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Date: 08-03-2022
Case Style:
JARED B. CHAMBERLAIN, Special
Administrator of the Estate of Isaac
Harrell nvs. OHIO DEPARTMENT OF JOB AND
FAMILY SERVICES
Case Number: C-210145
Judge:
; Presiding Judge
Court:
IN THE COURT OF APPEALS FIRST APPELLATE DISTRICT OF OHIO HAMILTON COUNTY, OHIO
On Appeal From The Hamilton County Court of Common Pleas
Plaintiff's Attorney:
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Defendant's Attorney: Dave Yost, Ohio Attorney General, and Rebecca L. Thomas, Assistant Attorney General
Description:
Cincinnati, Ohio - Medicaid lawyer represented Plaintiff-Appellant with challenging the denial for retroactive Medicaid benefits.
In 2017, Harrell was a resident of Indianspring, a nursing facility in
Cincinnati, Ohio. With his health in decline, Harrell appointed Indianspring as his
Medicaid representative. In February 2017, Indianspring applied for Medicaid
benefits retroactive to November 2016 on Harrell’s behalf. The Hamilton County
Department of Job and Family Services (“HCJFS”) approved Medicaid benefits
beginning in September 2017.
{¶3} But HCJFS denied Harrell retroactive benefits for the ten-month period
between November 2016 and August 2017. HCJFS informed Harrell that his countable
resources exceeded the $2,000 resource threshold under Ohio Adm.Code 5160:1-3-
05-1(B)(10) during that ten-month period. Specifically, he owned real property in
Laurel, Mississippi, worth around $100,000. Despite listing the property as “for sale”
in September 2016, it did not sell until September 2017.
{¶4} Harrell unsuccessfully appealed the denial of retroactive benefits to the
Ohio Department of Job and Family Services (“ODJFS”). Following a hearing, an
ODJFS hearing officer affirmed the denial. ODJFS agreed with the hearing officer.
Harrell appealed to the Hamilton County Court of Common Pleas. A magistrate
OHIO FIRST DISTRICT COURT OF APPEALS
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affirmed the denial of retroactive benefits because the Mississippi property was a
countable resource that exceeded the resource threshold.
{¶5} Harrell objected to the magistrate’s decision, but passed away while his
objections were pending. Jared B. Chamberlain was appointed the special
administrator for Harrell’s estate and substituted as a party. The trial court overruled
the objections and adopted the magistrate’s decision.
{¶6} Chamberlain appeals, raising three assignments of error.
II. Law and Analysis
{¶7} An appellate court’s review of a trial court’s decision in an
administrative appeal is narrow and deferential. Cleveland Clinic Found. v. Bd. of
Zoning Appeals, 141 Ohio St.3d 318, 2014-Ohio-4809, 23 N.E.3d 1161, ¶ 23, citing Kisil
v. Sandusky, 12 Ohio St.3d 30, 34, 465 N.E.2d 848 (1984). But an appeal raising pure
questions of law is reviewed de novo. Weaver v. Ohio Dept. of Job & Family Servs.,
153 Ohio App.3d 331, 2003-Ohio-3827, 794 N.E.2d 92, ¶ 3 (1st Dist.), citing Univ.
Hosp., Univ. of Cincinnati College of Medicine v. State Emp. Relations Bd., 63 Ohio
St.3d 339, 587 N.E.2d 835 (1992).
{¶8} Chamberlain’s three assignments of error raise questions of statutory
interpretation. When determining the meaning of the statute, our objective is to
determine the intent of the legislature. See State ex rel. Clay v. Cuyahoga Cty. Med.
Examiner’s Office, 152 Ohio St.3d 163, 2017-Ohio-8714, 94 N.E.3d 498, ¶ 14, quoting
Cline v. Bur. of Motor Vehicles, 61 Ohio St.3d 93, 97, 573 N.E.2d 77 (1991), citing
Carter v. Youngstown Div. of Water, 146 Ohio St. 203, 65 N.E.2d 63 (1946). But when
a statute is ambiguous and a text is “ ‘capable of bearing more than one meaning,’ ”
interpretive rules guide our analysis. Clay at ¶ 17, quoting Dunbar v. State, 136 Ohio
St.3d 181, 2013-Ohio-2163, 992 N.E.2d 1111, ¶ 16, citing Fairborn v. DeDomenico, 114
OHIO FIRST DISTRICT COURT OF APPEALS
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Ohio App.3d 590, 593, 683 N.E.2d 820 (2d Dist.1996). And as a general rule, we
consider the text as a whole rather than “ ‘pick[ing] out one sentence and
disassociat[ing] it from the context.’ ” Jacobson v. Kaforey, 149 Ohio St.3d 398, 2016-
Ohio-8434, 75 N.E.3d 203, ¶ 9, quoting Black-Clawson Co. v. Evatt, 139 Ohio St. 100,
104, 38 N.E.2d 403 (1941).
A. Medicaid Eligibility
{¶9} In his first two assignments of error, Chamberlain maintains that a
Medicaid applicant’s resources must be “available” under state and federal law to be a
“countable resource” for eligibility determinations. Chamberlain contends that
Harrell’s inability to sell the Mississippi property rendered it unavailable and
uncountable.
