In the Matter of the Appeal by Kind Heart Daycare, Inc. of the Order of License Revocation and the Appeal by Yasmin Muhina Salim of the Disqualification Determination
A15-1470
STATE OF MINNESOTA IN SUPREME COURT
November 22, 2017
Lillehaug, J. Concurring in part, dissenting in part, Anderson, J. Concurring in part, dissenting in part, Chutich, Anderson, JJ.
Court of Appeals
Lori Swanson, Attorney General, Heather N. Kjos, Assistant Attorney General, Saint Paul, Minnesota, for respondent.
S Y L L A B U S
- A person charged with obtaining “the receipt of payments to which the individual is not entitled” under
Minn. Stat. § 256.98, subd. 1(3) (2016) , is liable only if the person receives payments for public assistance to which the person would not have otherwise been entitled in the absence of a misrepresentation or concealment. The Minnesota Department of Human Services did not violate Minn. Stat. § 14.69 (2016) by revoking a child care provider‘s license and disqualifying its owner.- The court of appeals engaged in proper judicial review of the Department‘s actions.
Affirmed.
O P I N I O N
LILLEHAUG, Justice.
The Minnesota Department of Human Services (the Department) determined by a preponderance of the evidence that appellant Yasmin Salim wrongfully obtained public assistance for appellant Kind Heart Daycare, Inc. (Kind Heart), in violation of
FACTS
1. Minnesota‘s Child Care Assistance Program.
CCAP helps low-income parents pay for child care. In order for a licensed provider like Kind Heart to receive CCAP payments, it must fill out attendance records using CCAP‘s MEC2PRO billing system. Each county uses this billing system to administer CCAP and disburse payments directly to the provider. The Department, which is responsible for licensing child care providers, has a CCAP Child Care Provider Guide1 that sets forth the requirements to receive CCAP payments.
The Guide extensively addresses how to receive CCAP payments for days on which a child is absent. CCAP “will pay for up to 25 absent days per calendar year, per child,” but the provider may bill CCAP for those absent days only if the “hours are identified in the provider‘s attendance records as absent.” The Guide includes a sample Billing Form, which shows how to fill out the attendance record and expressly includes a section for identifying absences. The Guide directs, “Fill in an ‘A’ for any day the child is absent.” The Guide also states, “Providers who give false information on a Billing Form could be disqualified from receiving future CCAP payments and could face criminal charges.”
2. Kind Heart‘s billing history.
Salim was the sole owner, controlling individual,2 and license holder for Kind Heart.
From October 2013 until March 14, 2014, Diane Sorenson was responsible for submitting Kind Heart‘s CCAP bills, which Salim occasionally reviewed. Both Salim and Sorenson were listed as authorized users on the MEC2PRO billing system. The authorization forms included language to “prevent misuse of public funds,” including an acknowledgment that the provider is required to “authenticate the accuracy of the billing forms.”
Sorenson eventually resigned from Kind Heart. Her last day was March 14, 2014. Sorenson last submitted a bill seeking a CCAP payment on March 3, 2014.
After Sorenson left, Salim set up a new MEC2PRO account for which she was the sole authorized user. The Department alleges that an “egregious amount of discrepancies” began to appear in Kind Heart‘s CCAP bills. Salim asserts that she asked another employee, Kim Patterson, to take over Sorenson‘s CCAP billing responsibilities, but
3. The County‘s investigation.
In the spring of 2014, the Blue Earth County Sheriff‘s Office received reports indicating that Kind Heart was committing child care financial fraud. Investigator Ginger Peterson confirmed hundreds of instances in March, April, and May 2014, in which Kind Heart had submitted CCAP bills to the County, representing that children were present at Kind Heart, when in fact they were absent or no longer enrolled in the daycare. In total, the County determined that there was probable cause to believe that Kind Heart had billed for $12,437.94 to which it was not entitled. On June 17, 2014, the State of Minnesota charged Salim with one felony count of wrongfully obtaining child care payments, in violation of
4. The Department‘s actions.
The County informed the Department of its investigation and the charge against Salim. The Department considered whether the evidence supported disqualifying Salim from providing child care services. Specifically,
A person who commits any of the following acts or omissions with the intent to defeat the purposes of . . . child care assistance programs . . . is guilty of theft . . . : (3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments to which the individual is not entitled as a provider of subsidized child care, or by furnishing or concurring in a willfully false claim for child care assistance.
