Opinion ID: 2209974
Heading Depth: 3
Heading Rank: 1

Heading: Existence of administrative remedy.

Text: In addressing the existence of an administrative remedy for the claimed wrong, it is important to consider the relief sought. This first prong does not apply if the relief sought is not within the jurisdiction of the agency. See Aschan, 446 N.W.2d at 793. The county did not ask for judicial review but sought declaratory relief. However, the label attached to a petition is not determinative. See Kelly v. Nix, 329 N.W.2d 287, 290 (Iowa 1983). Although a portion of the petition sought confidential records from H.B., the county freely acknowledged the gist of the action was to obtain the declaration that H.B. was not mentally retarded. It also admitted the declaration was sought to declare H.B. ineligible for the waiver program. Federal law authorizing state participation in Title XIX programs require eligibility determinations to be made by a single state agency. See 42 U.S.C. § 1396A(a)(5). Under our governing statutes and rules, the Iowa DHS is the agency authorized to make eligibility determinations under federal/state Title XIX programs, including the HCBSMR waiver program. See Iowa Code § 249A.12; Iowa Admin. Code r. 44183.61 (1999). In turn, the DHS is authorized to obtain assistance in making eligibility determinations for the waiver program. See Bunger v. Iowa High Sch. Athletic Ass'n, 197 N.W.2d 555, 560 (Iowa 1972); Iowa Admin. Code r. 44183.61. The Iowa Foundation for Medical Care (IFMC) is the organization that assists the DHS in qualifying individuals for the program. Clearly, the gist of the relief sought by the county in its petition was within the jurisdiction of the DHS. Moreover, procedures exist for the review and appeal to the DHS director of the level of care decisions made by IFMC. See Iowa Admin. Code rs. 44183.69, 4417.5(1), (2). Any aggrieved person is permitted to appeal. Id. Notwithstanding, the county argues it is also authorized to determine eligibility for mental health services. It claims this authority establishes an independent basis for seeking relief to the district court. Our legislature has established a single entry point process for counties to coordinate delivery of mental health services which it funds. Iowa Code § 331.440. This process includes reviewing eligibility for services, determining the type, level, and duration of services, and reviewing a person's continuing eligibility and need for services. Id. § 331.440(1)(a). Additionally, a county, at its expense, may require a person to be professionally diagnosed to determine if the person is mentally retarded and be evaluated to determine the needed level of care. Id. § 222.60. Although the legislature has authorized counties to make decisions affecting the delivery of mental health services, the lawsuit initiated by Keokuk County does not implicate this authority. This is not a case involving a dispute over a delivery-of-service decision made by a county in a single entry point process. The county never made a level-of-care determination for H.B. Instead, it turned to the courts to challenge a decision made by the DHS. We conclude the gist of the relief sought by the county was within the jurisdiction of the DHS. Moreover, although the legislature contemplated cooperation between counties and the DHS in the delivery of mental health services, the eligibility determination for the waiver program remains with the DHS.