Correll v. Division of Social Services

406 S.E.2d 633, 103 N.C. App. 562, 1991 N.C. App. LEXIS 877
CourtCourt of Appeals of North Carolina
DecidedAugust 6, 1991
DocketNo. 9027SC218
StatusPublished
Cited by2 cases

This text of 406 S.E.2d 633 (Correll v. Division of Social Services) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Correll v. Division of Social Services, 406 S.E.2d 633, 103 N.C. App. 562, 1991 N.C. App. LEXIS 877 (N.C. Ct. App. 1991).

Opinion

PARKER, Judge.

The question presented by this appeal is whether an applicant for Aid to Families with Dependent Children-Medical Assistance (“Medicaid”) who does not own the real property on which he resides, but does own other real property contiguous to his residence, may be denied Medicaid benefits based on ownership of such other property.

The underlying facts are not in dispute. Petitioners rent their primary place of residence and they own in fee simple a lot with a tax value of $3,640.00 located directly across the road from their residence. Petitioner Russell Correll’s father lives in a trailer on the property owned by petitioners. The sole basis on which petitioners were denied Medicaid benefits was their ownership of this property.

On 22 November 1988 petitioners applied for Medicaid. On 6 January 1989 the Gaston County Department of Social Services (“DSS”) denied the application on grounds that petitioners’ real property constituted excess reserve. A local appeal hearing was held on 26 January 1989; the result was a decision upholding the DSS decision. Petitioners requested a State appeal hearing and on 9 May 1989 a hearing officer of respondent Division of Social Services upheld the denial of petitioners’ Medicaid application. On 21 June 1989, after reviewing the record and written arguments, the chief hearing officer of respondent Division of Social Services issued a final agency decision upholding the decision to deny petitioners’ application.

On 19 July 1989 petitioners filed a petition for judicial review pursuant to N.C.G.S. § 108A-79(k). The superior court’s final order reversed and remanded respondent’s final agency decision on grounds that it was affected by error of law and unsupported by substantial evidence of record. Respondents appealed to this Court.

Respondents contend the court below erred by reversing and remanding their final agency decision, since the decision was sup[564]*564ported by substantial competent evidence in the record as a whole and by applicable statutes, regulations and policies. We agree.

The North Carolina Administrative Procedure Act governs the standard of initial and appellate review of administrative agency decisions. Henderson v. N.C. Dept. of Human Resources, 91 N.C. App. 527, 530, 372 S.E.2d 887, 889 (1988). The Act provides that a superior court may affirm, reverse, or modify a final agency decision or remand the case to the agency for further proceedings. N.C.G.S. § 150B-51(b) (1987). A superior court may reverse or modify a final agency decision which is (i) in violation of constitutional provisions, (ii) in excess of the statutory authority or jurisdiction of the agency, (iii) made upon unlawful procedure, or (iv) affected by other error of law. Id.; Henderson v. N.C. Dept. of Human Resources, 91 N.C. App. at 530, 372 S.E.2d at 889. The standard of judicial review is the whole record test, under which the reviewing court must examine all competent evidence to support the agency’s findings and conclusions. Henderson v. N.C. Dept. of Human Resources, 91 N.C. App. at 530, 372 S.E.2d at 889. This test does not permit the reviewing court to substitute its own judgment for the agency’s as between two reasonable conflicting views. Instead, the reviewing court must “take into account both the evidence justifying the agency’s decision and the contradictory evidence from which a different result could be reached.” Lackey v. Dept. of Human Resources, 306 N.C. 231, 238, 293 S.E.2d 171, 176 (1982).

When an appellate court reviews the decision of a lower court, however (as opposed to when it reviews an agency’s decision on direct appeal), the scope of review is the same as for other civil cases. Henderson v. N.C. Dept. of Human Resources, 91 N.C. App. at 531, 372 S.E.2d at 890. Thus our consideration of the superior court judgment in this case is limited to determining whether the court committed any errors of law. Id. Considering the whole record, we must determine whether the superior court judge was correct as a matter of law in concluding that (i) pursuant to N.C.G.S. § 108A-55 petitioners’ real property had to be excluded from consideration as a resource without regard to whether petitioners had an ownership interest in their primary place of residence, (ii) it was error for respondents not to exclude petitioners’ property from consideration as a resource, and (iii) respondents’ decision was unsupported by substantial evidence in view of the entire record as submitted.

[565]*565The North Carolina statute at issue reads in pertinent part:

The Department may authorize [payments of the cost of medical care] when the total resources of such person are not sufficient to provide the necessary care. When determining whether a person has sufficient resources to provide necessary medical care, there shall be excluded from consideration the person’s primary place of residence and the land on which it is situated, and in addition there shall be excluded real property contiguous with the person’s primary place of residence in which the property tax value is less than [$12,000.00] ....

N.C.G.S. § 108A-55 (1988).

Medicaid is a cooperative federal-state program providing medical assistance to certain classes of needy persons. See 42 U.S.C. §§ 1396 et seq.; N.C.G.S. §§ 108A-54 through -65. North Carolina adopted the Medicaid program through the enactment of General Statutes Chapter 108, now recodified as Chapter 108A. Once a state elects to participate in the Medicaid program, it must comply with federal rules and regulations. Lackey v. Dept. of Human Resources, 306 N.C. at 235, 293 S.E.2d at 175.

States participating in the Medicaid program are required to provide coverage to “categorically” needy persons. In North Carolina, categorically needy persons include recipients of Aid to Families with Dependent Children (“AFDC”) and certain aged, blind, or disabled individuals. Morris by Simpson v. Morrow, 783 F.2d 454, 456 (4th Cir. 1986). Participating states may also provide coverage for “medically” needy persons. Medically needy persons are those who meet the nonfinancial eligibility requirements for cash assistance programs, such as AFDC and federal Supplemental Security Income (SSI), but whose income and resources are too high for them to qualify for categorical aid and who nonetheless lack the means to pay their medical expenses. North Carolina provides medically needy coverage to those who meet income and resources limitations established by respondents pursuant to authority delegated by the General Assembly. See N.C.G.S. §§ 108A-54 and -55; Morris by Simpson v. Morrow, 783 F.2d at 456; 10 N.C. Admin. Code tit. 10, ch. 50.

Relevant federal law provides as follows: “A State plan for medical assistance must . . . provide for taking into account only such income and resources as are . . . available to the applicant [566]*566. . . and ... as would not be disregarded (or set aside for future needs) in determining his eligibility . . . .” 42 U.S.C.

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Related

Haynes v. North Carolina Department of Human Resources
470 S.E.2d 56 (Court of Appeals of North Carolina, 1996)
Correll v. Division of Social Services
418 S.E.2d 232 (Supreme Court of North Carolina, 1992)

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Bluebook (online)
406 S.E.2d 633, 103 N.C. App. 562, 1991 N.C. App. LEXIS 877, Counsel Stack Legal Research, https://law.counselstack.com/opinion/correll-v-division-of-social-services-ncctapp-1991.