On June 18, 2014, the Department sent an e-mail asking for one of its staff attorneys to volunteer to conduct a preponderance-of-the-evidence (POE) review under
One of the staff attorneys for the Department volunteered to conduct the POE review. She correctly understood that a POE review “is a record review to determine whether it‘s more likely than not that the person committed an act” that warrants disqualification under
On June 30, 2014, Kind Heart appealed the license revocation. Consistent with standard procedure, Kind Heart was allowed to continue operating pending a final order from the Commissioner, and Salim submitted a supervision plan allowing her to continue working at Kind Heart in the interim.
On July 7 and 9, 2014, the Department sent two licensing investigators to Kind Heart to see whether the facility was complying with licensing requirements while the appeal was pending. The Department identified 14 new licensing violations, including failure to properly supervise Salim after her disqualification, failure to submit a background study request for an employee who had direct contact with children, failure to properly supervise children, failure to have required documentation establishing proper employee education and training, failure to maintain required staff-to-child ratios, failure to provide meals containing sufficient nutritional value, and hygiene violations. On July 24, 2014, the Department issued a supplemental order of license revocation to Kind Heart, determining that the violations constituted “additional reasons to revoke the license.” That same day, Salim requested reconsideration of the Department‘s order to disqualify her.
5. The Administrative Law Judge‘s decision.
The Department consolidated Salim‘s disqualification, Kind Heart‘s license revocation, the senior staff attorney‘s decision not to set aside Salim‘s disqualification, and the supplemental revocation order for the 14 licensing violations, for consideration by an administrative law judge (ALJ). The ALJ held an evidentiary hearing over 4 days.
The ALJ subsequently issued findings of fact, conclusions of law, and recommendations. The ALJ found that Kind Heart‘s post-Sorenson CCAP billings from March to May 2014 were submitted by Patterson and Salim, and that the “pattern of errors in the bills they submitted demonstrated incompetence in billing and dishonesty.”4 The
The ALJ also found that, although the staff attorney “mistakenly believed that the preponderance of evidence review . . . was a lower standard of review than the probable cause required for an arrest warrant . . . the evidence demonstrates that it is more likely than not that [Salim] wrongfully obtained public child care assistance for Kind Heart.” Accordingly, the ALJ concluded that Salim “wrongfully obtained child care assistance in violation of
But the ALJ disagreed with the senior staff attorney‘s determination that Salim posed a risk of harm to people served by Kind Heart. The ALJ found that “the purpose of [Salim‘s] activity was to aid families in obtaining and keeping access to child care.” Accordingly, the ALJ recommended that the Department‘s decision to disqualify Salim was proper, but that the disqualification be set aside.
Further, the ALJ concluded that the 14 licensing violations in the supplemental revocation order did not “reflect the need for license revocation.” Thus, the ALJ concluded and recommended that the order revoking Kind Heart‘s license be rescinded.
6. The Commissioner‘s order.
On August 6, 2015, the Commissioner issued a final order, through a designee, accepting in part and rejecting in part the ALJ‘s recommendations.
First, the Commissioner accepted the ALJ‘s recommendation to disqualify Salim. Specifically, the Commissioner adopted the ALJ‘s finding regarding the staff attorney‘s mistaken understanding of the relative burdens of proof, and the ALJ‘s conclusion that a preponderance of the evidence supported a determination that Salim wrongfully obtained public child care assistance. Regarding Salim‘s intent and knowledge of the wrongful billing, the Commissioner agreed with the ALJ‘s finding that Salim either submitted the erroneous bills herself or knew of them and did not stop them. Accordingly, the Commissioner concluded that the Department properly disqualified Salim. The Commissioner amended the dollar amount fraudulently obtained to $9,766 from the $9,434 found by the ALJ.