{¶10} Medicaid, codified in 42 U.S.C. 1396a, represents a joint state and
federal effort to provide medical assistance to individuals with limited financial
resources. Wisconsin Dept. of Health & Family Servs. v. Blumer, 534 U.S. 473, 495,
122 S.Ct. 962, 151 L.Ed.2d 935 (2002). While state participation in Medicaid is entirely
optional, “ ‘once a State elects to participate, it must comply with the requirements of
Title XIX.’ ” Rodefer v. Colbert, 2015-Ohio-1982, 35 N.E.3d 852, ¶ 19 (2d Dist.),
quoting Harris v. McRae, 448 U.S. 297, 301, 100 S.Ct. 2671, 65 L.Ed.2d 784 (1980).
{¶11} Under the federal statute, eligibility criteria for medical assistance must
fall “within boundaries set by the Medicaid statute and the Secretary of Health and
Human Services.” Blumer at 479, citing Schweiker v. Gray Panthers, 453 U.S. 34, 36-
37, 101 S.Ct. 2633, 69 L.Ed.2d 460 (1981), and 42 U.S.C. 1396a(a)(17). Indeed,
participating states like Ohio must develop a plan with reasonable standards for
eligibility and “provide for taking into account only such income and resources as are,
OHIO FIRST DISTRICT COURT OF APPEALS
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as determined in accordance with standards prescribed by the Secretary, available to
the applicant.” 42 U.S.C. 1396a(a)(17)(B).
{¶12} In Ohio, applicants are eligible for Medicaid benefits if, among other
criteria, their “countable resources” do not exceed the resource threshold established
by Ohio Adm.Code 5160:1-3-05.1. See Ohio Adm.Code 5160:1-3-02.4(B)(4). For
eligibility determinations, the resource threshold is the “maximum combined value of
all resources an individual can have ownership interest in and still qualify for medical
assistance.” Ohio Adm.Code 5160:1-3-05.1(A)(9). For applicants like Harrell, the
resource threshold was $2,000. See Ohio Adm.Code 5160:1-5-05.1(A)(9)(a).
{¶13} In Ohio, resources consist of “ ‘cash, funds held within a financial
institution, investments, personal property, and real property an individual * * * [1]
has an ownership interest in, [2] has the legal ability to access in order to convert to
cash, and [3] is not legally prohibited from using for support and maintenance.’ ”
Cowan v. Ohio Dept. of Job & Family Servs., 1st Dist. Hamilton No. C-200025, 2021-
Ohio-1798, ¶ 13, quoting former Ohio Adm.Code 5160:1-1-01(B)(72).1
{¶14} Chamberlain’s appeal focuses on the second part of that definition—
whether he had the “legal ability to access [the property] in order to convert to cash.”
He maintains the Mississippi property was not an “available” resource affecting
Harrell’s eligibility because Harrell was unable to secure a buyer, and therefore did not
have the power to liquidate the asset. In support, Chamberlain contends that 20 C.F.R.
416.1201(a)(1) limits countable resources to the resources available to the applicant,
meaning the applicant must have the power to liquidate the asset.
1 Effective April 1, 2022, “resources” are defined in Ohio Adm.Code 5160-1-01(B)(81).
OHIO FIRST DISTRICT COURT OF APPEALS
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{¶15} But Chamberlain’s argument misconstrues the plain language of the
administrative rule. When Indianspring submitted Harrell’s Medicaid application,
real property that a Medicaid applicant “ha[d] the legal ability to access” was a
countable resource affecting eligibility. See former Ohio Adm.Code 5160:1-1-01(B)(72)
and 5160:1-3-05.12 Chamberlain asks us to read “legal” out of “has the legal ability to
access in order to convert to cash,” something we cannot do. See D.A.B.E., Inc. v.
Toledo-Lucas Cty. Bd. of Health, 96 Ohio St.3d 250, 2002-Ohio-4172, 773 N.E.2d 536,
¶ 26 (“ ‘words in statutes should not be construed to be redundant, nor should any
words be ignored.’ ”), quoting E. Ohio Gas Co. v. Pub. Util. Comm., 39 Ohio St.3d 295,
299, 530 N.E.2d 875 (1988).
{¶16} ODJFS correctly points out that this court unequivocally rejected
Chamberlain’s arguments in Cowan v. Dept. of Job & Family Servs. Indeed, in Cowan
we explained that “the plain meaning of ‘legal ability to access’ precludes an exemption
for impracticability.” Cowan, 1st Dist. Hamilton No. C-200025, 2021-Ohio-1798, at ¶
16. In that case, we concluded that Mary Cowan’s two small parcels of land were a
“countable resource” because of her “legal authority to sell them, regardless of how
difficult or easy the task at hand.” Id. at ¶ 12. In other words, we refused “to read an
impracticability exception into the Administrative Code.” Id. at ¶ 17.
