IN THE COURT OF APPEALS OF TENNESSEE

AT JACKSON

Assigned On Briefs October 8, 2012 Session

IN THE MATTER OF: CHASE B.S., ET AL.

Direct Appeal from the Juvenile Court for Shelby County

No. X6145, X0784, X1494 and X1512 Curtis S. Person, Jr., Judge

No. W2011-02334-COA-R3-JV - Filed November 30, 2012

The trial court dismissed “petitions for medical support” of non-marital children filed by the

Department of Human Services asinconsistent with the child supportstatutes and guidelines.

We affirm.

Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Juvenile Court Affirmed

and Remanded

DAVID R. FARMER,J., delivered the opinion of the Court, in which HOLLY M. KIRBY,J., and

J. STEVEN STAFFORD, J., joined.

Robert E. Cooper, Jr., Attorney General and Reporter, William E. Young, Solicitor General

and Warren Jasper, Senior Counsel, for the appellant, State of Tennessee Department of

Human Services.

OPINION

This appeal arises from four petitions for medical support filed in the Juvenile Court

for Shelby County by the Department of Human Services (“DHS”) on behalf of four mothers

of non-marital children (“Mothers”) against the children’s fathers (“Fathers”). In each of the

petitions, DHS alleged Respondent Father owed a duty of support to a minor child, that the

minor child was in the care or custody of Petitioner Mother, and that Mother “hereby makes

application for medial support assistance pursuant to Title IV-D of the Social Security Act

and 42 U.S.C.A. § 1396k.” DHS prayed the court to “establish medical support of said

children pursuant to 42 U.S.C.A. § 1396k.” DHS did not pray for additional child support,

nor did it assert that prior support orders had been made by the court. Following hearings

before the magistrate, the magistrate dismissed the petitions. DHS requested a hearing of

each matter before the juvenile court judge, which conducted a consolidated hearing on

August 9, 2011. The trial court determined that it could not “parse” medical support from
child support, and that medical support could be awarded only in the context of child support

under the guidelines. It found that DHS has not prayed for child support, that no child

support worksheet had been entered in three of the four matters, and that it could not hear the

matter of child support absent the statutorily required notice to Fathers. The trial court

accordingly dismissed the petitions, and DHS filed notices of appeal to this Court.

Issue Presented

DHS presents the following issue for our review:

Whether the Shelby County Juvenile Court abused its discretion when it found

in these four consolidated matters that it must have the ability to set child

support before it may determine medical support.

Discussion

The issue presented by this lawsuit, as we perceive it, is whether, in a Title IV-D

action for support, the trial court may order “medical support only” without proof of the

Defendant Father’s income and without evidence to support a deviation from the child

support guidelines. DHS asserts that an action seeking only medical support for non-marital

children is permitted to effectuate its responsibility under 42 U.S.C.A. § 654 and Tennessee

Code Annotated § 71-5-115 and in light of the assignment of rights provided in section 71-5-

117. Although it cites no case law in its brief to support its contention that an action for

medical support of a child is distinct from an action for child support and, therefore, not

subject to the child support guidelines, in the trial court DHS asserted that its position was

supported by our holding in Corbin v. Corbin, No. W2008-00437-COA-R3-CV, 2009 WL

454134 (Tenn. Ct. App. Feb. 24, 2009). The trial court, on the other hand, determined that

it could not deviate from the child support guidelines to set “medical support only” without

considering the statutory factors and the requisites of the child support guidelines. We agree

with the trial court.

As initial matters, we note that the petitions filed in this case were not petitions to

modify child support, that no prior child support orders had been entered in the matters, and

that no orders of parentage had been entered in accordance with Tennessee Code Annotated

§ 36-2-311. The parents of the children for whom DHS sought medical support were not

1

and had never been married and apparently were not living together. Further,

notwithstanding DHS’s contention in its brief that it “will not always have authority under

It does not appear, from the record transmitted to this Court, that paternity was disputed in the four

1

actions.

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Title XIX to seek a support award . . . because these matters do not always fall under Title

IV-D granting the Department authority to seek child support on behalf of a custodial

parent[,]” it is not disputed that the petitions in these matters were filed pursuant to the

authority granted under Title IV-D of the Social Security Act. Accordingly, future

hypothetical actions which may not be encompassed by Title IV-D are not before us.

The provisions of Title 71 of the Tennessee Code also are not disputed in this case.

