Green v. Department of Public Aid

520 N.E.2d 860, 165 Ill. App. 3d 936, 117 Ill. Dec. 509, 1988 Ill. App. LEXIS 16
CourtAppellate Court of Illinois
DecidedJanuary 13, 1988
Docket85-1024
StatusPublished
Cited by1 cases

This text of 520 N.E.2d 860 (Green v. Department of Public Aid) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Green v. Department of Public Aid, 520 N.E.2d 860, 165 Ill. App. 3d 936, 117 Ill. Dec. 509, 1988 Ill. App. LEXIS 16 (Ill. Ct. App. 1988).

Opinion

JUSTICE RIZZI

delivered the opinion of the court:

Plaintiff, June Green, appeals from an order of the trial court af- ■ firming the administrative decision of defendant, Illinois Department of Public Aid, which found Green ineligible for medical assistance. We reverse and remand with directions.

On May 9, 1983, while her husband was a patient in South Suburban Hospital, Green applied for medical assistance on his behalf under the Illinois Aid to the Aged, Blind and Disabled Medical Assistance No Grant program (AABD-MANG) of the Illinois Public Aid Code (Code) (Ill. Rev. Stat. 1983, ch. 23, par. 3—1 et seq.). On May 16, 1983, Green met with a caseworker for the Cook County Department of Public Aid (county department) regarding her application. Thereafter, on May 18, 1983, the county department denied Green’s application. In a letter, the county department informed Green that her application for medical assistance was “[d]enied per policy statement contained in Manual Chapter PO — 505, explanation: value of [your] assets exceeds [the] maximum allowed by agency standards.”

Green appealed the denial of her application to the Illinois Department of Public Aid (Department). (Ill. Rev. Stat. 1983, ch. 23, par. 11—8 et seq.) Green’s husband died on June 24, 1983. Thereafter, an administrative hearing was conducted via telephone on July 22, 1983. Green was not represented by counsel.

At the hearing, Vera Shaw, a county department supervisor, who did not handle Green’s application, testified regarding Department regulations. Shaw explained that pursuant to Department regulations, Green’s husband would only be eligible for AABD-MANG if, as husband and wife, Green and decedent’s “non-exempt assets” totalled less than $2,250. According to Shaw’s testimony, Green and the decedent’s nonexempt assets amounted to $2,551.93. Therefore, their nonexempt assets exceeded the AABD-MÁNG eligibility requirement of $2,250 by $301.93. As a result, Green and decedent were not financially eligible for the AABD-MANG program. However, the figures utilized by the county department caseworker during the May 16, 1983, meeting with Green indicate that Green and decedent’s nonexempt assets totalled $2,276.36, an excess of $26.36 over the AABD-MANG eligibility requirement. The record does not explain this discrepancy. In response to a question by the hearing officer, Shaw further testified that she was not familiar with a Department provision which allows an applicant to reduce nonexempt assets to comply with the Department’s eligibility requirement.

Green also testified at the hearing. According to Green, prior to the Department’s rejection of her application, she had attempted to obtain a reduction in the decedent’s life insurance policy through the Veteran’s Administration. However, Green was advised by the administration that it did not recommend such a reduction due to the fact that no premiums would have to be paid during decedent’s hospitalization. Therefore, it would defer action on Green’s request for 30 days in the event that she wished to change her decision. Green’s application was denied prior to the expiration of the 30-day period.

Cheryl Whitney, a financial counselor at South Suburban Hospital, also testified on Green’s behalf. According to Whitney, Green is responsible for approximately $150,000 in medical expenses incurred by the decedent prior to his death. Whitney questioned why Green could not apply a portion of her noriexempt assets to the outstanding medical bills and thereby qualify for assistance.

On August 12, 1983, the Department affirmed the decision of the county department and’ found Green ineligible for AABD-MANG assistance. Thereafter, Green filed a complaint for administrative review in the trial court. The trial court affirmed the Department’s decision. This appeal followed.

On appeal, Green argues that: (1) the Department’s determination that she was ineligible for AABD-MANG assistance was against the manifest weight of the evidence; (2) the Department improperly applied the provisions of the Code and Departmental regulations to deny her medical assistance; and (3) the Department’s asset reduction policy is applied in an unconstitutional manner. However, prior to our analysis of Green’s contentions on appeal, we believe that a review of the relevant provisions of the Code and the Department's regulations is pertinent to an understanding of the issues raised in this appeal.

The purpose of the Code is to “assist in the alleviation and prevention of poverty and thereby to protect and promote the health and welfare of all the people of this State.” (Ill. Rev. Stat. 1985, ch. 23, par. 1—1.) To facilitate this purpose, the Code requires that every person administering any of its provisions perform his or her duties in the manner necessary to secure, for every applicant the aid and services to which the person may be entitled. Ill. Rev. Stat. 1985, ch. 23, par. 11—2.

Eligibility for medical assistance under the AABD-MANG program is set forth in section 5 — 2 of the Code, which provided:

“Persons otherwise eligible for basic maintenance under Articles III and IV but who fail to qualify thereunder on the basis of need, and who have insufficient income and resources to meet the costs of necessary medical care [are eligible for medical assistance].” (Ill. Rev. Stat. 1985, ch. 23, par. 5—2(2).)

Section 5 — 2 further provides:

“The Department shall by rule establish the amounts of assets to be disregarded in determining eligibility for medical assistance, for which federal reimbursement is available under Title XIX of the Social Security Act. The amount of assets *** of a married couple to be disregarded shall not be less than $2,250.” Ill. Rev. Stat. 1985, ch. 23, par. 5—2(7)(c).

The Department’s eligibility requirements and the formulas to be used to determine financial compliance for AABD-MANG assistance are set forth in the Department's AABD Categorical Assistance Manual (Manual), chapter 505, “Financial Factors Eligibility.” According to the Manual, eligibility is determined by the amount of an applicant’s nonexempt assets. A nonexempt asset is an asset not considered in determining eligibility for medical assistance. Section 505.1 delineates, among others, the following as exempt assets: (1) homestead property; (2) clothing and personal effects; (3) household furnishings; (4) a motor vehicle(s) except those used primarily for recreational purposes; and (5) a life insurance policy with a total face or cash value of $1,000 or less. To be eligible for AABD-MANG, a married person must not possess more than $2,250 in nonexempt assets. The $2,250 eligibility figure is commonly referred to as the asset disregard level.

However, the Department has, as part of its financial eligibility requirements, a provision which allows an applicant who has assets in excess of the asset disregard level to reduce these assets via an allowable transfer of a portion of the money to payment of outstanding medical bills. According to the department, this policy was clarified in an Illinois Department of Public Aid Manual Release No. 83.2 to encourage applicants to apply nonexempt assets toward outstanding medical expenses.

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Bluebook (online)
520 N.E.2d 860, 165 Ill. App. 3d 936, 117 Ill. Dec. 509, 1988 Ill. App. LEXIS 16, Counsel Stack Legal Research, https://law.counselstack.com/opinion/green-v-department-of-public-aid-illappct-1988.