Second, the Commissioner disagreed with the ALJ‘s conclusion that Salim did not pose a risk of harm and rejected the ALJ‘s recommendation that her disqualification should be set aside. The Commissioner struck the ALJ‘s finding that “the purpose of [Salim‘s] activity was to aid families in obtaining and keeping access to child care,” instead finding that Salim posed a risk of harm due to “the harm suffered by the government and other families needing child care.” In a supporting memorandum, the Commissioner explained:
I rejected the ALJ‘s recommendation that [Salim‘s] disqualification should be set aside. The ALJ found that [Salim] established that she does not pose a risk of harm to children enrolled in Kind Heart and that the Department had not demonstrated otherwise. I rejected both the findings and the ALJ‘s conclusion. As the Department pointed out, [Salim‘s] fraudulent billing is
an indication that she may provide erroneous information in other situations. [Salim‘s] failure to be truthful in other situations and comply with other program requirements could harm the children Kind Heart serves.
[Salim] was required to demonstrate that she does not pose a risk of harm to “any person served by the . . . license holder . . . or other entities.”
Minn. Stat. § 245C.22, subd. 4(a) (2014) . [Salim] did not make the required showing. The ALJ focused only on the children enrolled in Kind Heart. I take a much broader view. CCAP, Blue Earth County and [the Department] are entities that were harmed [by Salim‘s] fraudulent billings. State tax payers were also harmed by [Salim] when she received funds she was not entitled to receive. Moreover, the families waiting to be served by CCAP were also harmed. Money that could have been used to pay for their children‘s daycare services was unavailable because it was used to pay Kind Heart‘s erroneous bills.
Third, the Commissioner concluded that the Department properly revoked Kind Heart‘s license. But the Commissioner agreed with the ALJ that the licensing violations in the supplemental revocation order “by themselves did not warrant a license revocation sanction.” The Commissioner rescinded the supplemental order.
Salim and Kind Heart appealed by filing a writ of certiorari with the court of appeals.
7. The court of appeals decision.
On July 25, 2016, the court of appeals affirmed the Commissioner‘s order in its entirety. In re Kind Heart Daycare, No. A15-1470, 2016 WL 3961815 (Minn. App. Jul. 25, 2016). The court concluded that Salim was not entitled to any of the $9,766, and that the Department had not violated
ANALYSIS
This is a proceeding governed by the Minnesota Administrative Procedures Act (APA). See generally
I.
We first address the issue of whether the Commissioner correctly determined that appellants were not entitled to $9,766 of CCAP payments. Appellants argue that Salim was legally entitled to receive CCAP payments for up to 25 absent days per child, whether or not those days were identified as such by entering an “A” on the computerized billing form. In other words, appellants argue, had the form been completely accurate, Kind Heart would have received the same payments that it did in fact receive. Therefore, as to those days, appellants argue that Salim did not violate the statute.
In support, appellants cite State v. Ibarra, 355 N.W.2d 125, 127-32 (Minn. 1984), for the proposition that “the amount of assistance a person is ‘entitled to’ refers to the amount of assistance the person was eligible for absent the misrepresentation.” Appellants point out that enrolled children were actually absent in many of the erroneous CCAP billings, and that Salim was eligible to bill for these absent children. Thus, appellants argue, they are still entitled to those CCAP payments.
We agree with appellants. The plain language of
Read together, the statute‘s provisions plainly contemplate that a person is liable for wrongfully obtaining public assistance payments only to the extent that payments are received to which the person is not entitled and which would not have been received absent the concealment or misrepresentation. Of the $9,766 at issue in this case, appellants billed over $7,000 for enrolled children who were absent and for whom Kind Heart had not yet billed 25 absent days. Accordingly, appellants were entitled to these funds.
Even so, the precise amount of public assistance fraudulently obtained is immaterial to a violation of
II.
Appellants next argue that the Department took a number of unlawful actions leading up to and including the Commissioner‘s final order, all in violation of
A.
We first address various actions by the Department preceding the Commissioner‘s final order.
1. The staff attorney‘s misunderstanding of the relationship between preponderance of the evidence and probable cause.
Appellants first argue that the Department‘s decision was based on the wrong legal standard: probable cause instead of a preponderance of the evidence.
It is unclear whether the staff attorney correctly applied a preponderance-of-the-evidence standard in her initial determination. She understood that her review to determine whether a preponderance of the evidence supported Salim‘s disqualification required a determination of “whether it‘s more likely than not” that Salim violated
But we need not decide this issue, as any error was corrected when both the ALJ and the Commissioner applied the correct legal standard. Both the ALJ and the
We have affirmed final agency orders where an error in the underlying proceedings has been acknowledged and the actual circumstances still support the initial determination. For example, in In re Review of 2005 Annual Automatic Adjustment of Charges for All Elec. & Gas Utils., we affirmed the Minnesota Public Utilities Commission‘s denial of a request for a variance by a utility that sought to recoup unrecovered natural gas costs, despite an error in the initial determination that was corrected in the final order. 768 N.W.2d 112, 122 (Minn. 2009).