As DHS asserts, Title 71 authorizes the State to seek reimbursement from responsible parties

for medical assistance benefits. Tennessee Code Annotated § 71-5-115(2012) provides:

To the extent permitted by federal law, the department may require or permit

that responsible parties of a recipient of medical assistance supplement or

reimburse for any benefit or benefits rendered to the recipient pursuant to the

part.

Tennessee Code Annotated § 71-5-117 permits DHS to recover medical assistance provided

to a recipient from a responsible party. The section provides, in pertinent part:

(b) Upon accepting medical assistance, the recipient shall be deemed

to have made an assignment to the state of the right of third party insurance

benefits to which the recipient may be entitled. Failure of the recipient to

reimburse the state for medical assistance received from any third party

insurance benefits received as a result of the illness or injury from which the

medical assistance was paid may be grounds for removing the recipient from

future participation in the benefits available under this part; provided, that any

removal from participation shall be after appropriate advance notice to the

recipient and that the provider of service shall not be prevented from receiving

payment from the state for medical assistance services previously furnished the

recipient, and that nothing in this subsection (b) shall require an insurer to pay

benefits to the state that have already been paid to the recipient.

. . . .

(d)(1) To the extent necessary to reimburse the department for

expenditures for its costs for services provided for any child eligible for

medical services under Title XIX of the federal Social Security Act, compiled

in 42 U.S.C. § 1396 et seq., the department shall have a right of action against,

and shall be permitted to garnish the wages, salary, or other employment

income of, any person who:

(A) Is required by a court or administrative order to

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provide coverage of the costs of health services to a child who

is eligible for medical assistance under Title XIX of the federal

Social Security Act;

(B) Has received payment from a third party for the costs

of such services provided to such child; and

(C) Has not used such payments from the third party to

reimburse, as appropriate, either the other parent or guardian of

such child or the provider of such services.

(2) The claims by the department for the costs of such services shall be

subordinate to any claims for current or past-due child support.

Tenn. Code Ann. § 71-5-117(b)&(d)(2012)(emphasis added).

2

In its brief, DHS relies on these provisions of Title 71 and on 42 U.S.C.A. § 654 for

the proposition that it may assert its right to recover benefits in an action for support that does

not seek child support. Its argument, as we understand it, is that 42 U.S.C.A. § 654 provides

that the State must provide services relating to the enforcement of child support obligations

as appropriate, and in these cases, because the State was providing only medical assistance,

an action seeking medical support only, and not child support, is appropriate. We disagree.

42 U.S.C.A. § 1396k provides for the “assignment, enforcement, and collection of

rights of payments for medical care[.]” It states:

(a) For the purpose of assisting in the collection of medical support payments

and other payments for medical care owed to recipients of medical assistance

under the State plan approved under this subchapter, a State plan for medical

assistance shall--

(1) provide that, as a condition of eligibility for medical

assistance under the State plan to an individual who has the legal

capacity to execute an assignment for himself, the individual is

required--

(A) to assign the State any rights, of the individual

or of any other person who is eligible for medical

Formerly Tennessee Code Annotated § 71-5-117(e). We note that, in the 2012 bound replacement 2

volume 12B containing Title 71, former subsection 117(e) is contained at 117(d), and former subsection

117(d) is contained at 117(c). Former subsection 117(c) was deleted by 2010 Pub.Acts c. 776, § 1, effective

January 1, 2011. We observe that the version of the Code currently available on Westlaw does not reflect

the alterations made in the bound volume. 

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assistance under this subchapter and on whose behalf the

individual has the legal authority to execute an

assignment of such rights, to support (specified as

support for the purpose of medical care by a court or

administrative order) and to payment for medical care

from any third party;

(B) to cooperate with the State (i) in establishing

the paternity of such person (referred to in subparagraph

(A)) if the person is a child born out of wedlock, and (ii)

in obtaining support and payments (described in

subparagraph (A)) for himself and for such person,

unless (in either case) the individual is described in

section 1396a(l)(1)(A) of this title or the individual is

found to have good cause for refusing to cooperate as

determined by the State agency in accordance with

standards prescribed by the Secretary, which standards

shall take into consideration the best interests of the

individuals involved; and

(C) to cooperate with the State in identifying, and

providing information to assist the State in pursuing, any

third party who may be liable to pay for care and services

available under the plan, unless such individual has good

cause for refusing to cooperate as determined by the

State agency in accordance with standards prescribed by

the Secretary, which standards shall take into

consideration the best interests of the individuals

involved; and

(2) provide for entering into cooperative arrangements

(including financial arrangements), with any appropriate agency

of any State (including, with respect to the enforcement and

collection of rights of payment for medical care by or through a

parent, with a State's agency established or designated under

section 654(3) of this title) and with appropriate courts and law

enforcement officials, to assist the agency or agencies

administering the State plan with respect to (A) the enforcement

and collection of rights to support or payment assigned under

this section and (B) any other matters of common concern.

