APPEAL FROM THE VANDERBURGH SUPERIOR COURT, The Honorable William D. Stephens, Judge, Cause No. 85-CIV-1370.
Neal, J., Robertson, J. And Conover, J. Concur.
Plaintiff-appellant, Gertrude Glaser (Glaser), appeals a decision of the Vanderburgh Superior Court upholding the denial of her application for Medicaid by defendant-appellee, Indiana Department of Public Welfare (DPW).
Glaser is 80 years old and has lived in a nursing home since November 1983. Glaser's niece, Carolyn Clark (Clark), is authorized by a power of attorney to manage her affairs. In December 1984 Clark went to DPW's local office to obtain information on qualifying Glaser for the Medicaid program. Caseworker Nancy Rhodes informed Clark that Glaser was ineligible for Medicaid at that time because her resources considerably exceeded the ceiling amount of $1,500.00, but Clark was told to apply when Glaser's resources fell below the eligibility level. On March 20, 1985, Clark telephoned Rhodes and informed her that Glaser's resources now total approximately $1,700.00. Rhodes reiterated that Glaser would be eligible for Medicaid unless and until her resources were less than $1,500.00. Clark then inquired if she could purchase some nightgowns and robes for Glaser in order to reduce the resources below the eligibility level, but was told she could not. Clark then told Rhodes that, because Clark paid Glaser's nursing home bill a month behind, the resources Glaser had remaining were earmarked to pay the March bill; in reality, Glaser had scant resources. Rhodes replied that, as long as Glaser's account exceeded $1,500.00, she was ineligible for Medicaid. Rhodes then asked if Glaser's current balance included her latest Social Security check. Clark replied that it did, so Rhodes told her to come to the DPW office and apply Glaser for Medicaid. Clark went the next day, March 21, after first obtaining a statement from the bank reflecting the balance in Glaser's account. At the DPW office Clark spoke with caseworker Don Roberts. Roberts noted that the bank statement showed Glaser's account totaled $1,732.50, and he explained to Clark that it would have to be reduced below the $1,500.00 limit by April 1 in order for Glaser to be eligible beginning in April. Two weeks later, April 4, 1985, Clark telephoned Roberts to review Glaser's situation. The balance in Glaser's account totaled $2,097.50, Clark having deposited Glaser's April Social Security check, in the amount of $365.00, the day before. Roberts explained that, although the April 3 deposit would not affect Glaser's eligibility for April because it occurred after the first of the month, subtracting $365.00 from Glaser's balance still left $1,732.50 in the account, which was above the eligibility limit. Clark told Roberts she was under the impression that March's Social Security check did not affect the eligibility limit. Roberts responded that Clark's impression was incorrect. Glaser's application was denied. In mid-April Clark paid Glaser's March nursing home bill, which reduced Glaser's account balance to $83.07. Glaser's account balance being far below the eligibility limit, her May application was approved and she has been receiving Medicaid ever since.
On April 23, 1985, Clark requested a hearing from DPW to contest the denial of Medicaid assistance. The hearing, before a DPW hearing officer, was held on May 31, 1985. Clark and Roberts testified as related above. The hearing officer sustained the denial of Medicaid assistance on the basis that Glaser's account balance exceeded the $1,500.00 limit on the first day of the month, the date used to determine eligibility. Glaser, through Clark, appealed the decision to the State Board of Public Welfare, which sustained the denial by the hearing officer. Glaser then sought judicial review in the Vanderburgh Superior Court. The trial court, after reviewing the transcript of the proceedings held before the hearing officer, made an order book entry affirming the denial of Medicaid assistance. Glaser then filed her Motion to Correct Error. In overruling the motion the trial court filed Findings of Fact and Conclusions of Law. It found that Roberts had made Clark aware of the requirement that Glaser's account had to be reduced below $1,500.00 by the first of April in order to be eligible. The trial court also found that, although Clark may have been misinformed regarding the purchasing of clothing for Glaser as a means of reducing the account balance, it concluded that this was not sufficient to estop DPW from denying Medicaid assistance. It also concluded that Glaser's resources were reasonably evaluated and that the hearing officer's findings were sufficient to permit judicial review. From this decision Glaser instituted this appeal.
Glaser presents the following issues for our review:
I. Is DPW estopped from denying Glaser Medicaid assistance for April 1985 because of erroneous information Clark received from a DPW caseworker.
II. Does DPW's policy and practice violate the Social Security Act's requirement that Medicaid ...