Shagalow v. State, Department of Human Services

725 N.W.2d 380, 2006 Minn. App. LEXIS 170, 2006 WL 3719669
CourtCourt of Appeals of Minnesota
DecidedDecember 19, 2006
DocketA06-246
StatusPublished
Cited by4 cases

This text of 725 N.W.2d 380 (Shagalow v. State, Department of Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shagalow v. State, Department of Human Services, 725 N.W.2d 380, 2006 Minn. App. LEXIS 170, 2006 WL 3719669 (Mich. Ct. App. 2006).

Opinion

OPINION

MINGE, Judge.

Appellant challenges the decision of respondent Minnesota Department of Human Services (DHS) denying Medical Assistance coverage for habilitation services in Jerusalem, Israel. Appellant claims that there is no habilitation services program appropriate for her condition and compatible with her religious beliefs in Minnesota; that the only residential habili-tation program providing suitable services consistent with her beliefs is in Jerusalem, Israel; that rules governing the Medical Assistance program do not preclude payment for these services in Israel; and that denial of payment to the Israeli provider is improper, violates her right to religious freedom under the federal and state constitutions, and violates the Americans with Disabilities Act (ADA). Because we conclude that the state's decision not to pay for these services is not arbitrary and capricious, is not erroneous, was based on religiously neutral reasons, and does not directly affect appellant’s religious beliefs or practices, and that granting appellant’s request would place an unreasonable burden on the state’s administration of its Medical Assistance program, we affirm.

FACTS

Appellant Shaina Shagalow is a young Jewish Orthodox woman who has been diagnosed with mild mental retardation. She also has a developmental cognitive disorder and attention deficit hyperactivity disorder. Appellant reads at a sixth-grade level and requires assistance with grooming and similar everyday tasks. Appellant is dependent on others to make legal and medical decisions, and her parents are her court-appointed legal guardians.

Appellant attended a private Jewish Orthodox school for girls from the fourth grade through high school. She lived at home while she attended school. As high school graduation approached, her family began searching for habilitation programs for young adults that were also compatible with her Jewish Orthodox faith. Habilitation services assist persons to develop skills to live in society. Minn. R. 9525.1800, subp. 13a (2006). Appellant’s family knew that no day program consistent with appellant’s Orthodox faith is available in Minnesota. The only residential habilitation program which appellant’s parents could identify that adheres to Jewish Orthodox practices including gender segregation, strict observance of the Sabbath, and food preparation and consumption, is one conducted by Midreshet Dar-kaynu (Darkaynu), located in Jerusalem, Israel. There are no such residential Jewish Orthodox programs in the United States.

Appellant requested that the Hennepin County Children, Family, and Adult Services Department (county) provide financial support for habilitation services at Darkaynu as a part of Minnesota’s Medical Assistance program. Medical Assistance is this state’s part of the federal Medicaid program. Appellant does not request assistance for the room and board or travel portions of the program, only habilitation services. The county denied appellant’s request, and appellant requested review. The denial was upheld by a referee at DHS, and the commissioner of DHS adopted the referee’s decision. Appellant sought review of that decision by the Hen-nepin County District Court. The district court upheld the decision. This appeal follows.

*384 ISSUES
I. Did DHS err in refusing to pay for habilitation services at Darkaynu for appellant?
II. Does DHS’s refusal to pay for ha-bilitation services for appellant at Dar-kaynu violate her right to religious freedom secured by the United States Constitution and the Minnesota Constitution?
III. Does DHS’s refusal to pay for ha-bilitation services for appellant at Dar-kaynu violate the Americans with Disabilities Act?

ANALYSIS

“On appeal from the district court’s appellate review of an administrative agency’s decision, this court does not defer to the district court’s review, but instead independently examines the agency’s record and determines the propriety of the agency’s decision.” Johnson v. Minn. Dep’t of Human Servs., 565 N.W.2d 453, 457 (Minn.App.1997). In accordance with the Minnesota Administrative Procedure Act (APA), the reviewing court may “reverse or modify the decision if the substantial rights of the petitioners may have been prejudiced because the administrative ... decision” was:

(a) in violation of constitutional provisions; or
(b) in excess of the statutory authority or jurisdiction of the agency; or
(c) made upon unlawful procedure; or
(d) affected by other error of law; or
(e) unsupported by substantial evidence in view of the entire record as submitted; or
(f) arbitrary or capricious.

Minn.Stat. § 14.69 (2004). “Agency decisions are presumed to be correct by reviewing courts....” In re Hutchinson, 440 N.W.2d 171, 176 (Minn.App.1989), review denied (Minn. Aug. 9, 1989). Moreover, appellate courts generally defer to an agency’s expertise. Reserve Mining Co. v. Herbst, 256 N.W.2d 808, 824 (Minn.1977). The party challenging the agency decision has the burden of proving grounds for reversal. Markwardt v. State Water Res. Bd., 254 N.W.2d 371, 374 (Minn.1977); Johnson, 565 N.W.2d at 457.

I.

MEDICAL ASSISTANCE COVERAGE

The first issue is whether DHS’s decision was improper. Appellant challenges the conclusion of law that Medical Assistance funds may not be used to pay for services provided outside of the United States and claims that DHS and the county had discretion to pay for such services. Although it is not clear whether appellant claims that DHS erred as a matter of law and appellant does not expressly allege that the refusal was arbitrary and capricious, we will initially construe the appeal from that perspective because those are relevant standards for judicial review.

Both parties concede from the outset that there is no federal or state statute or regulation that explicitly prohibits Medical Assistance from paying for services provided outside of the country. Likewise, while Minnesota law permits payment of Medical Assistance to licensed Canadian institutions under some circumstances, Minn.Stat. § 256B.25, subd. 1 (2004), appellant cannot point to any explicit legal provisions requiring DHS to pay for habil-itation or other services being delivered outside of the United States. Moreover, there is no evidence that other states have authorized their Medicaid programs to pay out-of-country service providers. The federal and state legal framework, largely, does not speak to the question here. *385

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Stinemetz v. Kansas Health Policy Authority
252 P.3d 141 (Court of Appeals of Kansas, 2011)
Young v. Jesson
796 N.W.2d 158 (Court of Appeals of Minnesota, 2011)
Edina Community Lutheran Church v. State
745 N.W.2d 194 (Court of Appeals of Minnesota, 2008)

Cite This Page — Counsel Stack

Bluebook (online)
725 N.W.2d 380, 2006 Minn. App. LEXIS 170, 2006 WL 3719669, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shagalow-v-state-department-of-human-services-minnctapp-2006.