In re: Fujimori v. Department of Human Services.

517 P.3d 785, 151 Haw. 502
CourtHawaii Intermediate Court of Appeals
DecidedAugust 31, 2022
DocketCAAP-17-0000466
StatusPublished

This text of 517 P.3d 785 (In re: Fujimori v. Department of Human Services.) is published on Counsel Stack Legal Research, covering Hawaii Intermediate Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re: Fujimori v. Department of Human Services., 517 P.3d 785, 151 Haw. 502 (hawapp 2022).

Opinion

FOR PUBLICATION IN WEST'S HAWAIʻI REPORTS AND PACIFIC REPORTER

Electronically Filed Intermediate Court of Appeals CAAP-XX-XXXXXXX 31-AUG-2022 09:09 AM Dkt. 84 OP

IN THE INTERMEDIATE COURT OF APPEALS

OF THE STATE OF HAWAI‘I

---o0o---

IN THE MATTER OF FLORENCE FUJIMORI, Appellant-Applicant/Appellant, v. DEPARTMENT OF HUMAN SERVICES, STATE OF HAWAI‘I; PANKAJ BHANOT, DIRECTOR; LANE T. ISHIDA, HEARING OFFICER, Appellees-Appellees. (CIVIL NO. 16-1-1703)

AND

IN THE MATTER OF EDWARD FUJIMORI, Appellant-Applicant/Appellant, v. DEPARTMENT OF HUMAN SERVICES, STATE OF HAWAI‘I; PANKAJ BHANOT, DIRECTOR; LANE T. ISHIDA, HEARING OFFICER, Appellees-Appellees. (CIVIL NO. 16-1-1914)

NO. CAAP-XX-XXXXXXX

APPEAL FROM THE CIRCUIT COURT OF THE FIRST CIRCUIT

AUGUST 31, 2022

HIRAOKA, PRESIDING JUDGE, NAKASONE AND MCCULLEN, JJ. FOR PUBLICATION IN WEST'S HAWAIʻI REPORTS AND PACIFIC REPORTER

OPINION OF THE COURT BY MCCULLEN, J.

Appellants-Applicants/Appellants Edward Fujimori

(Edward) and Florence Fujimori (Florence) (collectively,

Fujimoris) appeal from the Circuit Court of the First Circuit's 1

April 26, 2017 order and May 11, 2017 judgment affirming

Appellees/Appellees Department of Human Services' (DHS)

administrative decisions denying Edward's and Florence's

applications for Medicaid assistance to pay for their long-term

care. In challenging the circuit court's order and judgment,

Edward and Florence request that we vacate and remand with

instructions to "issue all benefits . . . determined to be due

and owing since the time of their original applications." We

affirm the circuit court's order and judgment.

BACKGROUND

A. Relevant Medicaid History

"The purpose of [M]edicaid is to provide assistance to

those whose income and resources are inadequate to meet the

costs of necessary medical services." Barham by Barham v.

Rubin, 72 Haw. 308, 312, 816 P.2d 965, 967 (1991) (citing 42

U.S.C. § 1396). "Medicaid is a cooperative Federal and State

program that provides medical assistance to low income persons

based on financial need[,]" Fournier v. Sec'y of the Exec. Off.

of Health & Human Servs., 170 N.E.3d 1159, 1164 (Mass. 2021)

(citation and internal quotation marks omitted), and "is

1 The Honorable Bert I. Ayabe presided. 2 FOR PUBLICATION IN WEST'S HAWAIʻI REPORTS AND PACIFIC REPORTER

designed to be the payer of last resort, available only when no

other source is liable for the expense." Est. of Scheidecker v.

Montana Dept. of Pub. Health & Human Servs., 490 P.3d 87, 91

(Mont. 2021) (citation and internal quotation marks omitted).

Generally, an individual must have less than $2,000.00 in assets

to qualify for Medicaid assistance. See Hawai‘i Administrative

Rules (HAR) § 17-1725.1-43; see also Fournier, 170 N.E.3d at

1164; Social Security Programs Operations Manual System at SI

01110.003.A.1, SI 01110.003.A.2 (effective Dec. 8, 2010).

