{¶ 1} Defendant-appellant, Ohio Department of Job and Family Services ("ODJFS"), appeals from the Cuyahoga County Common Pleas Court's decision remanding an administrative appeal by plaintiff-appellee, Leonard Clark. On appeal, ODJFS raises one assignment of error for our review:
Because Mr. Clark's agency-level appeal request was untimely, the lower court erred by failing to either affirm the Administrative Appeal Decision, which dismissed Mr. Clark's administrative appeal request, or dismiss Mr. Clark's appeal to court for failure to exhaust administrative remedies.
{¶ 2} We find merit to ODJFS's assignment of error and reverse and remand for the common pleas court to dismiss Clark's appeal.
I. Procedural History and Factual Background
{¶ 3} Clark applied for Medicaid benefits with ODJFS in February 2015. Clark was a resident of Walton Manor, a nursing home, and sought the benefits to pay for the cost of care. On June 8, 2015, however, ODJFS denied Clark's application, finding
{¶ 4} After the hearing, but before the appeal deadline passed, the nursing facility policy administrator for the Ohio Department of Medicaid, Cheryl Guyman, emailed Walton Manor, informing the staff member in charge of Clark's case that ODJFS's denial of benefits was improper. Guyman stated, "The hearing officer is not basing his decision on the most recent CMS guidance which is in the State Medical Director Letters. You need to request an Administrative Appeal Request by email or phone." Unfortunately, when the staff member tried to forward this information to Clark's attorney, she sent it to the incorrect email address. As a result, Clark's attorney did not receive it until September 18, 2015. Upon receiving this information, Clark's counsel and Walton Manor appealed the administrative decision on behalf of Clark on September 18, 2015.
{¶ 5} On September 22, 2015, ODJFS dismissed Clark's request as untimely. Clark appealed to the Cuyahoga County Court of Common Pleas, contesting the dismissal as error. The court determined that Clark's "request for an administrative appeal with the Ohio Department of Job and Family Services was improperly denied as being untimely" and remanded the appeal to ODJFS for a hearing on the merits in accordance with the correct eligibility criteria. On April 6, 2017, ODJFS appealed the lower court's decision to this court.
II. Law and Analysis
A. Standard of Review
{¶ 6} "[A] recipient of assistance from a family services program may appeal a decision of the ODJFS to the common pleas court, pursuant to R.C. 119.12." Grill v. Ohio Dept. of Job & Family Servs. , 9th Dist. Summit No. 03CA0029-M,
{¶ 7} If a party appeals the common pleas court's judgment, the appellate court "review[s] and determine[s] the correctness of the judgment of the court of common pleas that the order of the agency is not supported by any reliable, probative, and substantial evidence in the entire record." R.C. 119.12(M). On appeal, we determine
B. Timeliness of Clark's Appeal
{¶ 8} ODJFS argues that the common pleas court erred when it found that Clark timely appealed ODJFS's denial of his Medicaid benefits. In response, although not raised in his brief, Clark argued at oral argument that, while his appeal was untimely, Ohio Adm.Code 5101:6-8-01(E)(1) gives ODJFS the discretion to accept untimely filed administrative appeals.
{¶ 9} Ohio Adm.Code 5101:6-8-01(C)(4) states that a request for an administrative appeal "must be received by the office of legal services, ODJFS, within fifteen calendar days from the date the decision being appealed was issued."
{¶ 10} Yet, as Clark correctly pointed out at oral argument, Ohio Adm.Code 5101:6-8-01(E)(1)(c) provides that "[a]n administrative appeal request may be dismissed because * * * [i]t is not timely, as defined by paragraph (C)(4)." In other words, ODJFS has the discretion to dismiss or not dismiss an appeal filed after the 15-day deadline.
{¶ 11} Corresponding with that point, Clark argues that subsections (C)(4) and (E)(1) create a conflict that must be resolved in his favor. A similar argument was raised in Stoyer v. Ohio Dept. of Job & Family Servs. , 10th Dist. Franklin No. 08AP-1118,
{¶ 12} Subsection (C)(4) requires that ODJFS receive an administrative appeal within 15 days after the decision being appealed. Subsection (E)(1) gives ODJFS the discretion to dismiss an appeal if it does not comply with subsection (C)(4)'s requirements. Those two provisions do not conflict-one defines the time limits of appealing an administrative decision, and the other governs ODJFS's power to accept or dismiss an appeal based on the timeliness or lack thereof.
{¶ 13} While Stoyer is instructive, we reach a different conclusion when applying Ohio Adm.Code 5101:6-8-01(C)(4) and (E)(1) to the facts of this case. Because the state hearing decision was issued on September 1, 2015, the Bureau of State Hearings had to receive Clark's request for an appeal by September 16, 2015. The evidence makes it clear-and the parties agree-that ODJFS did not receive Clark's request for an administrative appeal until September 18, 2015, two days after the September 16, 2015 deadline. Like Stoyer , Clark filed his administrative appeal after the deadline and ODJFS dismissed his appeal. Unlike Stoyer , however, the common pleas court in this case found that ODJFS's dismissal was not supported by reliable, probative, and substantial evidence and that Clark's appeal was timely. While the facts of this case certainly evoke sympathy for Clark, the evidence shows that his appeal was late, and under Ohio Adm.Code 5101:6-8-01, ODJFS's dismissal based on that late filing was a permissible use of its discretion. Further, our review is limited to the common pleas court decision finding ODJFS's dismissal as improper, and in light of the evidence presented, it is clear that the common pleas court abused its discretion.
C. Mistaken Good Faith
{¶ 14} In his brief, Clark also argues that his appeal was filed untimely because of the hearing officer's good-faith mistake and his representative's clerical error, and therefore, he should not be penalized. Although Clark's representative, not Clark, sent the request in late, that mistake is imputed to Clark. See Faulkner v. Integrated Servs. Network, Inc. , 8th Dist. Cuyahoga Nos. 81877 and 83083,
{¶ 15} All of this being said, this case is nothing short of unfair and dismaying. While we understand ODJFS's position on the appeal before us, we are nonetheless troubled by the fact that ODJFS exercised its discretion to dismiss Clark's appeal on a technicality instead of reviewing its prior decision that raised serious alarm within the Ohio Department of Medicaid.
{¶ 16} The Medicaid program was established to provide "federal financial assistance to States that choose to reimburse certain costs of medical treatment for
{¶ 17} ODJFS's assignment of error is sustained, and the judgment of the Cuyahoga County Court of Common Pleas is reversed. This case is remanded to the lower court to affirm ODJFS's dismissal of Clark's administrative appeal.
TIM McCORMACK, P.J., and FRANK D. CELEBREZZE, JR., J., CONCUR
Notes
The administrative-appeal process is explained in Rodefer v. McCarthy ,
ODJFS also filed a motion to stay execution of the lower court's judgment pending appeal, and the lower court granted the motion.
"[T]he statute requires receipt and merely depositing the request in the mail is not the same thing." B.B. at ¶ 10, citing Townsend v. Bd. of Bldg. Appeals ,