{ "id": 4779108, "name": "FORSYTH COUNTY BOARD OF SOCIAL SERVICES and FORSYTH COUNTY DEPARTMENT OF SOCIAL SERVICES v. DIVISION OF SOCIAL SERVICES, and DIVISION OF MEDICAL ASSISTANCE, NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, and ALEXANDER HINES (deceased), by WILLIAM EVERHART, Representative for Applicant", "name_abbreviation": "Forsyth County Board of Social Services v. Division of Social Services", "decision_date": "1986-08-12", "docket_number": "No. 194PA85", "first_page": "689", "last_page": "694", "citations": [ { "type": "official", "cite": "317 N.C. 689" } ], "court": { "name_abbreviation": "N.C.", "id": 9292, "name": "Supreme Court of North Carolina" }, "jurisdiction": { "id": 5, "name_long": "North Carolina", "name": "N.C." }, "cites_to": [ { "cite": "71 L.Ed. 2d 287", "category": "reporters:federal", "reporter": "L. Ed. 2d", "year": 1982, "opinion_index": 0 }, { "cite": "454 U.S. 1135", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 6514914, 6514661, 6514726, 6515154, 6514808, 6515037 ], "year": 1982, "opinion_index": 0, "case_paths": [ "/us/454/1135-04", "/us/454/1135-01", "/us/454/1135-02", "/us/454/1135-06", "/us/454/1135-03", "/us/454/1135-05" ] }, { "cite": "309 N.W. 2d 320", "category": "reporters:state_regional", "reporter": "N.W.2d", "case_ids": [ 10679363 ], "year": 1981, "opinion_index": 0, "case_paths": [ "/nw2d/309/0320-01" ] }, { "cite": "501 N.Y.S. 2d 659", "category": "reporters:state", "reporter": "N.Y.S.2d", "year": 1986, "pin_cites": [ { "parenthetical": "per curiam" } ], "opinion_index": 0 }, { "cite": "492 N.E. 2d 787", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1986, "pin_cites": [ { "parenthetical": "per curiam" } ], "opinion_index": 0 }, { "cite": "67 N.Y. 2d 848", "category": "reporters:state", "reporter": "N.Y.2d", "case_ids": [ 4405867 ], "year": 1986, "pin_cites": [ { "parenthetical": "per curiam" } ], "opinion_index": 0, "case_paths": [ "/ny-2d/67/0848-01" ] }, { "cite": "488 N.Y.S. 2d 316", "category": "reporters:state", "reporter": "N.Y.S.2d", "year": 1985, "opinion_index": 0 }, { "cite": "110 A.D. 2d 1028", "category": "reporters:state", "reporter": "A.D.2d", "case_ids": [ 3432166 ], "year": 1985, "opinion_index": 0, "case_paths": [ "/ad2d/110/1028-01" ] }, { "cite": "42 CFR \u00a7 431.10", "category": "laws:admin_compilation", "reporter": "C.F.R.", "weight": 3, "year": 1985, "pin_cites": [ { "page": "(b)(2)(ii)" }, { "page": "(e)(3)" }, { "page": "(e)(3)" } ], "opinion_index": 0 }, { "cite": "293 S.E. 2d 171", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 2, "year": 1982, "pin_cites": [ { "page": "175" } ], "opinion_index": 0 }, { "cite": "306 N.C. 231", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8568091 ], "year": 1982, "pin_cites": [ { "page": "235" } ], "opinion_index": 0, "case_paths": [ "/nc/306/0231-01" ] }, { "cite": "254 S.E. 2d 32", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1979, "opinion_index": 0 }, { "cite": "296 N.C. 583", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8568544, 8568580, 8568454, 8568502, 8568631 ], "year": 1979, "opinion_index": 0, "case_paths": [ "/nc/296/0583-03", "/nc/296/0583-04", "/nc/296/0583-01", "/nc/296/0583-02", "/nc/296/0583-05" ] }, { "cite": "248 S.E. 2d 567", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1978, "opinion_index": 0 }, { "cite": "38 N.C. App. 414", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8554394 ], "year": 1978, "opinion_index": 0, "case_paths": [ "/nc-app/38/0414-01" ] }, { "cite": "141 S.E. 2d 280", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1965, "opinion_index": 0 }, { "cite": "264 N.C. 168", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8571898, 8571940 ], "year": 1965, "opinion_index": 0, "case_paths": [ "/nc/264/0168-01", "/nc/264/0168-02" ] } ], "analysis": { "cardinality": 634, "char_count": 12189, "ocr_confidence": 0.826, "pagerank": { "raw": 2.300835558163084e-07, "percentile": 0.7873607689096932 }, "sha256": "1f40fa493c367eada09c4285f2f3547389f8c1da1cf4c48f19617441d5826e50", "simhash": "1:2627b557f03d84f0", "word_count": 1917 }, "last_updated": "2023-07-14T14:55:24.016055+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "FORSYTH COUNTY BOARD OF SOCIAL SERVICES and FORSYTH COUNTY DEPARTMENT OF SOCIAL SERVICES v. DIVISION OF SOCIAL SERVICES, and DIVISION OF MEDICAL ASSISTANCE, NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, and ALEXANDER HINES (deceased), by WILLIAM EVERHART, Representative for Applicant" ], "opinions": [ { "text": "FRYE, Justice.