(b) Such part of any amount collected by the State under an assignment

made under the provisions of this section shall be retained by the State as is

necessary to reimburse it for medical assistance payments made on behalf of

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an individual with respect to whom such assignment was executed (with

appropriate reimbursement of the Federal Government to the extent of its

participation in the financing of such medical assistance), and the remainder

of such amount collected shall be paid to such individual.

42 U.S.C.A. § 654 provides, in relevant part, that a state plan for child support must

provide that the State will provide services relating to establishing paternity or child support

with respect to each child for whom medical assistance is provided under subchapter XIX

of the chapter. 42 U.S.C.A. § 654 It states, in relevant part:

A State plan for child and spousal support must - -

(1) provide that it shall be in effect in all political subdivisions of the State;

(2) provide for financial participation by the State;

(3) provide for the establishment or designation of a single and separate

organizational unit, which meetssuch staffing and organizational requirements

as the Secretary may by regulation prescribe, within the State to administer the

plan;

(4) provide that the State will--

(A) provide services relating to the establishment of

paternity or the establishment, modification, or enforcement of

child support obligations, as appropriate, under the plan with

respect to--

(i) each child for whom (I) assistance is provided

under the State program funded under part A of this

subchapter, (II) benefits or services for foster care

maintenance are provided under the State program

funded under part E of this subchapter, (III) medical

assistance is provided under the State plan approved

under subchapter XIX of this chapter, or (IV)

cooperation is required pursuant to section 2015(l)(1) of

Title 7, unless, in accordance with paragraph (29), good

cause or other exceptions exist;

(ii) any other child, if an individual applies

for such services with respect to the child; and

(B) enforce any support obligation established with

respect to--

(i) a child with respect to whom the State

provides services under the plan; or

(ii) the custodial parent of such a child;

(5) provide that (A) in any case in which support payments are collected for an

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individual with respect to whom an assignment pursuant to section 608(a)(3)

of this title is effective, such payments shall be made to the State for

distribution pursuant to section 657 of this title and shall not be paid directly

to the family, and the individual will be notified on a monthly basis (or on a

quarterly basis for so long as the Secretary determines with respect to a State

that requiring such notice on a monthly basis would impose an unreasonable

administrative burden) of the amount of the support payments collected, and

(B) in any case in which support payments are collected for an individual

pursuant to the assignment made under section 1396k of this title, such

payments shall be made to the State for distribution pursuant to section 1396k

of this title, except that this clause shall not apply to such payments for any

month after the month in which the individual ceases to be eligible for medical

assistance[.]

42 U.S.C.A. § 652(f) provides:

The Secretary shall issue regulations to require that State agencies

administering the child support enforcement program under this part enforce

medical support included as part of a child support order whenever health care

coverage is available to the noncustodial parent at a reasonable cost. A State

agency administering the program under this part may enforce medicalsupport

against a custodial parent if health care coverage is available to the custodial

parent at a reasonable cost, notwithstanding any other provision of this part.

Such regulation shall also provide for improved information exchange between

such State agencies and the State agencies administering the State medicaid

programs under subchapter XIX of this chapter with respect to the availability

of health insurance coverage. For purposes of this part, the term “medical

support” may include health care coverage, such as coverage under a health

insurance plan (including payment of costs of premiums, co-payments, and

deductibles) and payment for medical expenses incurred on behalf of a child.

In its brief to this Court, DHS acknowledges that the actions filed in the trial court

were filed as child support enforcementservices pursuant to Title IV-D of the Social Security

Act, 42 U.S.C. § 1396k, and Tennessee Code Annotated § 71-3-124. Section 71-3-124

provides:

(a)(1) Each applicant or recipient who receives or authorizes payment of public

or temporary assistance pursuant to Title IV-A or IV-E of the Social Security

Act, compiled in 42 U.S.C. § 601 et seq. And 42 U.S.C. § 670 et seq.,

respectively, or any successor program providing temporary assistance or

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foster care or adoption assistance shall be deemed to have assigned to the state

any rights to support from any other person such applicant or recipient may

have:

(A) In the applicant's own behalf or in behalf of any other family

member for whom the applicant is applying for or receiving aid; and

(B) That have accrued at the time such assignment is executed.

