Vailes v. D'Elia

77 A.D.2d 45, 432 N.Y.S.2d 204, 1980 N.Y. App. Div. LEXIS 12608
CourtAppellate Division of the Supreme Court of the State of New York
DecidedOctober 6, 1980
StatusPublished
Cited by5 cases

This text of 77 A.D.2d 45 (Vailes v. D'Elia) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Vailes v. D'Elia, 77 A.D.2d 45, 432 N.Y.S.2d 204, 1980 N.Y. App. Div. LEXIS 12608 (N.Y. Ct. App. 1980).

Opinion

OPINION OF THE COURT

Mangano, J.

This CPLR article 78 proceeding raises two issues for review: (1) whether respondents properly computed petitioner’s public assistance grant by reducing by 50% her previous allowance for a family of four, having determined that two of petitioner’s children were no longer eligible for public assistance; and (2) whether, for the purpose of determining eligibility for medical assistance, respondents correctly calculated the income exemption level of petitioner’s two children who are nonrecipients of public assistance.

Petitioner resides in the same household with her three minor children. Prior to June, 1978, she and her children were recipients of a public assistance grant in the Aid to Families with Dependent Children category (ADC) from the Nassau County Department of Social Services (the agency). That grant was for $451 per month, which was computed by adding $258 (the basic needs allowance for a family of four) to $193 (petitioner’s actual rent). On June 2, 1978 the agency notified petitioner that her ADC grant would be reduced, since it had been determined that two of her children were receiving Social Security benefits under the Federal Old Age, Survivors, and Disability Insurance (OASDI) program. These two children were removed from petitioner’s ADC budget because their OASDI benefits exceeded their pro rata share of petition[47]*47er’s then current ADC grant, i.e., their combined OASDI monthly income was more than one half of the monthly ADC grant for a family of four. Consequently, the ADC grant for petitioner and one child was reduced to an amount equal to one half of the ADC allowance for a family of four.

Petitioner was also advised in the agency’s notice of June 2, 1978, and in a subsequent notice dated June 19, 1978, that her two children receiving OASDI benefits were no longer eligible for Medicaid. This determination was based on the fact that the OASDI income of these two children exceeded their pro rata share, i.e., one half, of the monthly net income exemption for a family of four.

Petitioner thereafter requested a fair hearing by the New York State Department of Social Services. The hearing was conducted on August 16, 1978, and a decision after fair hearing was rendered on September 6, 1978. In that decision, now under review, the State commissioner held as proper: (1) the agency’s method of prorating, i.e., reducing by 50%, the ADC budget for a family of four when computing the budget for two ADC recipients in a household of four, where the other two household members are not ADC recipients; and (2) the agency’s method of prorating, i.e., reducing by 50%, the monthly income exemption for a family of four in determining Medicaid eligibility for two nonrecipients of ADC funds in a household of four, where the other two household members are recipients of ADC funds.

I

With regard to the reduction of petitioner’s ADC grant, this court, in a scholarly opinion by Mr. Justice Gulotta, has recently considered the proration method employed herein. (Matter of Leone v Blum, 73 AD2d 252.) In that opinion (p 258), the proration method was described as follows: "(a) counting each person residing in the household (whether or not eligible for assistance) to determine household size, (b) referring to the schedules to find the appropriate allowance for that size household, and then (c) 'prorating’ that allowance to assure that only the eligible members of the household are assisted” (e.g., in the instant matter, where the household consists of two ineligibles and two eligibles, one half of a four person grant would be, and was, awarded). Leone held that this proration method violated State and Federal law, as well as the State commissioner’s own regulations. Specifically, it [48]*48concluded (pp 262-263) that where an OASDI beneficiary was not legally responsible to support other members of his household or the State commissioner was not authorized to compel any application of OASDI benefits towards such support, the OASDI beneficiary could not be automatically counted as a household member for public assistance budgeting purposes. Furthermore, it found impermissible the assumption that the OASDI beneficiary would be contributing his pro rata share to the household expenses, so as to warrant a prorated public assistance grant.

In the case at bar, the two minor children receiving OASDI benefits were clearly not responsible for the support of their mother or sibling. (See Domestic Relations Law, § 32; Family Ct Act, §§ 412, 413, 414, 415; Social Services Law, § 101.) Moreover, the State commissioner was not authorized to compel petitioner, as representative payee of the OASDI funds for her two beneficiary children, to apply those funds towards the support of herself or her nonbeneficiary child (20 CFR 404.1603—404.1605). Accordingly, under the holding of Leone (supra), the agency’s use of the proration method to reduce petitioner’s ADC grant was improper and the State commissioner’s decision affirming the agency’s action was erroneous.

It should be noted that respondent Blum has always maintained that in the instant matter she is not contesting the validity of petitioner’s challenge to that aspect of the fair hearing decision concerning the prorating of petitioner’s ADC grant. Nonetheless, she never admits error, but simply advises this court that on constraint of Swift v Toia (450 F Supp 983, affd sub nom. Swift v Blum, 598 F2d 312, cert den 444 US 1025), which accords with Leone (73 AD2d 252, supra), new regulations, consistent with the result we reach today, were promulgated on March 30, 1979, and March 31, 1980. The State commissioner thus implies that these new regulations render the instant challenge on the issue of the grant reduction moot. However, Leone (supra) found that under the relevant statutes and case law, as well as the pertinent regulations existing prior to the 1979 and 1980 revisions, the proration method was unauthorized. Therefore, since petitioner seeks not only prospective relief, but, also, retroactive relief to the date of the agency’s reduction of her ADC grant, the State commissioner’s qualified concession to petitioner’s challenge concerning the grant reduction would not moot the issue as it relates to the time prior to March 30, 1979. [49]*49Moreover, even though a stay of the fair hearing decision was granted by Special Term on January 3, 1979, there still existed a four-month period prior thereto during which the fair hearing decision was in effect. For that period, the State commissioner denies liability for retroactive payments. This denial is in keeping with her untenable position that the prospective effect of the 1979 and 1980 revisions in the regulations of the State Department of Social Services cure, retroactively, the unlawful withholding of rightful benefits. (See Matter of Leone v Blum, 73 AD2d 252, supra.) We reject this position of the State commissioner. Accordingly, this matter must be remanded for a recalculation of petitioner’s ADC benefits consistent with this opinion, and. to the date of the agency’s reduction of such aid.

II

With regard to prorating the income exemption for Medicaid eligibility, an analysis of the relevant statutes and regulations, both Federal and State, is required.1

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Bluebook (online)
77 A.D.2d 45, 432 N.Y.S.2d 204, 1980 N.Y. App. Div. LEXIS 12608, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vailes-v-delia-nyappdiv-1980.