\nThe dispositive issue in this case is whether the petitioners had standing to bring the suit. For the reasons set forth in this opinion, we conclude that they did not.\nOn 19 May 1981, one Alexander Hines was found in a comatose state while at work and was taken to North Carolina Baptist Hospital. There he was diagnosed as having a large intracerebral hematoma in the right frontal region of the brain with intraventricular hemorrhage. Surgery was to no avail, and Hines remained comatose in a \u201cpersistent vegetative state\u201d until he died on 7 October 1981. His medical care expenses totaled $45,145.14.\nOn 8 June 1981, Hines\u2019 sister, Della Black, submitted an application for Medicaid to the Forsyth County Department of Social Services (County Department) on behalf of Hines. The County Department learned that Hines had an interest in some real property located in Georgia and valued for taxation at $2,377. The Department contacted Hines\u2019 brother in Georgia who informed them that Jim Walter Homes in Jessup, Georgia, was holding the deed to the property because of the nonpayment of a second mortgage. The property consisted of a house and lot. The house was a deteriorating prefab structure that was abandoned and uninhabitable. The property was subject to unpaid taxes amounting to $951 and a possible second mortgage that the County Department was unable to verify. Although contacted on several occasions by the County Department, Hines\u2019 sister, brother, and ex-wife were unable to assist the County Department in obtaining any further information about the property. The County Department held the Medicaid application pending for twelve months and then notified Hines\u2019 sister, Della Black, on 8 June 1982, that the application was denied \u201cbased on inability to obtain information on which to base eligibility following the 12 month pending requirement.\u201d\nOn 11 June 1982, William Everhart, financial counselor at North Carolina Baptist Hospital, was appointed personal representative for Hines relative to Hines\u2019 eligibility for Medicaid benefits. Everhart requested a local appeal hearing which was held on 11 August 1982. At this hearing, Everhart and Della Black, Hines\u2019 sister, testified that Hines had been comatose throughout his hospitalization until his death. The hospital never had an opportunity to ask Hines whether the Georgia property was income-producing or to secure any information regarding any liens on the property. Della Black testified that she was unable to provide any information on the Georgia property. The programs supervisor who conducted this hearing affirmed the County Department\u2019s denial on 16 August 1982.\nEverhart, acting in his capacity as Hines\u2019 representative, appealed the local appeal hearing decision to the Division of Social Services, North Carolina Department of Human Resources. At this hearing it was again shown that Hines had remained in a comatose state and never regained consciousness throughout his hospitalization. Also offered in evidence was a URESA order for the support of Hines\u2019 dependent children dated 24 February 1977 and a letter from a Georgia attorney indicating that no money had been received by Hines\u2019 former wife in Georgia on this order, and a deed of trust on the Georgia property dated 26 May 1960. The state hearing officer determined that the County Department\u2019s decision to deny the application was incorrect and reversed the decision. The hearing officer relied on an earlier agency determination dated 7 October 1981 to the effect that a comatose patient unable to act in his own behalf cannot be held accountable for the lapse of time before the appointment of a guardian and that the cash value of certain insurance policies was not readily available within the meaning of the Medicaid regulations when an applicant was in a comatose state at the time of eligibility determination.\nUpon petitioners\u2019 petition for review of the decision of the Department of Human Resources, Judge Peter Hairston, presiding in Forsyth Superior Court, set aside the order of the state hearing officer on the ground that \u201cthe decision was erroneous and unsupported by substantial evidence.