"Through the practice known as Medicaid planning,

however, individuals with significant resources devise

strategies to appear impoverished in order to qualify for

Medicaid benefits." Fournier, 170 N.E.3d at 1164 (citation and

internal quotation marks omitted). "One such strategy is to

transfer assets into an inter vivos trust, whereby funds appear

to be out of the individual's control, yet generally are

administered by a family member or loved one." Id. (citation

omitted). "Accordingly, a loophole existed under the pre-1986

law, pursuant to which individuals anticipating the need for

expensive long-term medical care could impoverish themselves and

qualify for Medicaid assistance while preserving their resources

for their heirs." Petition of Est. of Braiterman, 145 A.3d 682,

687 (N.H. 2016) (cleaned up).

In 1986, Congress responded to this loophole by

enacting 42 U.S.C. § 1396a(k) (1988) (repealed 1993), which

3 FOR PUBLICATION IN WEST'S HAWAIʻI REPORTS AND PACIFIC REPORTER

"deemed available to the applicant (the beneficiary) the maximum

amount that could, at the trustee's discretion, be distributed

to the beneficiary from an irrevocable trust regardless of

whether the funds were actually distributed." Braiterman, 145

A.3d at 687 (cleaned up). In other words, Medicaid qualifying

trusts "were no longer a permissible means to shelter assets for

purposes of Medicaid eligibility." Id. at 688 (citation

omitted). "Congress sought to prevent wealthy individuals,

otherwise ineligible for Medicaid benefits, from making

themselves eligible by creating irrevocable trusts in order to

preserve assets for their heirs." Barham, 72 Haw. at 312, 816

P.2d at 967 (citation omitted).

"In 1993, in reaction to the sophisticated instruments

used to circumvent the [Medicaid qualifying trust] rules,

Congress repealed § 1396a(k) and enacted § 1396p(d) (1993),

which was aimed at more effectively curtailing the use of trusts

or similar mechanisms to qualify for Medicaid." Braiterman, 145

A.3d at 688 (cleaned up). In that enactment, the Omnibus Budget

Reconciliation Act of 1993, "Congress established a general rule

that trusts would be counted as assets for the purpose of

determining Medicaid eligibility." Id. (citation omitted).

With respect to an irrevocable trust, the act provides that "if there are any circumstances under which payment from the trust could be made to or for the benefit of the individual, the portion of the corpus from which, or the income on the corpus from which, payment to the individual could be made shall be considered resources available to the individual."

4 FOR PUBLICATION IN WEST'S HAWAIʻI REPORTS AND PACIFIC REPORTER

Fournier, 170 N.E.3d at 1164 (quoting 42 U.S.C.

§ 1396p(d)(3)(B)(i)).

B. Edward And Florence Fujimori

In August 2006, Edward and Florence created the

"Edward M. and Florence Y.K. Fujimori Irrevocable Trust" (Trust)

"for the benefit of [their] descendants, by representation," and

assigned their son, Alan Y. Fujimori, as trustee (Son). That

same day, they funded the Trust with their residential property

at 5314 Uhiuhi Street in Honolulu (Property), reserving "a life

estate in an undivided ten-thousandth (.0001 or 1/10,000)

interest in and to" the Property. (Formatting altered.)

Six years later, in 2012, Son, as trustee, sold the

Property for $700,000 to Clint and Lisa Kagami (Kagamis), and

conveyed the Property by warranty deed. In the same warranty

deed, Edward and Florence conveyed their life estate in the

undivided 0.0001% interest in the Property to the Kagamis. Two

checks totaling $666,873.81 ($333,436.90 and $333,436.91) were

made payable to the Trust and were deposited into two separate

bank accounts belonging to the Trust.

Two years later, in July 2014, Florence applied for

Medicaid assistance to pay for her long-term care, which was

approved. In September 2015, Edward applied for Medicaid

assistance to pay for his long-term care, and had been given

presumptive eligibility beginning December 16, 2015.

5 FOR PUBLICATION IN WEST'S HAWAIʻI REPORTS AND PACIFIC REPORTER

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Related

AlohaCare v. Ito
271 P.3d 621 (Hawaii Supreme Court, 2012)
Barham by Barham v. Rubin
816 P.2d 965 (Hawaii Supreme Court, 1991)

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Bluebook (online)
517 P.3d 785, 151 Haw. 502, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-fujimori-v-department-of-human-services-hawapp-2022.