Court Opinion

ID: 9863794
Source: CourtListenerOpinion
Date Created: 2023-09-25 05:54:05.159021+00
Date Added: 2024-06-11T12:04:19.479128
License: Public Domain

BISTLINE, Justice,
dissenting.
The Haymans had applied for and received public assistance at various times since 1959. They had received old age assistance and medical assistance and food stamps from November 1, 1975, until these benefits were terminated on June 14, 1976. The reason given for the termination was that an increase of 6.4% in their federal Social Security benefits on July 1, 1976, raised their income above that established by the Department for welfare eligibility. According to the Department, $255.80 of the Haymans’ income counted as “income” for eligibility. After considering the Hay-mans’ living expenses, which did not include medical expenses, the Department determined that the maximum eligibility income for the Haymans would be $234.50. Their income exceeded this figure by $21.30, and since they no longer had a “budget deficit” they were not eligible to receive the above grants.
The Haymans appealed the decision, and a hearing was held on August 13, 1976. The hearing officer for the Department concluded that the Haymans were medically needy, but because they no longer had a “budget deficit,” he affirmed the decision that they were not eligible for assistance.
The Haymans appealed the decision to the district court. In reversing the decision of the hearing officer the district court found: Haymans had a medical need of $210.00 per month, a total monthly need of $444.50, and an income of only $311.90. The court also found that the Department was arbitrary, capricious and unreasonable in omitting medical needs when determining the assistance required for a subsistence compatible with the individual’s health and well being. The Department was dissatisfied and took the case on into this Court.
The underlying issue on appeal1 is whether the Department acted in an arbitrary, capricious and unreasonable manner in its failure to consider medical needs in determining the eligibility of a party to receive public assistance benefits pursuant to Title 56, Chapter 2, I.C. In addressing this question, the trial judge stated:
“From time to time throughout man’s social evolution, society has perceived various duties of the individual to society, and obligations of society to the individual. These changing perceptions are evidenced in society’s written laws begin*715ning with the Code of Hammurabi through the Magna Charta, the State and Federal Constitutions and down through Title 56, Chapter 2 of the Idaho Code.
“The latter, it seems to me, produces the idea that individuals unable to provide themselves with the accouterments necessary to maintain a minimum standard of physical well-being have a right to help from society.”
The Department was given the responsibility of fulfilling this Herculean task by a legislature which obviously considered need to be a primary factor. This intent is indicated in several statutes. Idaho Code § 56-202 spells out the duties of the Department and in pertinent part says: “The state department shall: (a) Administer public assistance and social services to people who are in need.” I.C. § 56-203 provides the Department shall have the power to: “(i) Determine the amount, duration and scope of care and services to be purchased as medical assistance on behalf of needy eligible individuals.” See I.C. §§ 56-201(j), 56-201(m), 56-205, 56-207 and 56-210.
To aid the Department in accomplishing this goal, the legislature empowered it to establish and enforce necessary rules and regulations. I.C. § 56-202(b). In regard to the rules and regulations passed by the Department, the trial court said:
“One of these rules is found in Section 3143 of the Department’s Manual. It sets forth the proposition that the dollar-amount an individual needs to purchase a reasonable subsistence compatible with health and well-being is to be determined by reference to department rules and regulations. The rules and regulations just referred to are found in the Department's Manual under the general heading of ‘Standards of Assistance for Meeting Basic Requirements.’
“These standards begin with Section 3120 of the Department’s Manual, which reads in part:
“ ‘The Department recognizes certain requirements to a subsistence compatible with health and well-being, which are common to all people. The allowance for the requirements are shown in succeeding pages under the heading “Summary of Monthly Allowances.” * * * ’
“The Summary of Monthly Allowances indicates that the Department recognizes only the following items as requirements for a subsistence compatible with health and well-being:
Food
Clothing
Housing
Utilities
Fuel
Electricity
Water
Garbage Collection
Special Needs
Limited to eating in restaurants, education, and dog food for ‘seeing-eye’ dogs.
And here the list ends.
“It seems to me that a list of requirements for the support of human life compatible with health and well-being which fails to include medical aid wholly fails to meet realities existing in 1977. That the living-expense budget of the individual in the Year 1977 must include an outlay for medical expenses, or insurance premiums to cover that expense, is a truth more self-evident today than those famous self-evident truths found to exist in 1776— that all men are created equal and they are endowed by their Creator with certain inalienable rights.
“The budget format adopted under the rules and regulation of the Department allegedly setting forth basic requirements for health and well-being fails to meet the clear and unequivocal intent expressed by the Legislature that the Department recognize ALL reasonable requirements to a subsistence compatible with health and well-being — not merely certain requirements which the Department may choose to recognize at its own discretion.” (my emphasis — not Judge Cunningham’s)
