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Friou v. Office of Family Independence

Superior Court of Maine, Cumberland

August 24, 2015

GEORGE FRIOU, ADMINISTRATOR OF SPRINGBROOK CENTER, Petitioner,
v.
OFFICE OF FAMILY INDEPENDENCE, DEPT. OF HEALTH AND HUMAN SERVICES, Respondent.

ORDER

Ronald Cole, Chief Justice

I. Background

Petitioner George Friou, administrator of the Springbrook Center ("Springbrook"), brings this Rule 80C appeal of a decision by the Department of Health and Human Services ("DHHS") assessing a penalty resulting in MaineCare ineligibility for Thelma Taylor.[1] Thelma is an elderly resident of Springbrook. Thelma's son and attorney-in-fact, Anthony Taylor, transferred Thelma's cottage property to himself and then to his son within a five-year "look back" period considered for MaineCare eligibility. The cottage was therefore an asset considered available to pay for expenses when Thelma applied for MaineCare and resulted in a penalty equivalent to the fair market value of the property. On behalf of Thelma, Anthony sought a hardship waiver of the penalty, which DHHS denied. A hearing was held on December 17, 2013 before a DHHS hearing officer. The hearing officer affirmed the decision on May 15, 2014, concluding that the Petitioner failed to make "reasonable efforts" to recover the cottage property, which precluded a waiver of the penalty. Petitioner appeals that decision.

II. Discussion

A. Standard of Review

In Rule 80C appeals, the reviewing court "is limited to determining whether the [agency] correctly applied the law and whether its fact findings are supported by competent evidence." McPherson Timberlands v. Unemployment Ins. Comm'n, 1998 ME 177, ¶ 6, 714 A.2d 818. The standard of review is "identical to the 'clear error' standard used by the Law Court." Gulick v. Bd of Envtl Prot., 452 A.2d 1202, 1207-08 (Me. 1982). The burden of proof is on the claimant to prove that "no competent evidence supports the [agency's] decision and that the record compels a contrary conclusion." Bischoff v. Maine State Ret. Sys., 661 A.2d 167, 170 (Me. 1995) (citation omitted). The court may not substitute its judgment for the agency's simply because the evidence could give rise to more than one result. See Dodd v. Sec'y of State, 526 A.2d 583, 584 (Me. 1987).

B. Standing

DHHS first argues that George Friou, administrator of the Springbrook Center, lacks standing to pursue this Rule 80C appeal. The Taylors are not parties in this case. Under Maine's Administrative Procedures Act, "any person who is aggrieved by final agency action shall be entitled to judicial review thereof in the Superior Court." 5 M.R.S. § 11001(1). A party is "aggrieved" if they have suffered a particularized injury, the standard for which considers "whether the party seeking judicial relief has suffered an injury in fact distinct from the harm experienced by the public at large." Ricci v. Superintendent, Bureau of Banking, 485 A.2d 645, 647 (Me. 1984). In addition to the requisite injury, the individual must also participate at the administrative proceeding. Norris Family Assocs., LLC v. Town of Phippsburg, 2005 ME 102, 111, 879 A.2d 1007.

Springbrook, as the nursing facility caring for Thelma Taylor, has a pecuniary interest in the result of her MaineCare eligibility and the penalty imposed. This is an injury different from the public at large. Heather Holland of Genesis Healthcare appeared and participated at the DHHS hearing. (Tr. 1.) Springbrook is a subsidiary of Genesis and George Friou, as administrator of Springbrook, thus meets the requirement of having participated as a party below. The Petitioner has standing.

C. Hardship Waiver under MaineCare

Waiver of a penalty on hardship grounds is a two-step process. The individual must first establish that there is a hardship, which considers whether denial would "deprive the individual of medical care such that the individual's health or life would be threatened; or deprive the individual of food, clothing, shelter, or other needs of life." 10-144 C.M.R. 332 15 § 1.9 (I)(A)-(B). If a hardship is proven, the individual must then establish that because of the hardship, the penalty should be waived.

The penalty can be waived if:

A. the individual was exploited as assessed by the Office of ...

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