SUPERIOR COURT OF NEW JERSEY

APPELLATE DIVISION DOCKET NO. A-3838- 21 R.R., Petitioner-Appellant,

v. DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES and MORRIS COUNTY OFFICE OF TEMPORARY ASSISTANCE, Respondents-Respondents.

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Submitted April 8, 2024

– Decided April 19, 2024 Before Judges Sabatino and Vinci. On appeal from the New Jersey Department of Human Services , Division of Medical Assistance and Health Services. Mandelbaum Barrett, PC, attorneys for appellant (Richard I. Miller, of counsel and on the briefs ; Donald A. Dennison III , on the briefs). Matthew J. Platkin, Attorney General, attorney for respondent New Jersey Department of Human Services,

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court. " Although it is posted on the internet, this opinion is binding only on the parti es in the case and its use in other cases is limite d. R. 1:36- 3.2 A- 3838

- 21 Division of Medical Assistance and Health Services (Melissa H. Raksa, Assistant Attorney General, of counsel; Francis Xavier Baker, Deputy Attorney General, on the brief). John A. Napolitano, Morris County Counsel, and Johnson & Johnson, attorneys for respondent Morris County Office of Temporary Assistance (John A. Napolitano and William George Johnson, on the brief ).
PER CURIAM Petitioner R.R. appeals from the June 14, 2022 fina l agency decision of the New Jersey Department of Human Services, Division of Medical Assistance and Health Services ("Division") denying his applic ation for retroactive Medicaid benefits for June, July, and August 2021. Based on our review of the record and applicable legal standards, we affirm. Petitioner, now deceased, suffered from dementia an d resided in a nursing facility. On March 10, 2021, he was adjudicated an incapacitated person, and a guardian of the estate was appointed. On April 7, 2021, letters of guardianship were issued. Petitioner's guardian investigated his assets, which included a Toyota Landcruiser and a Chevrolet Corvette. The g uardian asked petitioner's wife, who was appointed as guardian of R.R.'s perso n, to search for both vehicle titles. The titles were not located.3 A- 3838

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On June 28, 2021, the guardian obtained a duplicate title for the Toyota from the New Jersey Motor Ve hicle Commission ("MVC"). On July 12, 2021, petitioner, through his guardian, applied for Medic aid benefits with the Morris County Department of Human Services, Office of Temp orary Assistance ("OTA"), requesting retroactive eligibility as of J une 1, 2021. Petitioner disclosed his ownership of both vehicles on the application. On July 28, 2021, the OTA issued a letter confirming receipt of the Medicaid application and requesting further informa tion and documentation. It noted Medicaid regulations allow an exemption for one car but advised it "must consider the value of one car to be a countable res ource until it is sold." On August 9, 2021, the guardian sold the Toyota for $6 ,000, and spent down the proceeds to meet Medicaid eligibility standards. On December 9, 2021, the OTA issued a second letter requesting further information and documentation to determine petition er 's eligibility for Medicaid. It also advised that his "second car ," the Toyota , was countable as an available resource. It reasoned becaus e the funds from the sale of the Toyota were deposited into petitioner's bank account on Au gust 9, 2021, "the earliest eligibility [the OTA] can consider would be [Septem ber 1, 2021,] upon4 A- 3838

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confirmation that [petitioner] was otherwise eligib le at that time." On January 4, 2022, R.R. died. On January 10, 2022, the OTA issued a third letter, requesting the same information and documentation requested in its prev ious letter, again noting it considered the Toyota a countable resource. By letter dated January 31, 2022, the OTA determined petitioner was eligible for Medicaid ef fective October 5,
2021 . According to the OTA , petitioner would have been eligible effective September 1, 2021, but it imposed a penalty period of ineligibility of thirty-fourdays for transferring resources. 1 The same day, the OTA issued a corresponding Retroactive Notice of Eligibility, denying petition er 's request for retroactive Medicaid benefits for June, July, and August 2021 , because petitioner's resources exceeded the $2,000 maximum for Medicaid eligibility set forth in N.J.A.C. 10:71-4.5(c) during those months. Petitioner requested a Fair Hearing to appeal the OTA 's decision, and the Division transmitted the matter to the Office of Administra tive Law. On April 21, 2022, an administrative law judge ("ALJ") condu cted a telephonic hearing, during which petitioner's guardian and Maira Rogers , the OTA caseworker , testified.