“I recognize that it is the Department’s contention that the Legislature *716has given it carte blanche authority to arbitrarily manage the monstrosity created by Title 56, Chapter 2, Idaho Code, because the Department points to the 1974 amendment to 56-205, Idaho Code, in which the Legislature stated:
“ ‘Public assistance shall be awarded * * * sufficient to provide a reasonable standard of health and well being as defined by department regulation and subject to the availability of funds.’ (Judge Cunningham’s emphasis)
“But the Public Assistance Law clearly limits the Department’s right to define standards for health and well-being to REASONABLE standards. Standards which fail to take into account man’s medical needs are just as unreasonable as standards which fail to take into account man’s shelter, clothing or .nutritional needs. And the Department does not have the power to make unreasonable standards reasonable by simply defining them as such.”
I.C. § 56-210 is, of course, the statutory-mandate for that language above which I have emphasized. I.C. § 56-210 provides that the Department in determining the amount of assistance to which an individual is entitled shall consider his requirements, conditions in his case, and all available income in order “to provide him with a reasonable subsistence compatible with health and his well being . . . (my emphasis)
The trial court accordingly was correct in modifying the. conclusion of the hearing officer by adding Conclusion III which read:
“The Department’s Summary of the monthly Allowance is arbitrary, capricious, and unreasonable insofar as the summary fails to include any determination of medical assistance required for a subsistence compatible with the individuals’ health and well-being.”
It is obvious that when Haymans’ medical expenses are included, Haymans had a “budget deficit.” They also meet the other requirements of I.C. § 56-207 in that they are needy people 65 or over, Idaho residents, and are not inmates of a public institution. Old age assistance includes medical care for needy aged people. I.C. § 56-201(j). Again the Haymans clearly qualify as needy aged people in that they are 65 years or older and their income and sources of subsistence are clearly insufficient to supply them with the common necessities of life commensurate with their needs and health. I.C. .§ 56-201(m).
The Department contends that I.C. § 56— 209b is the exclusive basis for the award of medical assistance. The trial court was correct in finding otherwise. In so doing,. Judge Cunningham said:
“[I]t is my view that Section 56-209b, Idaho Code, is not the exclusive authority or basis for the State granting medical aid to its citizens. The criterion] for granting medical aid under this Section is whether or not the person is a member of a particular group — old-age assistance recipients, blind, totally disabled, etc. It has nothing to do with the criteria set out for public assistance in Section 56-205, Idaho Code. That criterion is whether the person has. available resources sufficient to provide a reasonable standard of health and well-being. If he does not have resources sufficient to provide necessities for a reasonable standard of health and well being, including medical aid, the State must consider, determine and provide that person with medical aid reasonably necessary for that person’s health and well-being. And this, it seems to me, applies to all citizens and whether they are blind, recipients of old-age assistance, totally disabled or merely feeble, old, medically needy people, such as the Haymans. To interpret Section 56-205, Idaho Code, otherwise makes a mockery of the Legislative mandate.”
No question is raised as to the legislature^ authority to approve the kind of regulations which the Department has promulgated, and which are here under attack. Judge Cunningham did not attempt to substitute his judgment for that of the legislature as to the best allocation of resources for the needy. The trial court’s holding *717should be affirmed simply because the Department failed to follow the requirements set out by the legislature. Although the statutes are somewhat unclear as to exactly how much latitude the Department has in administering its programs, it seems highly improbable that the legislature intended elderly citizens like the Haymans to be made worse off because of the Social Security Administration’s decision to adjust their payments upward because of inflation. Under the Department’s guidelines, a $20 increase in the Haymans’ benefits from the Social Security Administration results in a $200 drop in the Department’s medical benefits. While it is understandable that the Department, working with limited funds, would reduce — even dollar for dollar — payments to the medically needy by the amount of additional funds received by the needy from other sources, the trial court was not in error in holding arbitrary and capricious a Department reduction of benefits by more than ten times the amount of collateral funds received. Concluding, it is apparent that Judge Cunningham’s decision was predicated wholly upon Idaho statutory law, i. e., he did not allow his determination to become bogged down by consideration of federal law which is thought by the Court’s opinion to be applicable. That Regulation 3120 may have been approved by “the Secretary” should play little part in our review of Judge Cunningham’s conclusions as to what is or is not required by Idaho statutory law. Attorneys and judges could quibble forever in discussing the intertwining of Title XIX and Idaho legislative law. Meanwhile ag^ng and sick Idaho citizens may expire because their Social Security payments were slightly raised.
The decision of the trial court is correct, just, and should be affirmed.
SHEPARD, J., concurs.

. The issue as stated in Haymans’ brief: “Can the Idaho DEPARTMENT OF HEALTH and WELFARE enforce administrative regulations which conflict with the provisions of Title 56, Chapter 2 of the Idaho Code?”