{ "id": 3738957, "name": "RUTH L. HARRIS, as Ex'r of the Estate of Bernice Harris, Plaintiff-Appellant, v. THE DEPARTMENT OF HUMAN SERVICES et al., Defendants-Appellees", "name_abbreviation": "Harris v. Department of Human Services", "decision_date": "2004-01-30", "docket_number": "No. 2-03-0011", "first_page": "764", "last_page": "768", "citations": [ { "type": "official", "cite": "345 Ill. App. 3d 764" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "338 Ill. App. 3d 929", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 25410 ], "weight": 2, "year": 2003, "pin_cites": [ { "page": "933" }, { "page": "933" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/338/0929-01" ] }, { "cite": "201 Ill. 2d 351", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 1477051 ], "weight": 3, "year": 2002, "pin_cites": [ { "page": "369" }, { "page": "369" }, { "page": "369" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/201/0351-01" ] }, { "cite": "307 Ill. App. 3d 52", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 173507 ], "year": 1999, "pin_cites": [ { "page": "55" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/307/0052-01" ] } ], "analysis": { "cardinality": 478, "char_count": 9433, "ocr_confidence": 0.703, "pagerank": { "raw": 1.0076538710665395e-07, "percentile": 0.5412091592984765 }, "sha256": "da05a02e63c4bb7c83f44efaaddf23b1783507f25137a425e183a91c4a278a38", "simhash": "1:9b166ca64c3e0670", "word_count": 1563 }, "last_updated": "2023-07-14T15:40:04.128176+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "O\u2019MALLEY, EJ, and BYRNE, J., concur." ], "parties": [ "RUTH L. HARRIS, as Ex\u2019r of the Estate of Bernice Harris, Plaintiff-Appellant, v. THE DEPARTMENT OF HUMAN SERVICES et al., Defendants-Appellees." ], "opinions": [ { "text": "JUSTICE McLAREN\ndelivered the opinion of the court:\nPlaintiff, Ruth Harris, appeals from the trial court\u2019s order affirming the order of defendants, the Department of Human Services (DHS) and the Department of Public Aid (DPA) (collectively, \u201cthe State agencies\u201d). We affirm.\nWe first note that Ruth Harris, Bernice\u2019s daughter, had Bernice\u2019s power of attorney and initiated these proceedings. We also note that Bernice died during the pendency of the proceedings, which were continued by Ruth as executor of Bernice\u2019s estate.\nBernice Harris, a nursing home resident, applied for Medicaid assistance under the Medical Assistance \u2014 No Grant (MANG) program. Bernice\u2019s husband, David, was not a nursing home resident; therefore, Bernice sought to transfer assets to David pursuant to section 120.379(d) of the Illinois Administrative Code (89 Ill. Adm. Code \u00a7 120.379(d) (1998)). Under that section, a mu-sing home resident may transfer to his or her \u201ccommunity spouse\u201d (a spouse not residing in a nursing home) assets that need not be spent on the resident\u2019s medical care. The amount of assets that may be transferred is known as the \u201cCommunity Spouse Asset Allowance\u201d (CSAA). See 89 Ill. Adm. Code \u00a7 120.379(d) (1998). At the time of Bernice\u2019s application, the CSAA maximum was $89,280. However, Bernice sought to increase the amount of assets to be transferred by $25,000. After an administrative hearing, the State agencies denied the request. The trial court affirmed the order. This appeal followed.\nRuth contends that the State agencies erred in determining that David was not entitled to an increased CSAA. When reviewing the appeal of an administrative decision, this court reviews the agency\u2019s decision, not the decision of the trial court. Metropolitan Airport Authority v. Property Tax Appeal Board, 307 Ill. App. 3d 52, 55 (1999). When reviewing purely factual findings, this court will deem the agency\u2019s findings and conclusions to be prima facie true and correct, and they will be reversed only if they are against the manifest weight of the evidence. Carpetland U.S.A., Inc. v. Illinois Department of Employment Security, 201 Ill. 2d 351, 369 (2002). If the decision involves a pure question of law, our review is de novo. Carpetland U.S.A., 201 Ill. 2d at 369. Mixed questions of law and fact are to be reviewed under the \u201cclearly erroneous\u201d standard and will be reversed only if, after a review of the entire record, this court is left with the firm and definite conviction that a mistake has been committed. Carpetland U.S.A., 201 Ill. 2d at 369.