1 Petitioner does not dispute the penalty and it is not a subject of this appeal.5 A- 3838

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Petitioner 's guardian testified he was the only person with the legal right and authority to sell the vehicles, but he was not able to locate the original title s to the vehicles, and without the titles he was not able to sell the vehicles. He testified, "after [he] got appointed as the guardia n of the property[,] [he] made an effort to obtain a replacement title so that . . . the cars . . . could be sold because . . . [he] was aware that the property needed to be sold in order to spend down and qualify for Medicaid." The guardian continued:

So, I visited the [MVC] in order to get a replaceme nt title. And I did that on June 28, 2021 . . . . And then first I needed to make an appointment [be]cause everything was by appointment only at that point. And I was able to receive the title to the Toyota in pe rson on June 28 [] . . . at my visit to . . . [the MVC]. According to Rogers, Medicaid regulations exempt o ne vehicle from being counted as an available resource, but any add itional vehicles are countable as available resources. T he OTA determined the Toyota was petitioner's second vehicle and counted toward his available resources. According to Rogers, but for the Toyota petitioner would have been eligible for Medicaid benefits effective June 1, 2021. On April 29, 2022, the ALJ issued an initial decision affirm ing the OTA 's denial of petitioner's application for retroactive Medicaid benef its . The ALJ concluded th e Toyota was countable as an available resource val ued at $6,000.6 A- 3838

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Because petitioner had available resources in exces s of $2,000 in June, July, and August 2021 , he was ineligible for benefits during those months. She found petitioner, through his guardian, "did have the rig ht, power[,] and authority to liquidate [the] [Toyota] during the three months predatin g eligibility" and "only had to request a duplicate title from the MVC in or der to do so." She reasoned: [t]he car was a nonliquid resource owned by [petitioner] at the time, and while this resource m ay not have been available to him when he was adjudicated mentally incapacitated in March 2021, it remained a n available resource as [the guardian] became [petitioner 's ] [g]uardian at that time. While the [g]uardian may not have been legally authorized to sell the [Toyota] without the title, his inability to lo cate the title of the car alone does not render the resource unavailable. The ALJ also noted al though the guardian "testified that he and [petitioner's wife ] looked for the title, there is nothing in the recor d to suggest that the [g]uardian was unable to present to the [M VC] for a duplicate title months prior to August 2021." On June 14, 2022, the Division issued a final agenc y decision adopting the ALJ's initial decision. The Division determine d petitioner, through his guardian, "had the right, power[,] and authority to liquidate [the Toyota] during the months of eligibility, whether because he merel y had to request a duplicate7 A- 3838

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title or because he in fact held one." Because the guardian obtained the Toyota's duplicate title on June 28, 2021, the Division reas oned he "certainly had the power to liquidate the [Toyota] at least as early a s June 2021." It further noted al though "the ALJ found that [the guardian] credibly testif ied to his efforts" to obtain the duplicate title, "there is no documentat ion in the record to support his testimony or provide a timeline of his attempts to obtain a duplicate title." As a result, the Division determined petitioner "had cou ntable resources in excess of the $2,000 limit for June, July [,] and August 2021" and "there is simply no provision [in the Medicaid regulations] which permi ts a relaxation of the eligibility date so long as the countable resources exceed the maximum limit."
On appeal , petitioner argues: (1) his available resources fel l below the $2,000 resource cap for Medicaid eligibility as of June 1, 2021; and (2) the Division's decision was arbitrary and capricious because it did not fairly and predictably apply the regulations. More particularly, petitioner argues the guardian could not sell the Toyota until he had the duplicate title , and he did not obtain the title from the MVC until June 28, 2021. Therefore, the Division's determination that he had the legal right , authority, or power to sell the Toyota prior to June 1, 2021, was arbitrary, capricious, a nd unreasonable.8 A- 3838

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"This court's review of [the Division's] determinat ion is ordinarily limited." C.L. v. Div. of Med. Assistance & Health Servs., 473 N.J. Super. 591, 597 (App. Div. 2022). "An administrative agency's deci sion will be upheld 'unless there is a clear showing that it is arbitra ry, capricious, or unreasonable, or that it lacks fair support in the record.'" R.S . v. Div. of Med. Assistance & Health Servs., 434 N.J. Super. 250, 261 (App. Div. 2014) (q uoting Russo v. Bd. of Trs., Police & Firemen's Ret. Sys., 206 N.J. 14, 27 (2011)). "The burden of demonstrating that the agency's action was arbitrar y, capricious or unreasonable rests upon the [party] challenging the administrati ve action." E.S. v. Div. of Med. Assistance & Health Servs., 412 N.J. Super. 34 0, 349 (App. Div. 2010) (alteration in original) (quoting In re Arenas, 385 N.J. Super. 440, 443- 44 (App. Div. 2006)). "Deference to an agency decision is particularly ap propriate where interpretation of the [a]gency's own regulation is in issue." I.L. v. N.J. Dep't Hum. Servs., Div. of Med. Assistance & Health Servs ., 389 N.J. Super. 354, 364 (App. Div. 2006). "Nevertheless, we are 'in no way bound by the agency's interpretation of a statute or its determination of a strictly legal issue.'" C.L. , 473 N.J. Super. at 598 (quoting R.S., 434 N.J. Supe r. at 261).9 A- 3838

