Hallgren v. Department of Public Welfare

712 A.2d 776, 1998 Pa. Commw. LEXIS 330
CourtCommonwealth Court of Pennsylvania
DecidedMarch 16, 1998
StatusPublished
Cited by2 cases

This text of 712 A.2d 776 (Hallgren v. Department of Public Welfare) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hallgren v. Department of Public Welfare, 712 A.2d 776, 1998 Pa. Commw. LEXIS 330 (Pa. Ct. App. 1998).

Opinion

JIULIANTE, Senior Judge.

Petitioner Susan Hallgren petitions for review of the May 16, 1997 order of the Department of Public Welfare, Bureau of Hearings and Appeals (Bureau)' affirming the Hearing Officer’s May 8, 1997 denial of Petitioner’s appeal of United Cerebral Palsy of Lancaster County’s (UCP’s) termination of attendant care services (AC services) under the Attendant Care Services Act (the Act).1 Under the Act, physically disabled and mentally alert persons from 18 to 59 years of age who meet certain eligibility requirements may receive basic and ancillary services which enable them to live at home and in the community rather than in an institution. Section 3 of the Act, 62 P.S. § 3053. We [777]*777affirm the Department’s order terminating AC services.

Hearing Officer Claudia Maines held a hearing on June 24, 1996 and adduced the following facts:

1. UCP administers services for the Department in Lancaster, Chester and Lebanon Counties.
2. The Appellant resides with her husband and three sons. The Appellant and two (2) of her sons, Jason Hallgren, age 23 at the time of the hearing, and Christopher [sic2], age 20 at the time of the hearing, have Muscular Dystrophy.
3. Both the Appellant and her son Jason were authorized for services on or about November 11,1991.
4. During July 1992, Jason was hospitalized. He did not return home until approximately five (5) months later.
5. On October 13, 1992, UCP issued written notice terminating services for the Appellant on the basis of abuse of service, forged time sheets, submission of time sheets for services not provided and failure to disclose a hospitalization. [Original Record “O.R.,” Exhibit C-12.]
6. The Appellant filed a timely appeal.
7. Neither the Appellant nor Jason have received services since July 20, 1993.

(Findings of Fact Nos. 1-7.)

Before the Hearing Officer, Petitioner alleged that no one informed her of the requirement that she had to report a hospitalization. Further, with regard to the hours per week she billed for Jason during his hospitalization, she contended that some of those hours were used to provide her with transportation to the hospital, to provide care and/or to get training for future care of Jason, to maintain Jason’s living space during his hospitalization and to provide care for her then minor son Christian.3

In denying Petitioner’s appeal from UCP’s termination of services, the Hearing Officer noted that the Reduction and Termination of Service section of the 1992-1993 Attendant Care Program Requirements provides that “[a] contractor shall reduce or terminate service to consumers when, in the contractor’s professional judgment ... the consumer’s uncooperative behavior and abuse, misuse of the service or the program” occurs. (O.R., Exhibit C-l; Section VIII, part H(l)(c) of the 1992-1993 AC Program Requirements.)

The Hearing Officer concluded that UCP had not abused its discretion in terminating service in light of Petitioner’s sworn testimony that she submitted bills for Jason for hours of service not provided to him. The Hearing Officer recognized Petitioner’s dual role as Jason’s representative and as a consumer, but noted that even though she may not have personally abused the service, her “role as a representative for Jason in submitting bills for service not provided to him demonstrates uncooperative behavior and abuse/misuse of service which also taints her role as a consumer.” (Hearing Officer’s Adjudication at 3.) The Hearing Officer granted no weight to Petitioner’s testimony that “she thought sharing of hours with nonap-proved family members [Christian] was appropriate and, by inference, acceptable to UCP.” (Id.)

The Director of the Bureau of Hearings and Appeals affirmed the Hearing Officer’s Adjudication. Petitioner filed a timely appeal with this Court.

There are two issues for our review: 1) whether the Department erred in determining that UCP’s termination of AC services was correct based on UCP’s professional-judgment that Petitioner demonstrated uncooperative behavior and abuse and misuse of the service or the program; and 2) whether Petitioner met her burden of establishing equitable estoppel against a government agency. Contrary to Petitioner’s proffered “capricious disregard” scope of review,4 [778]*778this Court must affirm the adjudication of the Bureau unless we find that the adjudication is in violation of constitutional rights, or is not in accordance with the law or that any finding of fact made by the Bureau and necessary to support its adjudication is not supported by substantial evidence. York County Children and Youth Services v. Department of Public Welfare, 668 A.2d 185 (Pa.Cmwlth.1995).

Petitioner argues that the Bureau erred in disregarding the regulation that permits attendants to accompany consumers on trips or stays away from home and the one that governs receipt of service during hospitalization. Further, she contends that the Bureau erred in disregarding the humanitarian purpose behind the Act, which essentially is to promote adults being able to live in their own homes rather than institutions.

The regulation governing in-state or out-of-state travel provides that, with certain restrictions, “[ajttendants may accompany consumers on business trips, vacations or other temporary stays away from home.” (O.R., Exhibit C-l; Section IV, Part E of the 1992-1993 AC Program Requirements.), The Hearing Officer, however, did not base her decision on the attendant transporting Petitioner to the hospital in order to visit Jason. As the Hearing Officer stated, “Appellant may not have personally abused/misused the service received as a consumer.”5

The regulation governing receipt of service during hospitalization provides as follows:

Consumers of Attendant Care Service who are temporarily hospitalized may continue to receive Service as long as they meet eligibility requirements and the services provided by the attendant do not duplicate or replace those services available through other third-party payers. Contractors shall conduct an assessment of need and adjust the service plan accordingly. Such plans shall be reviewed by the contractor at least every two weeks; continued payment for services beyond 30 days shall be subject to approval by the Department.
This option must be explained to a consumer during the initial visit after acceptance into the Attendant Care Program, and/or a pamphlet may be given explaining this option. After the initial explanation, this option must be reviewed with consumers at least- one other time, preferably during reassessments.

(O.R., Exhibit C-l; Section IV, Part F of the 1992-1993 AC Program Requirements.)

The Hearing Officer did not specifically address the above-quoted regulation in her adjudication. The basis for her decision was Petitioner’s sworn testimony that she submitted bills for Jason for hours of service not provided to him.6

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Bluebook (online)
712 A.2d 776, 1998 Pa. Commw. LEXIS 330, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hallgren-v-department-of-public-welfare-pacommwct-1998.