\nThe hearing officer found the following uncontested facts. As of December 3, 2001, Bernice had nonexempt assets in her name or held jointly with David in the amount of $123,404.62, and David held nonexempt assets in the amount of $7,403. David\u2019s monthly income, for purposes of the request for an increased CSAA, totaled $1,185, and consisted of $1,035 from Social Security and $150 from a pension.\nAlso uncontested are the applicable statutory figures. At the time of the application, the CSAA was not to exceed $89,280 unless more was needed to raise the community spouse\u2019s income to the maximum amount permitted as the \u201cCommunity Spouse Maintenance Needs Allowance\u201d (CSMNA). See 89 Ill. Adm. Code \u00a7 120.379(d)(2) (1998). The CSMNA is a minimum level of monthly income allowed to the community spouse. See 89 Ill. Adm. Code \u00a7 120.379(f) (1998). At the time of the application, the CSMNA was $2,232.\nIn this case, the State agencies found that Bernice could transfer $81,877 to David (the $89,280 CSAA minus David\u2019s nonexempt assets of $7,403). This left, after certain other minor adjustments, $39,634 in excess nonexempt assets that Bernice was required to spend on her own health care. Bernice requested that she be allowed to transfer a total of $114,280 ($81,877 plus $7,403 and an additional $25,000) in order to raise David\u2019s income closer to the CSMNA. This additional transfer would come out of her spend-down amount of $39,634.\nSection 1396r \u2014 5(e)(2)(C) of the Medicare Catastrophic Coverage Act (MCCA) provides:\n\u201cIf either such spouse establishes that the community spouse resource allowance [the federal appellation for the CSAA] (in relation to the amount of income generated by such an allowance) is inadequate to raise the community spouse\u2019s income to the minimum monthly maintenance needs allowance, there shall be substituted, for the community spouse resource allowance under subsection (f)(2) of this section, an amount adequate to provide such a minimum monthly maintenance needs allowance.\u201d 42 U.S.C. \u00a7 1396r \u2014 5(e)(2)(C) (2000).\nThe MCCA does not specify how the income generated by the CSMNA is to be determined. Such a calculation is left to the states as they administer the Medicaid program. The DPA has determined that it will:\n\u201c[M]easure the amount of \u00e1n allowable increase in the CSAA by the cost to purchase an actuarially sound single premium life annuity producing monthly payments that, when added to the community spouse\u2019s income, will be sufficient to raise the community spouse\u2019s income to, but not more than, the [CSMNA], If assets are insufficient to purchase such an annuity, the Department will measure the amount of an allowable increase in the CSAA by the cost to purchase an actuarially sound single premium life annuity producing monthly payments using available assets.\u201d (Emphasis added.) 89 Ill. Adm. Code \u00a7 120.379(d)(2)(A) (1998).\nIt is the appellant\u2019s duty to provide DPA with the estimated cost to purchase the annuity. 89 Ill. Adm. Code \u00a7 120.379(d)(2)(B) (1998). Although the calculation of income after the approval of an increased CSAA will include the amount of the annuity payment, the spouse is not required to actually purchase the annuity. 89 Ill. Adm. Code \u00a7 120.379(d)(2)(D) (1998).\nRuth argues that both the CSAA asset allowance and the CSMNA income are minimum entitlements such that \u201cneither should be sacrificed so that the other minimum amount can be achieved.