Valliere v. Comm'r of Soc. Servs.

178 A.3d 346, 328 Conn. 294
CourtSupreme Court of Connecticut
DecidedFebruary 1, 2018
DocketSC 19701
StatusPublished
Cited by5 cases

This text of 178 A.3d 346 (Valliere v. Comm'r of Soc. Servs.) 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
Valliere v. Comm'r of Soc. Servs., 178 A.3d 346, 328 Conn. 294 (Colo. 2018).

Opinion

ROBINSON, J.

**296In this appeal, we consider the relationship between General Statutes § 45a-655 (b) and (d)1 in determining whether a *349spousal support order **297previously rendered by the Probate Court is binding on the defendant, the Commissioner of Social Services (commissioner), when calculating the allowance that may be diverted to the support of the community spouse of a Medicaid eligible institutionalized person pursuant to 42 U.S.C. § 1396r-5, a provision originally enacted as part of the Medicare Catastrophic Coverage Act of 1988 (catastrophic coverage act), Pub. L. No. 100-360, § 303 (a) (1) (B), 102 Stat. 683, 754. The commissioner appeals2 from the judgment of the trial court sustaining the administrative appeal brought by the plaintiffs, Paul Valliere (Paul) and Ellen Shea, the conservatrix and executrix of the estate of Paul's late wife, Marjorie Valliere (Marjorie), from the commissioner's decision to set a community spouse allowance for Paul in the amount of $0 with respect to the Medicaid benefit that paid for Marjorie's long-term residential care. On appeal, the commissioner contends that, because § 45a-655 (b) and (d) must be construed in light of the federal single state agency requirement that is implemented by General Statutes § 17b-261b,3 the trial court improperly **298*350concluded that the community spouse allowance was controlled by a spousal support order rendered by the Probate Court prior to the application for, and award of, Medicaid benefits. We disagree and, accordingly, affirm the judgment of the trial court.

The record reveals the following undisputed facts and relevant procedural history. On November 18, 2012, Marjorie was admitted to MidState Medical Center (MidState). On November 24, 2012, MidState discharged Marjorie to the Meriden Center, a skilled nursing facility, where she resided until her death on October 17, 2013. Paul continued to reside in their family home in Meriden. On March 18, 2013, the Probate Court appointed Shea, Marjorie's daughter, as conservatrix of Marjorie's estate.4

On March 21, 2013, Shea filed an application in the Probate Court seeking an order of spousal support for Paul pursuant to § 45a-655, contending that, in order to continue to reside in the community and pay the cost of his own "support, maintenance and medical treatment,"5 Paul needed to "own, use and exercise control over all or some of the [nonincome] producing assets, the income producing assets, [Marjorie's] total net income and [his own] total net income, all retroactive to March 18, 2013," the date that the Probate Court appointed Shea as conservatrix. The application further represented that Marjorie was "not receiving public assistance, state administered general assistance, or **299Medicaid, and [she] has not applied for or is receiving such medical assistance, but [she] reserves, and does not waive, her right to prepare, file and prosecute in the future [an] application, claiming [Medicaid] benefits." (Emphasis in original.) Shea provided notice of the application to the commissioner and to the Department of Administrative Services.

Following a hearing, on June 25, 2013, the Probate Court issued a decree, pursuant to §§ 45a-655 (a) and (b), and 17b-261b, which made findings in accordance with the representations in the application, namely, that, "[i]n order to continue to reside in the community and pay the cost of [his own] support, maintenance and medical treatment," Paul "now requires, and in the future will continue to require, to own, to use, and to exercise control over all or some of the [nonincome] producing assets, of the income producing assets, of [Marjorie's] total net income and [his own] total net income." In addition to directing Shea to transfer Marjorie's assets to Paul, the Probate Court ordered Shea, inter alia, to pay Marjorie's total net monthly income of $1,170.33 to Paul as spousal support, "which amount ... is known, identified, and defined as ... the community spouse allowance in [ 42 U.S.C. § 1396r-5 (d) (5) ]6

*351and in [Dept. of Social Services, Uniform Policy Manual § 5035.30 (B) (1) (b) ]."7 (Footnote added.) The **300Probate Court directed that this payment be made retroactive to November 18, 2012, the date Marjorie was admitted to MidState. The Probate Court provided notice of the hearing and a copy of the decree to the commissioner.

On July 15, 2013, an application was filed with the Department of Social Services (department) seeking Medicaid assistance for Marjorie. The department granted that application but, in doing so, declined to follow the community spouse allowance set in the Probate Court's decree. Instead, the department determined that Marjorie had an applied income obligation that required her to pay $898.45 monthly toward her care from April, 2013, through her death in October, **3012013, and that no community spouse allowance was available pursuant to department policy.8

On February 13, 2014, Shea requested an administrative fair hearing for the purpose of challenging the department's refusal to accept the community spouse allowance set by the Probate Court. After a hearing, the commissioner, acting through a hearing officer, issued a decision on October 10, 2014, upholding the denial of the requested community spouse allowance and the determination of Marjorie's applied income obligation. The hearing officer concluded that, under § 17b-261b, the department is the "sole agency" tasked with determining eligibility for Medicaid benefits under state and federal law, and the Probate Court lacked the authority to set the community spouse allowance for *352Medicaid purposes. Specifically, the hearing officer concluded that, once an individual applies for Medicaid under § 45a-655 (d), only the department may set the community spouse allowance. Rejecting the plaintiffs' reliance on 42 U.S.C. § 1396r-5 (d) (5), the federal Medicaid statute addressing preexisting court orders, the hearing officer criticized the plaintiffs for what he described as "obvious" forum shopping, observing that it was "clear from a review of the Probate Court decree and the sequence of events that ...

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

Related

Dept. of Pubic Health v. Estrada
Connecticut Appellate Court, 2022
In re Teagan K.-O.
Supreme Court of Connecticut, 2020
Muckle v. Pressley
197 A.3d 437 (Connecticut Appellate Court, 2018)
Handel v. Commissioner of Social Services
193 A.3d 90 (Connecticut Appellate Court, 2018)
Vansach v. Dep't of Health & Human Servs. (In re Estate of Vansach)
922 N.W.2d 136 (Michigan Court of Appeals, 2018)

Cite This Page — Counsel Stack

Bluebook (online)
178 A.3d 346, 328 Conn. 294, Counsel Stack Legal Research, https://law.counselstack.com/opinion/valliere-v-commr-of-soc-servs-conn-2018.