\u201d Although all defendants initially gave notice of appeal from Judge Hairston\u2019s judgment, rendered on 19 August 1983, ultimately all except respondent Hines withdrew their appeal.\nThe Court of Appeals in an unpublished opinion affirmed Judge Hairston\u2019s decision. Respondent accordingly petitioned this Court for discretionary review on 8 April 1985. His petition was allowed on 13 August 1985.\nRespondent and amicus curiae contend that petitioners\u2019 action should be dismissed because petitioners lack standing to bring this action. Although they raise this question for the first time on appeal and would normally be barred by N.C. R. App. P. 16, questions of subject matter jurisdiction may properly be raised at any point, even in the Supreme Court. Askew v. Tire Co., 264 N.C. 168, 141 S.E. 2d 280 (1965); see N.C. R. Civ. P. 12(b)(3); see also Stuart v. Hunsucker, 38 N.C. App. 414, 248 S.E. 2d 567 (1978), cert. denied, 296 N.C. 583, 254 S.E. 2d 32 (1979).\nPetitioners brought this action before the superior court pursuant to N.C.G.S. \u00a7 108A-79(k) (Cum. Supp. 1985), which provides that \u201c[a]ny . . . county board of social services . . . who is dissatisfied with the final decision of the Department [of Human Resources] may file ... a petition for judicial review in superior court of the county from which the case arose.\u201d On its face, this section appears to give petitioners standing to contest the Department of Human Resources\u2019 award of Medicaid benefits to an applicant.\nHowever, the Medicaid program is a cooperative federal-state program established by Congress in 1965 for the purpose of enabling the states to furnish medical assistance to certain classes of needy people. Lackey v. Department of Human Resources, 306 N.C. 231, 235, 293 S.E. 2d 171, 175 (1982). Participation by the state is optional, but those states that choose to participate must comply with the requirements of federal law. Id.\nNorth Carolina adopted the Medicaid program through the enactment of N.C.G.S. \u00a7 108-59 to -61.4 (1978), amended and re-codified effective 1 October 1981 as N.C.G.S. \u00a7 108A-54 to -62 (Cum. Supp. 1985). N.C.G.S. \u00a7 108A-56 (Cum. Supp. 1985) provides that all provisions of the federal Social Security Act are accepted and adopted. N.C.G.S. \u00a7 108A-79(1) (Cum. Supp. 1985) provides that in the event of conflict between state law and federal law or regulations, the latter will control.\nThe question is therefore whether federal law or regulations would prohibit petitioners from challenging the Department of Human Resources\u2019 determination that respondent was eligible for Medicaid benefits. A review of the applicable statutes and regulations leads to an affirmative answer to the question.\nTitle 42, Section 1396a(a)(5) of the United States Code provides that a state\u2019s Medicaid plan must designate \u201ca single State agency to administer or to supervise the administration of the plan.\u201d 42 U.S.C. \u00a7 1396a(a)(5) (1982). This requirement is further defined by the Code of Federal Regulations. The regulations in effect both at the time petitioners brought their action and at the present time require that this single State agency, inter alia, \u201c[m]ake rules and regulations . . . that are binding upon local agencies that administer the plan.\u201d 42 CFR \u00a7 431.10(b)(2)(ii) (1985). When this agency is charged with determining eligibility, other State or local agencies that perform services for it \u201cmust not have the authority to change or disapprove any administrative decision of that agency, or otherwise substitute their judgment for that of the Medicaid agency with respect to the application of policies, rules, and regulations issued by the Medicaid agency.\u201d 42 CFR \u00a7 431.10(e)(3) (1985).\nIn North Carolina, the \u201csingle State agency\u201d is the Department of Human Resources (hereinafter DHR). N.C.G.S. \u00a7 108A-71 (Cum. Supp. 1985). The county departments of social services perform various services for DHR, including the making of initial decisions on eligibility for Medicaid. Therefore, federal regulations prohibit local agencies such as petitioners from changing or disapproving of DHR\u2019s decisions or \u201cotherwise\u201d substituting their judgment for DHR\u2019s.