{¶17} We find Cowan controls the outcome of this appeal and reiterate that,
under the plain language of former Ohio Adm.Code 5160:1-1-01(B)(72), a Medicaid
applicant’s property was a “countable resource” despite the applicant’s inability to
secure a buyer. Id. at ¶ 12 and 17. At oral argument, Chamberlain attempted to
distinguish Harrell’s residential property in Mississippi from the two parcels of land
2 On April 1, 2022, the rule was amended to address “[p]roperty that has not been sold.” See Ohio
Adm.Code 5160:1-3-05.1(C)(6).
OHIO FIRST DISTRICT COURT OF APPEALS
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valued at $3,000 each in Cowan. See id. at ¶ 3. But this distinction is inconsequential
because Chamberlain had the legal ability to sell the Mississippi property. While
Chamberlain contends that Mississippi requires a written contract for the sale of the
property and attorney oversight, we fail to see how these requirements presented a
legal barrier to selling the Mississippi property.
{¶18} Chamberlain argues that federal law carves out a resource exception for
Medicaid applicants unable to sell their property. First, Chamberlain maintains that,
under 20 C.F.R. 416.1201(a), resources consist of property an individual “owns and
could convert to cash to be used for his or her support or maintenance.” And
Chamberlain asserts that 20 C.F.R. 416.1201(a)(1) clarifies that “[i]f a property right
cannot be liquidated, the property will not be considered a resource of the individual.”
According to Chamberlain, courts have left no doubt that these federal regulations
apply to state Medicaid eligibility standards. Therefore, Chamberlain contends, the
magistrate failed to address whether Harrell had the power to liquidate the Mississippi
property.
{¶19} But once again, Chamberlain’s argument is contrary to this court’s
controlling precedent. See Gardner v. Ohio Dept. of Job & Family Servs., 1st Dist.
Hamilton No. C-210376, 2022-Ohio-2021, ¶ 18-21 (“SSI’s definition of ‘resources’ in
20 C.F.R. 416.1201 is inapplicable in the Medicaid context and does not inform our
interpretation of ‘resources’ under the Ohio Administrative Code.”). In Cowan, we
recognized that “20 C.F.R. 416.1201 deals with SSI determinations, a federal
obligation.” Cowan, 1st Dist. Hamilton No. C-200025, 2021-Ohio-1798, at ¶ 14. Still
more, Ohio courts “have squarely rejected the grafting of 20 C.F.R. 416.1201 onto
Medicaid eligibility, which represents a state responsibility.” Id. at ¶ 15, citing
Underwood v. Ohio Dept. of Job & Family Servs., 11th Dist. Geauga No. 2019-G-0215,
OHIO FIRST DISTRICT COURT OF APPEALS
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2019-Ohio-4924, ¶ 29, citing Communicare v. Ohio Dept. of Job & Family Servs., 8th
Dist. Cuyahoga No. 106874, 2019-Ohio-3757, ¶ 14-15.
{¶20} Recently, in Garner v. Ohio Dept. of Job & Family Servs., we recognized
that Ohio’s consideration of resources in Medicaid eligibility determinations must
include a reasonable-efforts exclusion under 42 U.S.C. 1382b(b)(2). Gardner at ¶ 27.
Otherwise, Ohio’s methodology for determining Medicaid eligibility would be more
restrictive than SSI eligibility criteria. Id. We note that Chamberlain limits his
arguments in this appeal to the application of both 20 C.F.R. 416.1201 and 41 U.S.C.
1396(a) to Ohio Medicaid eligibility determinations. Still, there is no evidence of
reasonable efforts in the record.
{¶21} We understand Chamberlain’s frustration. But we find no reason to
depart from our recent decision in Cowan. See Gardner at ¶ 21. We therefore overrule
his first and second assignments of error.
B. Federal Preemption
{¶22} In his third assignment of error, Chamberlain contends that the federal
regulations preempt Ohio law.
{¶23} Specifically, Chamberlain maintains that Ohio failed to submit an
amended Medicaid plan to the Centers for Medicare and Medicaid Services (“CMS”),
a division of the Department of Health and Human Services. See 42 U.S.C. 1396a and
b; see also 42 C.F.R. 430.12(c)(2)(i). To qualify for Medicaid funding, a state must
receive approval from CMS for any amendment to that state’s Medicaid plan. Douglas
v. Indep. Living Ctr. of S. California, Inc., 565 U.S. 606, 610, 132 S.Ct. 1204, 182
L.Ed.2d 101 (2012). Specifically, CMS “reviews the State’s plan and amendments to
determine whether they comply with the statutory and regulatory requirements.” Id.
OHIO FIRST DISTRICT COURT OF APPEALS
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{¶24} But we find nothing in the record to suggest that Ohio’s plan is
noncompliant. This assignment of error is overruled.
Outcome: When Indianspring submitted an application for retroactive Medicaid
benefits on Harrell’s behalf, his Mississippi property was a countable resource
affecting his eligibility. In light of our decision in Cowan, we overrule Chamberlain’s three assignments of error and affirm the trial court’s judgment.
Plaintiff's Experts:
Defendant's Experts:
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