Morales v. McMahon

223 Cal. App. 3d 184, 272 Cal. Rptr. 688, 1990 Cal. App. LEXIS 917
California Court of Appeal·Decided August 27, 1990·No. No. D010392·Published·Cited by 3 cases

Opinion

[186] Opinion

FROEHLICH, J.

Appellant Cleotilde Morales brought an action for declaratory and injunctive relief, and for mandamus, challenging a certain regulation promulgated by the Department of Social Services (D.S.S.). Such regulation limits the time for a welfare recipient to request a fair hearing to challenge adverse determinations on certain benefits. Appellant sued individually, and as representative of a class consisting of all recipients of benefits under the “Aid to Families with Dependent Children” program (AFDC program) (42 U.S.C. § 601 et seq.), whose request for a fair hearing was denied pursuant to D.S.S.’s manual of policy and procedures (M.P.P.) section 22-009.11 (the challenged regulation). Appellant contends the challenged regulation is invalid, because it is inconsistent with controlling federal regulations and state statutes providing for rights to notice and hearing, and also is inconsistent with federal and state procedural due process rights. Appellant appeals from the judgment finding the challenged regulation valid.

Because the challenged regulation appears incompatible with controlling federal regulations which mandate written notice of certain adverse determinations, we are compelled to conclude the regulation is invalid and unenforceable.

1. Statutory Context

The AFDC program is a cooperative federal and state program of financial assistance to needy children and their families. (See 42 U.S.C. § 601 et seq.; Shea v. Vialpando (1974) 416 U.S. 251, 253 [40 L.Ed.2d 120, 94 S.Ct. 1746].) Although a state is not required to participate in the program, once a state chooses to participate it must administer the state plan in conformity with the federal laws and regulations governing the program. (King v. Smith (1968) 392 U.S. 309, 316-317 [20 L.Ed.2d 1118, 1125, 88 S.Ct. 2128]; Camp v. Swoap (1979) 94 Cal.App.3d 733, 743 [156 Cal.Rptr. 600].)

There is no dispute that 45 Code of Federal Regulations section 205.5 governs state plans administering certain benefits under the Social Security Act, including the benefits appellant claims were improperly denied based on the challenged regulation. When the state intends to take certain types of “adverse action” as to certain benefits (such as reducing or ending payments to the recipient), federal regulations under 45 Code of Federal Regulations section 205.10(a)(4) provide that: “(i) The State . . . shall give timely and adequate notice, except as provided for in paragraphs (a)(4)(ii), (iii), or (iv) of this section. Under this requirement:

[187] “(A) ‘Timely’ means that the notice is mailed at least 10 days before the date of action, that is, the date upon which the action would become effective;
“(B) ‘Adequate’ means a written notice that includes a statement of what action the agency intends to take, the reasons for the intended agency action, the specific regulations supporting such action, explanation of the individual’s right to request an evidentiary hearing (if provided) and a State agency hearing, the circumstances under which assistance is continued if a hearing is requested, [and an explanation of repayment obligations, if any].” (Italics added.)1

Federal regulations also mandate that aggrieved recipients, dissatisfied with the agency action, be provided the right to a hearing to be conducted under the due process standards enunciated in Goldberg v. Kelly (1970) 397 U.S. 254 [25 L.Ed.2d 287, 90 S.Ct. 1011] (see 45 C.F.R. § 205.10(a)(1)). Such regulations further provide the claimant shall be given a reasonable time, not to exceed 90 days, in which to appeal the agency action. (See 45 C.F.R. § 205.5(a)(5)(iii).)

Appellant challenges a state regulation, promulgated by D.S.S. as part of its M.P.P., which ostensibly implements the 90-day limitation period for filing appeals of adverse actions. State regulations include a requirement for notifying a claimant of an adverse action2 which parallels the federal notice requirements, and mandate that a dissatisfied claimant request a hearing within 90 days after the date of the action. (M.P.P., §22-009.1.)

The specific regulation which appellant contends is invalid provides: “If the claimant received adequate notice of the action (see Section 22-GO 1(a)(1)), the date of the action shall be the date on which the notice was mailed to the claimant. In all other cases, the date of the action or inaction shall be considered to be the date the action was discovered. The date of discovery is the date the claimant knew, or should have known, of the action. ” (M.P.P., §22-009.11, italics added.)3

[188] It is the highlighted portion of the regulation which appellant contests, arguing it effectively dispenses with the necessity of providing written notice. She claims such language precludes a recipient from a fair hearing without ever receiving any written notice if the hearing officer concludes the recipient had obtained (or was charged with) knowledge of the agency’s action reducing benefits and of the recipient’s right to appeal.

2. Factual and Procedural Background

In appellant’s case, her aid was reduced in 1981 based on the D.S.S.’s determination she had been overpaid in prior benefit periods, because she failed to report that an “absent” parent was in fact living in her home during these prior periods. The “Notice of Action” (NOA) sent in 1981 informed her of the proposed action reducing her benefits, but failed to state the reason for the proposed action, as required by state and federal regulations. The 1981 NOA invited the claimant to call her eligibility worker if she had any questions, and informed her of her right to appeal within 90 days of the NOA.

In 1983 Morales first received a NOA stating “absent parent at home” as the reason for reducing her benefits. Morales filed for a fair hearing within 90 days of the 1983 NOA. The hearing officer, relying on the “knew or should have known” language of the challenged regulation, concluded the action was barred as untimely because Morales knew or should have known in 1981 of the action reducing her benefits and of her right to appeal, thereby triggering the 90-day period of appeal.

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Morales v. McMahon, 223 Cal. App. 3d 184, 272 Cal. Rptr. 688, 1990 Cal. App. LEXIS 917 (Cal. Ct. App. 1990).

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