(2) Each paymentshall constitute “receipt” for purposes of determining

when the assignment is executed.

(3) During the terms of such assignment, the department shall be

subrogated to the rights of the child or children or the person having custody

to collect and receive all child support payments.

(4) The department has the right to initiate any support action in its own

name or in the name of the recipient under existing laws of this state and to

recover any payments ordered by the courts of this or any other state.

(5) In the exercise of its subrogation rights, the department shall give

the person having custody prior notice of any action taken to enforce or modify

support and shall inform the custodian of the right to intervene to protect any

future interest; provided, that failure to provide such notice shall not be a

defense to the obligor in any proceeding.

(6)(A) Notwithstanding any other provision of law to the contrary,

neither the department of human services, nor any Title IV-D child support

contractor of the department, nor any recipient of public assistance in this or

any other state or territory, shall be required to demonstrate to a court or

administrative tribunal in this state that the caretaker of the child for whom

child support is sought is vested with any more than physical custody of the

child or children in order to have standing to petition for child support from the

legal parent of the child or children for whom support is sought, or to seek

enforcement or modification of any existing orders involving such child or

children.

(B) Legal custody of a child to whom a child support obligation is owed

shall not be a prerequisite to the initiation of any support action or to the

enforcement or modification of any support obligation, whether or not the

obligation has been assigned to this state or any other state or territory by

operation of law.

(b) The department shall certify to the clerks of the appropriate state

courts that an assignment of any and all rights, title and interest in support

rights has been made to this state by a public assistance or temporary

assistance recipient of this state. The department may also, in its discretion,

certify to the clerk of the appropriate court in this state that a recipient of

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public assistance or temporary assistance in another state has assigned support

rights to that state pursuant to federal law. Upon receipt of this certification,

the clerks of the appropriate state courts shall transmit support payments that

they receive on behalf of such public assistance or temporary assistance

recipient. The clerk shall transmit the amount directly to the agency specified

by the department in accordance with § 36-5-101. The clerks are to identify

these payments by the names of the parties involved in the cause of action and

by the docket number of the cause of action. These support payments shall be

transmitted to the department or the specified agency continuously until the

department notifies the clerks of the appropriate state courts that it is no longer

necessary to do so. The department shall send to each recipient notice of

payments received in such recipient's behalf quarterly.

(c)(1) Upon the filing of an application by an individual not otherwise

eligible for support services under this section, the department may initiate

support actions for an individual, in accordance with the provisions of Title

IV-D of the Social Security Act, compiled in 42 U.S.C. § 652 et seq., as

amended.

(2) The department or any entity, public or private, that contracts with

the department to establish paternity or to establish, modify or enforce child

or spousal support pursuant to the provisions of Title IV-D of the Social

Security Act shall have authority and standing to file any legal actions to

establish paternity or to establish, modify or enforce child or spousal support

in any judicial or administrative proceeding on behalf of the department and

the state for persons who have assigned rights of support to the department

pursuant to this section, or who have otherwise applied for child or spousal

support services pursuant to the provisions of subdivision (c)(1) or Title IV-D

of the Social Security Act. The department or its contractors may file such

legal actions without the necessity of intervening in an existing action or

naming the state as a party to the action. The department or its contractors shall

not be required to provide proof that the obligor, the obligee or the child has

applied for or is receiving Title IV-D child support services in order to meet

the requirements for conducting Title IV-D child support judicial or

administrative actions.

(d) The provision of services under a child support enforcement

program that includes services by an attorney or an attorney's representative

employed by, under contract to, or representing the department shall not create

an attorney-client relationship with any party other than the state. Attorneys

employed by or under contract to the departmentshall have an affirmative duty

to notify individuals applying for child support services or temporary

assistance for needy families (TANF) recipients or recipients of any successor

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program providing temporary assistance whose rights to support have been

assigned, who contact or are contacted by the attorney or other child support enforcement

program staff that any legal services provided by the child support enforcement program are

solely on behalf of the state, and that no incidents of the lawyer-client relationship, including

the confidentiality of lawyer-client communications, exist between the attorney and the

applicant or recipient. No such duty shall exist when the applicant for services is another

governmental agency acting on behalf of an individual and there is no direct contact between

the child support enforcement program and the individual seeking support.