Here, we decline to reverse Salim‘s disqualification on the basis of the staff attorney‘s misunderstanding. Any error in the initial determination was corrected by the ALJ and the Commissioner.
2. Department POE reviews based on arrest reports.
Appellants next argue that the Department improperly disqualified Salim based solely on a criminal complaint and supporting documents.
In this case, the County provided the Department with an incident report, a supplemental report, and a criminal complaint, which totaled 22 pages and were the products of months of investigation. The supplemental report is particularly thorough, including day-by-day comparisons of attendance records against MEC2PRO bills, analysis of administrative and banking records, and information from multiple interviews. The staff attorney reviewed the reports and complaint when conducting her POE review.
3. The Department‘s alleged predetermination to disqualify Salim and revoke Kind Heart‘s license.
Appellants also point to several Department actions to argue that the agency predetermined that it would disqualify Salim and revoke Kind Heart‘s license.
First, appellants argue that the Department‘s internal e-mail asked a staff attorney to disqualify Salim “right away” and that being “a part of history” implied that her disqualification was inevitable. But the e-mail asked someone to conduct a POE review “right away,” not to disqualify Salim. Further, the e-mail attached a Mankato Free Press article stating “this is the first criminal prosecution of a child care center for fraudulently billing for child care assistance.” The e-mail‘s subject line, “Be a part of history,” although inartful, referred to the prosecution, not a predetermination to disqualify.
Next, appellants argue that the Department‘s supplemental revocation order evinces a predetermined mindset that requires reversal of Kind Heart‘s license revocation. We disagree, because the ALJ recommended that the supplemental revocation order be rescinded, and the Commissioner agreed, negating any effect of the supplemental order. Moreover, Kind Heart‘s license revocation was based on Salim‘s disqualification, not on the supplemental order.5
In sum, none of the alleged pre-final-order errors require reversal.
B.
Appellants additionally allege various errors in the Commissioner‘s final order that they assert require reversal.
1. Salim‘s intent.
Appellants first argue that the Commissioner‘s order is based on an error of law: Salim cannot be held liable for Patterson‘s incompetence because Patterson lacked intent.6 Specifically, appellants argue that Patterson‘s incompetent filings cannot satisfy
Intent is an element of the statute under the introduction to subdivision 1, which requires “intent to defeat the purposes of . . . child care assistance programs.”
As to intent under the latter statute—“to defeat the purposes of . . . child care assistance programs“—the Commissioner adopted the ALJ‘s findings that Salim either submitted the erroneous bills herself or knew of them and did nothing to correct them, and that billing for services that were not provided defeats the purpose of CCAP. Regardless of whether Salim was acting for the benefit of her clients under the risk-of-harm analysis, Salim still knew that she was receiving CCAP payments for services she did not provide, and that the program depended upon accurate billing by child care providers. There is substantial evidence to support a preponderance-of-the-evidence determination that Salim knew she was defeating the purpose of CCAP. Accordingly, the Commissioner did not
2. Striking a finding by the ALJ without explanation.
Appellants next argue that the Commissioner acted in an arbitrary and capricious manner by striking a finding by the ALJ—allegedly without explanation—that Salim acted for the purpose of helping families obtain child care assistance.
This is simply incorrect. The Commissioner expressly addressed the stricken language in the supporting memorandum, and adequately explained how the Commissioner was taking a broader view of the risk of harm that Salim posed.
3. The Commissioner‘s alleged rejection of testimony that Patterson billed, which was allegedly credited by the ALJ.
Appellants also argue that the Commissioner rejected testimony by Salim that Patterson, not Salim, conducted the billing, and that the ALJ had actually credited Salim‘s testimony on this point.