\nBy bringing this action before the Superior Court, petitioners were seeking to have DHR\u2019s decision overturned and their own initial decision reinstated. The quarrel was over the application and interpretation of DHR\u2019s rules and regulations. Petitioners were essentially requesting the court to adopt their interpretation of the rules and regulations over DHR\u2019s. Petitioners were thereby seeking to substitute their judgment for that of DHR. The State is forbidden by 42 CFR \u00a7 431.10(e)(3) to allow petitioners to do so. Accordingly, we hold that petitioners could not contest DHR\u2019s final decision finding respondent eligible for Medicaid benefits. We further hold, in keeping with N.C.G.S. \u00a7 108A-79 (1) (federal law controls), that so much of N.C.G.S. \u00a7 108A-79(k) as purports to authorize county boards of social services to petition for judicial review in superior court does not apply to this type of final agency decision. Accord, Romano v. Perales, 110 A.D. 2d 1028, 488 N.Y.S. 2d 316 (1985), aff\u2019d, 67 N.Y. 2d 848, 492 N.E. 2d 787, 501 N.Y.S. 2d 659 (1986) (per curiam). But see Cass County Welfare Department v. Wittner, 309 N.W. 2d 320 (Minn. 1981), cert. denied, 454 U.S. 1135, 71 L.Ed. 2d 287 (1982).\nPetitioners contend further that interpreting the \u201csingle State agency\u201d requirement to forbid local arms of the state agency from attacking that agency\u2019s decisions in court will also preclude any review of a final agency decision. We disagree with this interpretation. The state agency is not immune from attack. Our decision limits only local agencies acting in their capacity as an agent or delegate of DHR, such as petitioners in the instant case. Other parties are not barred hereby.\nFor the reasons set forth herein, the decision of the Court of Appeals is reversed, and the case is remanded to that court for further remand to the Superior Court, Forsyth County, with directions to vacate the judgment of the Superior Court, Forsyth County, to the end that the decision of the Department of Human Resources may be reinstated.\nReversed and remanded.", "type": "majority", "author": "FRYE, Justice." } ], "attorneys": [ "Bruce E. Colvin, for petitioner-appellee.", "Turner, Enochs & Sparrow, P.A., by Wendell H. Ott and Thomas E. Cone, for respondent-appellant Hines.", "North Carolina Legal Services Resource Center, by Pam Silberman; East Central Community Legal Services, by Jane Wettach; and Legal Services of the Southern Piedmont, by Douglas Sea, for Amicus Curiae Alliance for Social Security Disability Recipients." ], "corrections": "", "head_matter": "FORSYTH COUNTY BOARD OF SOCIAL SERVICES and FORSYTH COUNTY DEPARTMENT OF SOCIAL SERVICES v. DIVISION OF SOCIAL SERVICES, and DIVISION OF MEDICAL ASSISTANCE, NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, and ALEXANDER HINES (deceased), by WILLIAM EVERHART, Representative for Applicant\nNo. 194PA85\n(Filed 12 August 1986)\nSocial Security and Public Welfare \u00a7 1\u2014 eligibility for Medicaid benefits \u2014 standing of county to appeal DHR award\nPetitioners could not contest the Department of Human Resources\u2019 final decision finding respondent eligible for Medicaid benefits where the dispute involved the application and interpretation of DHR\u2019s rules and regulations and petitioners were seeking to have DHR\u2019s decision overturned and their own initial decision reinstated. Federal regulations prohibit local agencies such as petitioners from changing or disapproving DHR\u2019s decisions or otherwise substituting their judgment for DHR\u2019s. N.C.G.S. \u00a7 108A-71 (Cum. Supp. 1985), N.C.G.S. \u00a7 108A-79U) (Cum. Supp. 1985), N.C.G.S. \u00a7 108A-79(k).\nOn discretionary review of an unpublished decision of the North Carolina Court of Appeals, affirming the judgment of Hairston, J., setting aside the North Carolina Department of Human Resources\u2019 award of Medicaid benefits to respondent Hines. Judgment entered 19 August 1983, in Superior Court, Forsyth County. Heard in the Supreme Court on 19 December 1985.\nBruce E. Colvin, for petitioner-appellee.\nTurner, Enochs & Sparrow, P.A., by Wendell H. Ott and Thomas E. Cone, for respondent-appellant Hines.\nNorth Carolina Legal Services Resource Center, by Pam Silberman; East Central Community Legal Services, by Jane Wettach; and Legal Services of the Southern Piedmont, by Douglas Sea, for Amicus Curiae Alliance for Social Security Disability Recipients." }, "file_name": "0689-01", "first_page_order": 725, "last_page_order": 730 }