Smith v. Department of Human Resources

570 S.E.2d 337, 257 Ga. App. 33, 2002 Fulton County D. Rep. 1596, 2002 Ga. App. LEXIS 699
CourtCourt of Appeals of Georgia
DecidedMay 30, 2002
DocketA02A1182
StatusPublished
Cited by1 cases

This text of 570 S.E.2d 337 (Smith v. Department of Human Resources) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Smith v. Department of Human Resources, 570 S.E.2d 337, 257 Ga. App. 33, 2002 Fulton County D. Rep. 1596, 2002 Ga. App. LEXIS 699 (Ga. Ct. App. 2002).

Opinion

Phipps, Judge.

Lawanda Smith owned and operated an assisted living facility primarily for Medicaid recipients enrolled in a state and federally funded program known as the “Community Care Services Program” (CCSP). Following an anonymous complaint of inadequate heating and food at the facility, the Georgia Department of Human Resources (DHR) issued a directive immediately relocating all CCSP residents, and the Georgia Department of Medical Assistance (DMA) terminated Smith’s Medicaid provider status. The directive, however, was later rescinded.

Both individually and through her corporation, Smith then sued DHR, DMA, the private case manager responsible for relocating the facility’s residents, and an employee of the case manager. Smith’s pri[34]*34mary claim is that DHR knew that the complaint of inadequate heat and food was false and unfounded, but used it as a pretext to relocate the residents in a malicious, racially motivated, and successful effort to destroy her business. Smith also complains that the government agencies implemented the decision to relocate the residents without giving her an opportunity to appeal, thereby violating her due process rights1 and committing a breach of contract.2 In addition, Smith seeks damages for a variety of torts she claims the defendants committed in their efforts to relocate the residents. By an amendment to her complaint, she invoked the Georgia Tort Claims Act (GTCA).3

The trial court awarded summary judgment to the case manager and its employee on the ground that the case manager was an independent contractor doing business with the State and, therefore, not subject to being sued under the GTCA. The court dismissed Smith’s tort claims against DHR and DMA on grounds that they have immunity from suit under the GTCA. The court awarded summary judgment to DHR and DMA on Smith’s breach of contract and due process claims, finding that Smith was notified of and waived her appeal rights. We conclude that the trial court erred in granting summary judgment to the case manager and its employee under the GTCA, that the court also erred in dismissing Smith’s due process and breach of contract claims against DHR and DMA, but that the court did not err in awarding summary judgment to the latter defendants on Smith’s tort claims.

DHR operates the CCSP through its Division of Aging Services (DAS). The CCSP provides monies and services to assist in placing Medicaid recipients in community-based “personal care homes” rather than nursing homes. The CCSP is administered by private nonprofit agencies known as regional development centers, which contract with DAS. The regional development centers in turn subcontract with private for-profit case managers, who place and monitor the elderly in the homes.

In order to be a CCSP service provider, a facility must be licensed as a personal care home and certified as an authorized Medicaid provider. When those conditions are met, DMA issues a Medicaid provider number to the facility operator. If the facility is found not to be in compliance with any applicable rules or regulations, [35]*35DHR may recommend that the provider number be withdrawn, and the provider’s license may be suspended. Also if DHR receives information that CCSP personal care home residents may be at risk of harm, it may recommend that they be relocated to other facilities.

The Medicaid participation agreement between DHR and providers such as Smith incorporates a policies and procedures manual that requires DHR to give written notice of its intent to suspend or terminate a provider’s participation in the Medicaid program. The provider is then given a right of administrative appeal. A request for appeal must be submitted to DHR within 20 days of the date of the notice proposing the adverse action, but this period may be shortened through written notice by the department when it determines that endangerment of health, safety, or welfare would otherwise result.

As an initial matter, the manual gives the Medicaid provider “the right to submit documents and written argument” when requesting an administrative appeal of proposed action by DHR to terminate the provider’s participation in the Medicaid program. The manual later states, however, that failure to submit documents and written argument along with the request for appeal “shall constitute a waiver by the provider of any and all further appeal rights.”

DHR sent Smith a letter dated January 30, 1998, informing her that due to failure to correct serious regulatory violations found at her facility, it would instruct CCSP personnel to relocate all their clients and would recommend that Smith’s Medicaid provider status be terminated. The letter informed Smith of requirements that “[t]o oppose/appeal this action a written request for administrative review must be received by [DAS] within 15 days of receipt of this notice” and that “[t]he request must be accompanied by any supporting documentation you wish [DAS] to consider.”

On February 16, caseworkers employed by the defendant case manager investigated Smith’s facility after an anonymous telephone caller complained to the regional development center of inadequate heat and food in the facility. The caseworkers conducting that investigation have testified by affidavit that they accurately reported to DHR that the investigation, found the complaint unfounded. Nonetheless, DHR sent Smith another letter dated February 17 informing her that it had ordered the immediate relocation of all of her CCSP clients to another facility. The reason given was that the residents were at risk due to current conditions in the facility, such as insufficient heat and food.

On February 17, Smith submitted a written request for administrative review of the department’s decision. DHR responded with a letter dated February 19 informing Smith that her request for administrative review was denied “because you failed to submit any supporting documentation for further consideration.”

[36]*361. Smith first contends that the trial court erred in awarding summary judgment to the case manager and its employee.

The court’s ruling was premised on the ground that Smith is seeking to hold these defendants liable as joint tortfeasors with the state agencies. The trial court reasoned that the case manager is an independent contractor doing business with the state and, as such, is specifically excluded from coverage under the GTCA.4 We cannot agree with the trial court’s reasoning or ruling.

Although Smith invoked the GTCA in her pleadings, her tort claims against the case manager and its employee are not affected by operation of this statute. Through the GTCA, the state has enacted a waiver of sovereign immunity for the torts of state officers and employees while acting within the scope of their official duties or employment.5 But the waiver is limited, as the GTCA provides for numerous exceptions to state tort liability.6 Moreover, the GTCA immunizes the state officer or employee from tort liability by requiring the government entity for which the officer or employee was acting to be named as the party defendant.7

That the case manager and its employee do not fall within the coverage of the GTCA, therefore, simply means that the tort claims against them rest on the same footing as do similar claims against any other nongovernmental defendants.

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Cite This Page — Counsel Stack

Bluebook (online)
570 S.E.2d 337, 257 Ga. App. 33, 2002 Fulton County D. Rep. 1596, 2002 Ga. App. LEXIS 699, Counsel Stack Legal Research, https://law.counselstack.com/opinion/smith-v-department-of-human-resources-gactapp-2002.