\u201d Thus, it is the institutionalized spouse\u2019s assets, not those of the community spouse, that are to be used to purchase the annuity. We disagree. Section 1396r \u2014 5(e)(2)(C) of the MCCA clearly provides that it is \u201cthe amount of income generated by\u201d the CSAA (i.e., the income generated by the assets) that is to raise the community spouse\u2019s income to the \u201cminimum monthly maintenance needs allowance,\u201d or CSMNA; only if the CSAA is insufficient to raise the community spouse\u2019s income to the minimum level will another amount beyond the established CSAA be substituted. See 42 U.S.C. \u00a7 1396r \u2014 5(e)(2)(c) (1998). In construing a statute, a court is not at liberty to depart from its plain language and meaning by reading into the statute exceptions, limitations, or conditions that conflict with the intent of the legislature. Inphoto Surveillance, Inc. v. Crowe, Chizek & Co., LLP, 338 Ill. App. 3d 929, 933 (2003). If the language of the statute is plain, clear, and unambiguous, the intent of the legislature is to be ascertained therefrom. Inphoto Surveillance, Inc., 338 Ill. App. 3d at 933. Only a tortured reading of section 1396r \u2014 5(e)(2)(C) of the MCCA could lead to Ruth\u2019s interpretation of that section. Therefore, we conclude that the State agencies did not err in denying an increase in the CSAA.\nSection 120.379(d)(2) of the Administrative Code requires evidence of the cost of a single premium life annuity that produces payments that would raise the community spouse\u2019s income to the CSMNA. In this case, that would be evidence of the cost of an annuity that would provide monthly income of $1,047 (the CSMNA of $2,232 minus David\u2019s income of $1,185). Ruth presented evidence of a $25,000 annuity that would produce income of $460.42. As the cost of this annuity was less than the CSAA, there were sufficient assets in the CSAA to purchase the annuity, and no increase in the CSAA was warranted. See 89 Ill. Adm. Code \u00a7 120.379(d)(2) (1998).\nIt is evident that Ruth presented evidence of the income production of an annuity purchased with the $25,000 increase that she sought. While this evidence may have been presented because Ruth misread the applicable statute, it was not the evidence required to demonstrate a need for an increased CSAA. Ruth should have presented evidence of the income generated by the CSAA and whether that income, added to David\u2019s income of $1,185, provided David with the CSMNA of $2,232. The burden of providing proper evidence proving the insufficiency of the CSAA was on Ruth. The State agencies can make a decision based only on the evidence presented. Based on the evidence presented in this case, Ruth failed to demonstrate that an amount over and above the CSAA was necessary to provide David with the minimum income. Therefore, we find no error in the State agencies\u2019 denial of an increase in the CSAA.\nFor these reasons, the judgment of the circuit court of Winnebago County is affirmed.\nAffirmed.\nO\u2019MALLEY, EJ, and BYRNE, J., concur.", "type": "majority", "author": "JUSTICE McLAREN" } ], "attorneys": [ "Steven C. Perlis, of Family Center for Elder Law, P.C., of Arlington Heights, for appellant.", "Lisa Madigan, Attorney General, of Chicago (Gary S. Feinerman, Solicitor General, and Carl J. Elitz, Assistant Attorney -General, of counsel), for appellees." ], "corrections": "", "head_matter": "RUTH L. HARRIS, as Ex\u2019r of the Estate of Bernice Harris, Plaintiff-Appellant, v. THE DEPARTMENT OF HUMAN SERVICES et al., Defendants-Appellees.\nSecond District\nNo. 2-03-0011\nOpinion filed January 30, 2004.\nSteven C. Perlis, of Family Center for Elder Law, P.C., of Arlington Heights, for appellant.\nLisa Madigan, Attorney General, of Chicago (Gary S. Feinerman, Solicitor General, and Carl J. Elitz, Assistant Attorney -General, of counsel), for appellees." }, "file_name": "0764-01", "first_page_order": 784, "last_page_order": 788 }