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"Medicaid is a federally-created, state-implemented program that provides ‘medical assistance to the poor at the exp ense of the public. '" In re Est. of Brown, 448 N.J. Super. 252, 256 (App. Div. 2017) (quoting Est . of DeMartino v. Div. of Med. Assistance & Health Servs., 373 N.J . Super. 210, 217 (App. Div. 2004)); see also 42 U.S.C. § 1396-1. To receive f ederal funding, the State must comply with all federal statutes and regulations. Harris v. McRae, 448 U.S. 297,
301 (1980). In New Jersey, the Medicaid program is administered by the Division pursuant to the New Jersey Medical Assistance and H ealth Services Act, N.J.S.A. 30:4D-1 to -19.5. Through its regulations , the Division establishes “policy and procedures for the application process

. . . . ” N.J.A.C. 10:71-2.2(b). “[T]o be financially eligible, the applicant must m eet both income and resource standards.” Brown, 448 N.J. Super. at 257; see N.J.A.C. 10:71- 3.15; N.J.A.C.
10:71 -1.2(a). To be financially eligible for Medicaid, an applica nt 's total countable resources cannot exceed $2,000. N.J.A.C. 10 :71 -4.5(c). A resource is "any real or personal property which is owned by the applican t [] or by those persons whose resources are deemed available to him or her . . . and which could be converted to cash to be used for his or her support and maintenance." N.J.A.C.10 A- 3838

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10:71 -4.1(b). Only "available" resources are counted in determining eligibility. N.J.A.C. 10:71-4.1(c). A resource is considered "available" to an applicant if "[t]he person has the right, authority or power to liquidate real or personal property or his or her share of it." N.J.A.C. 10:71 -4.1(c)(1). Certain resources are classified as excludable in d etermining eligibility. N.J.A.C. 10:71-4.4(b). For example, "[o]ne automob ile is totally excluded regardless of value if it is used for transportation for the individual or a member of the individual's household." N.J.A.C. 10:71-4.4 (b)(2)(i). "Any other automobiles shall be considered to be non-liquid re sources." N.J.A.C. 10:71- 4.4(b)(2)(ii). Resources "which are not accessible to an individua l through no fault of his or her own" are also excluded from the eligibility determination. N.J.A.C. 10:71-4.4(b)(6). "Resource eligibility is determined as of the first moment of the first day of each month." N.J.A.C. 1 0:71-4.1(e). We are satisfied the Divi si on's decision is amply supported by the record and wa s not arbitrary, capricious, or unreasonable. Peti tioner's contention that his guardian did not have the legal right, power, o r authority to sell the Toyota because he could not locate the original title is n ot convincing. As the Division concluded, the guardian had the legal authority and power to obtain a duplicate11 A- 3838

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title and sell the Toyota upon his appointment as g uardian on March 10, 2021. 2 Petitioner does not offer any explanation for the g uardian's delay in obtaining the duplicate title and, as the Division noted, fai led to proffer any evidence to establish a "timeline of his attempts to obtain a d uplicate title ." As the Division properly concluded, the Toyota was personal propert y that could have been sold "at least as early as June 2021, " but was not sold because petitioner, through his guardian, did not take the first step necessary to effectuate the sale until June 28, 2021. There is no evidence in the record to support petitioner's contention that a duplicate title coul d not be obtained before June 28, 2021, nor is there any evidence to support peti tioner's contention that the delay was "through no fault of [his own]." Even if, as petitioner contends, he could only obtain the duplicate title from the MVC by appointment, he offers no explanation as to why he did not make an appointment before June 28, 2021. Petitioner failed to meet his burden to demonstrate the Division's determination was arbitrary, capricious, or unreasonable. Petitioner's contention that the Division's decision violates "the spirit of" our Supreme Court's decision in

2 The guardian had the authority and power to obtain a duplicate title, at the latest, as of April 7, 2021, when the letters of gu ardianship were issued.12 A- 3838

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Metromedia, Inc. v. Director, Division of Taxation, 97 N.J. 313, 327 (1984), lacks merit for the same reasons. The Division's decision is supported by sufficient credible evidence on the record as a whole. R. 2:11 -3(e)(1)(D). To the extent we have not otherwise addressed petitioner's arguments, they are without sufficient merit to warrant discussion in a written opinion. R. 2:11 -3(e)(1)(E). Affirmed.