Palomba-Bourke v. Commissioner of Social Services

CourtSupreme Court of Connecticut
DecidedJune 17, 2014
DocketSC19044
StatusPublished

This text of Palomba-Bourke v. Commissioner of Social Services (Palomba-Bourke v. Commissioner of Social Services) is published on Counsel Stack Legal Research, covering Supreme Court of Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Palomba-Bourke v. Commissioner of Social Services, (Colo. 2014).

Opinion

****************************************************** The ‘‘officially released’’ date that appears near the beginning of each opinion is the date the opinion will be published in the Connecticut Law Journal or the date it was released as a slip opinion. The operative date for the beginning of all time periods for filing postopinion motions and petitions for certification is the ‘‘officially released’’ date appearing in the opinion. In no event will any such motions be accepted before the ‘‘officially released’’ date. All opinions are subject to modification and technical correction prior to official publication in the Connecti- cut Reports and Connecticut Appellate Reports. In the event of discrepancies between the electronic version of an opinion and the print version appearing in the Connecticut Law Journal and subsequently in the Con- necticut Reports or Connecticut Appellate Reports, the latest print version is to be considered authoritative. The syllabus and procedural history accompanying the opinion as it appears on the Commission on Official Legal Publications Electronic Bulletin Board Service and in the Connecticut Law Journal and bound volumes of official reports are copyrighted by the Secretary of the State, State of Connecticut, and may not be repro- duced and distributed without the express written per- mission of the Commission on Official Legal Publications, Judicial Branch, State of Connecticut. ****************************************************** MARY PALOMBA-BOURKE v. COMMISSIONER OF SOCIAL SERVICES (SC 19044) Rogers, C. J., and Palmer, Zarella, Eveleigh, McDonald and Espinosa, Js. Argued January 8—officially released June 17, 2014

Jeffrey R. Lindequist, with whom was Scott A. Storms, for the appellant (plaintiff). Hugh Barber, assistant attorney general, with whom, on the brief, was George Jepsen, attorney general, for the appellee (defendant). Opinion

EVELEIGH, J. The plaintiff in this administrative appeal, Mary Palomba-Bourke, appeals from the judg- ment of the trial court affirming the decision of the administrative hearing officer, in favor of the defendant, the Commissioner of Social Services (department).1 The plaintiff contends on appeal that the department failed to apply the correct eligibility and availability of assets criteria when evaluating the application for Medicaid benefits submitted by the plaintiff’s spouse, Daniel Bourke. We disagree and, accordingly, we affirm the judgment of the trial court. Bourke applied to the department for Medicaid bene- fits in 2009 and, in 2010, the department informed Bourke that, based on its review of the combined assets of both Bourke and the plaintiff, Bourke was not cur- rently eligible to receive Medicaid benefits. The plaintiff then sought an administrative hearing to contest the department’s determination of Bourke’s eligibility.2 The hearing officer denied her appeal of the department’s decision, and the plaintiff appealed to the Superior Court.3 The Superior Court dismissed her appeal. This appeal followed.4 The relevant facts in the present case are undisputed, and are recounted in the decisions of both the adminis- trative hearing officer and the Superior Court. On Sep- tember 10, 1968, the plaintiff’s husband at the time, Edward Palomba, created the Edward A. Palomba resid- ual trust (trust), and, upon his death on September 5, 1976, the plaintiff was made a beneficiary of the trust. The trust was intended to permit the trustees to provide for, in their sole discretion, the education and support of Palomba’s children, and for the support of the plain- tiff. As of April, 2010, the principal of the trust was equal to $514,977.17. In 2000, the plaintiff married Bourke. Bourke, who is not a beneficiary of the trust, entered a long-term care facility on February 2, 2009, while the plaintiff continued to reside in the community. On August 3, 2009, Bourke applied for Medicaid benefits, and on June 9, 2010, the department conducted its analy- sis of the combined assets of the plaintiff and Bourke and concluded that, based on the total value of their combined assets, Bourke was not at that time eligible for Medicaid benefits. Specifically, the department con- cluded that, including the value of the trust, the couple’s combined assets totaled $655,624.61. Pursuant to state regulation; see Dept. of Social Services, Uniform Policy Manual § 4005.10 (A) (2) (a) (Uniform Policy Manual);5 Bourke, as the individual applying for benefits, could not hold more than $1600 in assets, and that the plaintiff, as a ‘‘community spouse’’6 could not have greater assets than the applicable ‘‘community spouse protected amount’’ (protected amount),7 which the hearing officer found to be $109,540. Thus, because the department determined that the couple’s combined assets exceeded $111,140,8 it concluded that Bourke was not eligible for Medicaid benefits. The plaintiff contested the department’s determina- tion and sought an administrative hearing to challenge it. Specifically, the plaintiff objected to the department’s decision to count the value of the trust when determin- ing the total value of the assets available to Bourke. The plaintiff claimed that, in including the value of the trust in Bourke’s available assets, the department was following the rules created by the Medicare Cata- strophic Coverage Act of 1988 (catastrophic coverage act), Pub. L. No. 100-360, § 303 (c), 102 Stat. 683, 762, regarding the availability of spousal assets, and not the rules governing asset valuation that were in effect either at the time that the trust was created in 1968 or when the trust became irrevocable due to Palomba’s death in 1976. At the administrative hearing, the hearing officer rejected the plaintiff’s argument. The hearing officer concluded that the plaintiff and Bourke met the defini- tion of ‘‘[catastrophic coverage act] spouses’’ as defined in § 0500 of the Uniform Policy Manual,9 and that, as a result, the calculation method for determining the assets available to a Medicaid applicant found in § 4025.67 (A) of the Uniform Policy Manual applied. Pursuant to § 4025.67 (A), the value of the nonexcluded assets10 owned by a community spouse, after sub- tracting the protected amount, are ‘‘deemed’’11 available to the institutionalized spouse for purposes of the insti- tutionalized spouse’s eligibility determination. As a result, the hearing officer concluded that, because the plaintiff conceded that the trust principal was available to the plaintiff, the department was correct to include its value as an asset when determining Bourke’s Medicaid eligibility. The plaintiff appealed this decision to the trial court on the same basis, and the trial court affirmed the hearing officer’s decision, finding that the cases cited by the plaintiff in support of her position were all distinguishable, and relying, instead, ‘‘on the general rule that when one applies for Medicaid, the applicant is subject to whatever statutes are then in effect regarding assets in existence at the time of institutionalization or application.’’ This appeal followed.12 The sole issue on appeal is whether the trial court properly affirmed the hearing officer’s determination that the availability and eligibility rules of the cata- strophic coverage act apply to the trust and thus, that it should be considered an asset of Bourke for purposes of his Medicaid eligibility.13 The plaintiff claims that by applying the provisions of the catastrophic coverage act, a law which came into effect after the trust in the present case became irrevocable, the hearing officer and reviewing Superior Court have frustrated the intent of the trust’s settlor and have also acted contrary to what the plaintiff contends is settled Connecticut law regarding the applicability of the catastrophic coverage act to trusts that were in existence prior to the enact- ment of the law. We begin with the appropriate standard of review.

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Palomba-Bourke v. Commissioner of Social Services, Counsel Stack Legal Research, https://law.counselstack.com/opinion/palomba-bourke-v-commissioner-of-social-services-conn-2014.