Logan Munoz, V. Washington State Health Care Authority

CourtCourt of Appeals of Washington
DecidedJuly 8, 2025
Docket59631-8
StatusUnpublished

This text of Logan Munoz, V. Washington State Health Care Authority (Logan Munoz, V. Washington State Health Care Authority) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Logan Munoz, V. Washington State Health Care Authority, (Wash. Ct. App. 2025).

Opinion

Filed Washington State Court of Appeals Division Two

July 8, 2025

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION II LOGAN MUNOZ, No. 59631-8-II

Appellant,

v.

WASHINGTON STATE HEALTH CARE UNPUBLISHED OPINION AUTHORITY,

Respondent.

MAXA, J. – LM is an eight-year-old child with profound cognitive and physical

disabilities who requires care 24 hours per day. He appeals the dismissal as moot of his

administrative appeal regarding the number of personal care and respite care hours provided to

him through Community First Choice, a Medicaid plan.

In Washington, the Health Care Authority (HCA) is responsible for administering

Medicaid, and HCA has an agreement with the Developmental Disabilities Administration

(DDA) to administer the Community First Choice program. Community First Choice offers in-

home personal care services to certain eligible disabled people living outside of an institution.

Under WAC 388-106-0125(1)(a), a child in LM’s disability category qualifies for 393

personal care hours per month. However, WAC 388-106-0130(7)(a) states that services will not

be provided if they are “within the range of activities that a legally responsible parent or other

responsible adult would ordinarily perform on behalf of a child of the same age who does not No. 59631-8-II

have a disability or chronic illness.” And WAC 388-106-0130(8)(c) states, “When you are living

with your legally responsible parent(s), [DDA] will presume that you have informal supports

available to assist you with your ADLs [activities of daily living] and IADLs [instrumental

activities of daily living] over three-fourths but not all the time.” This presumption is rebuttable.

WAC 388-106-0130(8)(c).

LM lived at home with his two parents and five siblings. In September 2022, DDA

conducted an assessment to determine the amount of in-home personal care and respite hours to

which LM was entitled under the Community First Choice program. DDA reduced the

maximum allowable personal care hours because some of LM’s ADLs were met by informal

support provided by his parents, resulting in a determination that LM was eligible for only 216

personal care hours per month. DDA also determined that LM was eligible for 336 hours of

respite care per year.

LM appealed DDA’s assessment to an administrative law judge (ALJ), who scheduled a

hearing for July 2023. But in May 2023, LM’s parents, citing their exhaustion and need to work

at their jobs, placed LM in institutional care paid for by a different Medicaid program. After a

hearing, the ALJ adjusted LM’s personal care hours upward to 299 and respite care hours

upward to 528.

LM and HCA both appealed to HCA’s Board of Appeals (BOA). The BOA determined

sua sponte that because LM currently was in institutional care and would need a new assessment

if he returned home, his administrative appeal of the September 2022 assessment was moot. LM

filed a petition for judicial review, which the superior court transferred to this court.

On appeal, LM argues that his appeal to the BOA was not moot. He also makes several

arguments regarding the merits of his appeal to the BOA.

2 No. 59631-8-II

We hold that (1) LM’s appeal to the BOA was not moot because a favorable ruling from

the BOA could have provided LM with partial relief and a mootness exception applies because

the issue is capable of repetition but will evade review, and (2) the remedy is to remand to the

BOA for a determination on the merits, and we cannot address the merits of LM’s BOA appeal

because our review is limited to agency orders. Accordingly, we reverse the BOA’s ruling that

LM’s administrative appeal was moot and remand for the BOA to address LM’s appeal on the

merits.1

FACTS

Background

LM currently is eight years old, and he was five years old at the time of the September

2022 assessment. LM has cerebral palsy, epileptic encephalopathy, failure to thrive, hearing loss

in both ears, and developmental delays, and is fed exclusively through a feeding tube. He has

seizures between 30 and 50 times a day. He is immobile and cannot communicate with others.

These conditions require constant support and supervision. LM’s seizures require

immediate intervention. Because LM cannot move and is confined to a wheelchair or bed,

someone must reposition him at least every two hours. LM’s mother stated that she sometimes

has to reposition him every half hour because LM will squirm in his wheelchair or bed. Because

LM is fed through a feeding tube, someone must also suction his mouth and throat to prevent

him from aspirating on his food. Someone must change his diaper every two hours. LM’s

1 LM also argues that the BOA’s determination of mootness violates Section 504 of the Rehabilitation Act and Title II of the Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12131-12134. Because we hold that LM’s BOA appeal is not moot, we do not address this argument.

3 No. 59631-8-II

healthcare provider specifically stated that LM requires “full time 24 hour care” and that he “is

unable to perform any [activity of daily life] without assistance.” Admin. Rec. (AR) at 742.

LM’s family built an ADA-compliant bed on the ground floor of their home. LM sleeps

around two hours at a time. His mother and father alternated sleeping with him. They must

monitor him while he sleeps to ensure that he is breathing and not aspirating.

Before May 2023, LM lived at home with his parents and five siblings between the ages

of 2 and 19. Both of his parents work full time, and at the relevant time of HCA’s determination

of LM’s care hours his father had moved to Seattle for several months to train to be a sheriff’s

deputy.2

Community First Choice Program and CARE Assessments

HCA administers the Community First Choice program with the assistance of DDA.

WAC 388-106-0270. Through Community First Choice, a person can receive personal care

services, which means assistance with activities of daily living (ADL) and instrumental activities

of daily living (IADL). WAC 388-106-0270; WAC 388-106-0010 (defining “personal care

services”). To determine the amount of personal care services to which a person is entitled,

DDA uses an assessment tool called the comprehensive assessment reporting evaluation

(CARE). WAC 388-106-0065, 0070. DDA uses information from clients, caregivers, and

family members to determine how a client performs personal care tasks, taking into account

developmental milestones for children. WAC 388-106-0075.

A CARE assessment analyzes self-performance by assessing ADLs and IADLs. WAC

388-106-0075. ADLs include bathing, bed mobility, eating, locomotion in a room and outside a

2 LM’s father stated that after his training, he was let go from a police department job because his sleep deprivation caused him to be unable to make decisions quickly enough. LM’s father attributed this sleep deprivation to the near constant care of LM.

4 No. 59631-8-II

room, ability to walk, medication management, toilet use, transfer between surfaces, and

personal hygiene. WAC 388-106-0010. IADLs include meal preparation, ordinary housework,

essential shopping, and travel to medical services. WAC 388-106-0010. The CARE assessment

evaluates a person’s self-performance based on which ADLs a person actually performed in the

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Logan Munoz, V. Washington State Health Care Authority, Counsel Stack Legal Research, https://law.counselstack.com/opinion/logan-munoz-v-washington-state-health-care-authority-washctapp-2025.