328 Conn. 294
Conn.2018Background
- Marjorie Valliere was institutionalized and her conservatrix (Ellen Shea) sought a Probate Court spousal support order for her husband Paul under Conn. Gen. Stat. § 45a-655 before a Medicaid application was filed. The Probate Court ordered monthly spousal support of $1,170.33 (declared to be the community spouse allowance) and gave notice to the Commissioner of Social Services.
- The Department of Social Services later approved Marjorie’s Medicaid application but refused to follow the Probate Court’s spousal support amount, treating Marjorie as having an applied income obligation and setting the community spouse allowance at $0 under department policy.
- Shea requested an administrative hearing; the hearing officer upheld the department, reasoning that under Conn. Gen. Stat. § 17b-261b the department is the sole Medicaid eligibility agency and only it may set community spouse allowances once Medicaid is applied for.
- Plaintiffs appealed administratively; the trial court reversed the department, holding that (1) § 45a-655(b) authorized the Probate Court to set spousal support prior to a Medicaid application, and (2) federal law (42 U.S.C. § 1396r-5(d)(5)) requires agencies to honor preexisting court-ordered support.
- The Commissioner appealed to the Supreme Court, arguing that state and federal statutes and the single-state-agency rule (implemented by § 17b-261b) limit Probate Court authority and make the department the exclusive determiner of community spouse allowances.
- The Connecticut Supreme Court affirmed the trial court: a preexisting Probate Court order under § 45a-655(b) is binding on the department when the order predates the Medicaid application; the department has process-based remedies (notice right, participation, appeal) to protect the public fisc.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a Probate Court spousal support order issued before a Medicaid application binds the Medicaid agency's community spouse allowance calculation | Probate Court order under §45a-655(b) is valid and, per 42 U.S.C. §1396r-5(d)(5), the department must honor preexisting court orders | §17b-261b (single state agency) and §45a-655(d) limit court authority once Medicaid is applied for; only department may set allowance | Held for plaintiff: preexisting Probate Court order is binding on department when it predates the Medicaid application |
| Whether §45a-655(d) nullifies existing court orders upon a later Medicaid application | §45a-655(d) restricts only actions after an application/receipt of Medicaid; it does not retroactively void prior court orders | Department reads (d) to limit any court approval to department-set amounts regardless of timing | Held for plaintiff: (d) applies when person "has applied for or is receiving" Medicaid and does not void earlier orders; tense matters |
| Whether §17b-261b renders the department the exclusive arbiter of community spouse allowances, removing court role | Plaintiffs: §17b-261b gives department notice and participation rights but contemplates complementary Probate Court role; department can appear and object | Defendant: as sole agency, department must control allowance determinations to preserve uniformity and protect Medicaid resources | Held for plaintiff: §17b-261b provides participation and appeal remedies for department but does not eliminate binding effect of preexisting court orders |
| Whether honoring preexisting orders permits impermissible "forum shopping" or evasion of Medicaid rules | Plaintiffs: Congress expressly protected preexisting court orders; department may participate in probate hearings to prevent abuses | Defendant: allowing preapplication court orders risks inequity and drains public resources; agency should have final say | Held for plaintiff with caveat: department has procedural means (notice, hearing participation, appeal) and could seek legislative change; honoring orders is consistent with federal statute (d)(5) |
Key Cases Cited
- Heussner v. Hayes, 289 Conn. 795 (Conn. 2008) (Probate Court is a court of limited statutory jurisdiction)
- In re Bachand, 306 Conn. 37 (Conn. 2012) (questions of Probate Court jurisdiction turn on statutory interpretation)
- Burinskas v. Dept. of Social Services, 240 Conn. 141 (Conn. 1997) (explains Medicaid community spouse allowances under 42 U.S.C. § 1396r-5)
- Gross v. Rell, 304 Conn. 234 (Conn. 2012) (conservator acts as agent of Probate Court when acting pursuant to court authorization)
- Gomprecht v. Gomprecht, 86 N.Y.2d 47 (N.Y. 1995) (family court must consider Medicaid standards when adjudicating spousal support after Medicaid eligibility)
- M.E.F. v. A.B.F., 393 N.J. Super. 543 (N.J. Super. Ct. App. Div. 2007) (discusses interaction between court-ordered support and administrative fair-hearing process under the catastrophic coverage act)