(e)(1) As a condition of eligibility for consideration of the caretaker

relative in the request for assistance under the TANF program or any successor

program providing temporary assistance, each applicant for or recipient of

benefits under this program shall cooperate, unless good cause not to cooperate

is shown to exist in accordance with 45 Code of Federal Regulations, Sections

232.40 through 232.49 as they may be amended, with the department and its

Title IV-D contractors in:

(A) Identifying and locating the parent of a child for

whom aid is claimed;

(B) Establishing the paternity of a child born out of

wedlock for whom aid is claimed;

(C) Obtaining support payments for the applicant or

recipient and for a child for whom aid is claimed; and

(D) Obtaining any other payments or property due the

applicant or recipient of the child.

(2) Cooperation with the department and its Title IV-D contractorsshall

be defined by the department in rules that are consistent with federal

regulations.

(3) If a caretaker relative fails to cooperate with the department or its

Title IV-D contractors under subdivision (e)(1), the department shall,

consistent with federal regulations, deny assistance to that caretaker relative

of a child or children who are otherwise eligible for TANF or any successor

program providing temporary assistance and it shall, consistent with federal

regulations, provide assistance to the eligible child in the form of a protective

payment, but such assistance will be determined without regard to the needs

of the caretaker relative.

(4) The commissioner shall promulgate rules to carry out this section.

Tenn. Code Ann. § 71-3-124 (2012).

Reading the statutes together as a whole, we agree with the trial court that the cause

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of action through which DHS seeks to assert its right to reimbursement is, simply, an action

for child support and that, as such, the action is governed by the child support statutes and

guidelines. DHS’s argument in the trial court was somewhat unclear. On one hand, it

asserted that medical support is not child support and, therefore, the child support guidelines

were not applicable. On the other hand, it asserted that child support may consist of medical

support only and may be ordered without application of the guidelines. The statutory scheme

outlined above, however, gives DHS the authority to bring a support action seeking child

support for the benefit of a non-marital child, and permits it to recover assistance benefits

paid by the State. The Title IV-D action is not merely an action to recover benefits, but to

establish a duty of support in the first instance. The current actions are child support actions

in which DHS attempts to waive the Mothers’ right to all support other than medical support,

and in which DHS seeks to simply ignore the child support guidelines. DHS effectively

asserts that Tennessee Code Annotated 71-5-115 & 117 permits the trial court to enter child

support orders limited to the recoupment of State-provided benefits. We disagree.

Considered together, the statutes of Tennessee “impose a duty on trial courtsto protect

the best interests of children.” Tuetken v. Tuetken, 320 S.W.3d 262, 271 (Tenn. 2010). This

duty “comports with the long-standing notion that the state stands in parens patriae of the

minor children within its borders.” Id. Parties may not relieve a trial court of the duty to

ensure that disputes are resolved in the best interests of the child. Id. at 272. Thus, for

example, parents may not enter into private child support agreements that circumvent the

child support obligations imposed by the statutes. Id. (citing Berryhill v. Rhodes, 21 S.W.3d

188, 192 (Tenn. 2000)). Parents also cannot bind the court on matters of child support by

submitting the matter to an arbitrator. Id.

It is well-settled that the child support guidelines govern both the process and criteria

for determining a parent’s child support obligation. E.g., Reeder v. Reeder, 375 S.W.3d 268,

275 (Tenn. Ct. App. 2012)(citation omitted). The amount of support that is determined by

a correct application of the formula contained in the guidelines is the presumptive child

support amount. Id. Although the presumptive support amount is rebuttable and the trial

court may, in its discretion, deviate from the guidelines, any deviation must be supported by

specific written findings stating why application of the guidelines would be unjust or

inappropriate. Id. The trial court’s discretionary decision to deviate from the child support

guidelines must nevertheless “take into consideration the applicable law and the relevant

facts.” Id. (citing Ballard v. Herzke, 924 S.W.2d 652, 661 (Tenn. 1996)).

In the current case, DHS petitioned the trial court for orders of support that deviated

from the child support guidelines and that considered neither the applicable law nor the

relevant facts. The trial court determined that it could not set “medical support only” without

reference to the child support guidelines. We review a trial court’s decision with respect to

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whether a deviation from the child support guidelines is warranted under an abuse of

discretion standard, and will uphold the trial court’s determination if the trial court has

applied the correct legal standard and its decision is not clearly unreasonable. Id. Having

determined that the trial court applied the correct legal standard in this case, we find no abuse

of discretion on the part of the trial court.

Holding

In light of the foregoing, we affirm the judgment of the trial court. This matter is

remanded to the trial court for the collection of costs. Costs on appeal are taxed to the

Appellant, the State of Tennessee Department of Human Services.

_________________________________

DAVID R. FARMER, JUDGE

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