genesee [59]*59County, index No. 37201); second, to the extent those regulations have been recodified, that the Department’s construction is arbitrary and capricious as applied; and, third, that in so doing the respondents are liable for depriving petitioners their civil rights under the laws of the United States. In point of law, respondents objected that the noninstitutionalized spouse’s resources may now be considered pursuant to regulations enacted after the Antinore decision, and that class certification is not warranted. That the determination herein was arbitrary and capricious or in violation of petitioners’ Federal civil rights is generally denied.

As submitted by petitioners, this court previously construed former section 360.5 (e) (1) of the Department regulations, on its face and despite broader Federal regulations, to permit consideration only of the noninstitutionalized spouse’s income in determining those maintenance needs for which the income of an institutionalized Medicaid recipient could be utilized. That decision, in Antinore v Perales (supra), was rendered July 6, 1987. Subsequently, without substantially amending former section 360.5 (e) (1) itself, the State Commissioner added a new section 360.7 (b) (4) to the Department regulations in order to conform with Federal regulations. The new section specifically conditioned that "if the spouse or family in the community does not have sufficient income or resources to meet their own needs, an amount will be deducted from the patient’s income, if any, to bring the income of the spouse or family in the community up to the higher of the medical assistance standard or the public assistance level” (emphasis added). Thereafter, part 360 of the Department regulations was recodified in its current configuration, effective March 1, 1989, specifically integrating the utilization formula now contained in section 360-4.9 (c), with the condition now contained in section 360-4.3 (f) (1) (iii) (e) that the spouse of an institutionalized recipient "does not have enough income and resources to meet their own needs” (emphasis added).

In this context, the court discerns no practical difference in the distinction between "income or resources” as opposed to "income and resources”. The fact that the set aside is ultimately determined under section 360-4.9 (c) according to the noninstitutionalized spouse’s income is not logically inconsistent with the initial determination of need based upon both income and resources. Further, the Commissioner’s pronouncements that the subsequent amendments change no existing Medicaid requirements or policies is simply not per[60]*60suasive as a matter of regulatory construction in the face of the clear language of the regulations.

As advanced by respondents, it appears from the foregoing that, as a matter of regulatory construction, this court’s decision in Antinore v Perales (supra) had been implicitly overruled and was no longer controlling at the time of petitioners’ application herein. Petitioners’ first cause of action is therefore denied.

Petitioners’ second cause of action, insofar as it attributes respondent’s error in relation to Antinore v Perales (supra) is, by virtue of the foregoing, insufficient on its face. Nonetheless, for the purposes of a summary determination (CPLR 409 [b]), petitioners’ pleading may be construed liberally as supported by the record (People ex rel. Brooklyn Union Gas Co. v Miller, 253 App Div 162; Matter of Litemore Elec. Co. v Kawecki, 48 Misc 2d 347) in order to preserve an inartfully pleaded but potentially meritorious claim (see generally, Rovello v Orofino Realty Co., 40 NY2d 633).

In substance, the regulatory scheme, on its face, requires only a finding that the income and resources of the noninstitutionalized spouse are generally insufficient to meet her maintenance needs as a prerequisite to utilization of the institutionalized spouse’s income. Thus, the essential issue before this court is limited to whether the discretionary determination of the respondents to deny utilization of Mr. Conrad’s income for the maintenance of Mrs. Conrad was arbitrary and capricious or an abuse of discretion (CPLR 7803 [3]; see generally, Matter of Diocese of Rochester v Planning Bd., 1 NY2d 508; Matter of Adelman v Bahou, 85 AD2d 862; Matter of Douglas v Miller, 55 Misc 2d 303, affd 31 AD2d 889). Specifically, an agency’s interpretation of its own rules is to be upheld unless it is irrational or unreasonable and the administrative determination is to be accepted by the courts if it has warrant in the record and a reasonable basis in law (see generally, Matter of Howard v Wyman, 28 NY2d 434; Matter of Huntington TV Cable Corp. v State of New York Commn. on Cable Tel., 94 AD2d 816, affd 61 NY2d 926; Matter of Watkins v Toia,

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Related

Law Enforcement Officers Union, District Council 82 v. State
168 Misc. 2d 781 (New York Supreme Court, 1995)
Conrad v. Hackett
184 A.D.2d 995 (Appellate Division of the Supreme Court of New York, 1992)

Cite This Page — Counsel Stack

Bluebook (online)
149 Misc. 2d 56, 562 N.Y.S.2d 331, 1990 N.Y. Misc. LEXIS 555, Counsel Stack Legal Research, https://law.counselstack.com/opinion/conrad-v-hackett-nysupct-1990.