Again, this is simply incorrect. The ALJ found that the erroneous bills were either submitted by Salim herself, or by Patterson with knowledge by Salim of the errors and without an intention to correct them. Thus, the ALJ did not unequivocally adopt Salim‘s testimony in this regard. The ALJ also noted in a supporting memorandum that Salim more likely than not knew of the erroneous billing, regardless of who actually submitted the bills. The Commissioner expressly stated that she was deferring to the ALJ on this point and, in any event, agreed with the ALJ.
III.
Finally, we consider the issue of whether the court of appeals provided meaningful judicial review of the Department‘s actions under
CONCLUSION
For the foregoing reasons, we affirm the decision of the court of appeals.
Affirmed.
In the Matter of the Appeal by Kind Heart Daycare, Inc. of the Order of License Revocation and the Appeal by Yasmin Salim of the Order of Disqualification
Supreme Court of Minnesota
CONCURRENCE & DISSENT
ANDERSON, Justice (concurring in part, dissenting in part).
I join in the concurrence and dissent of Justice Chutich, but write separately to note that given the increasing use of administrative power—particularly in licensure matters—in the appropriate case we may need to reconsider the very high level of judicial deference extended to the executive branch. See Reserve Mining Co. v. Herbst, 256 N.W.2d 808, 824-25 (Minn. 1977); see also
In the Matter of the Appeal by Kind Heart Daycare, Inc. of the Order of License Revocation and the Appeal by Yasmin Salim of the Order of Disqualification
Supreme Court of Minnesota
CONCURRENCE & DISSENT
CHUTICH, Justice (concurring in part, dissenting in part).
The Department of Human Services disqualified appellant Yasmin Salim from having direct contact with the children served by appellant Kind Heart Daycare, Inc. See
Appellants sought review by an administrative law judge, who held an evidentiary hearing on the consolidated matter. The judge found that Salim had wrongfully obtained payments but further found that Salim had demonstrated that she “poses no risk of harm to the children or families Kind Heart Daycare serves.” See
Accordingly, the judge recommended that Salim‘s disqualification, although appropriate, be “set aside” to allow Salim to continue to have direct contact with children in the daycare. Because Kind Heart‘s loss of license was based in part upon Salim‘s disqualification, which the judge recommended setting aside, the judge further
The administrative law judge also concluded that the additional violations reported in the supplemental revocation order “were all relatively minor” and did not merit license revocation. Finally, the judge recommended that Kind Heart could continue to operate, albeit under a conditional license that set forth a specific timeframe for Kind Heart to comply with a correction order.
The Commissioner of Human Services, acting through a representative, rejected the administrative law judge‘s recommendation on whether Salim posed a risk of harm to the children or their families. Her order therefore refused to set aside Salim‘s disqualification and upheld the revocation of Kind Heart‘s license. The Commissioner agreed that the supplemental violations did not merit revocation.
Under the Minnesota Administrative Procedure Act, we may reverse or modify the Commissioner‘s decision if, among other things, the agency proceedings were made upon unlawful procedure, affected by other error of law, unsupported by substantial evidence, or arbitrary and capricious.
I.
The Department‘s involvement began when Blue Earth County informed it that Salim had been arrested and charged with violating
A Department staff attorney volunteered and made the determination based solely on documentation—namely, the County‘s incident report, a supplemental report, and the criminal complaint. The staff attorney mistakenly believed that the preponderance-of-evidence review she conducted on behalf of the Department was a lower standard of review than the probable cause required for an arrest warrant. But as the court points out, she
This sequence of events is troubling for at least two reasons. First, the initial e-mail sent by the Department, seeking volunteers to be “part of history in the making,” certainly could give the appearance that the Department put a hand on the scale in favor of finding a preponderance of evidence to disqualify Salim. Unlike the court, I am not so certain that the reference to being “a part of history” referred to the historic nature of the prosecution rather than a predetermination to disqualify Salim. Even assuming, as the court does, that the Department‘s invocation of “history in the making” was intended to refer to the allegedly historic first criminal prosecution of a child care center for fraudulently billing for child care assistance—an argument that the Department notably does not make in its brief to our court—that assumption does not alleviate an unseemly appearance of bias by the Department. The Department‘s invitation to be a part of that history is more readily interpreted as an invitation to sign-off on the review and find disqualification. After all, the staff attorney would not be “part of history in the making” if she came back with a review that found no disqualifying event.
Second, the court asserts that it is “unclear” whether staff counsel applied the incorrect standard when undertaking the initial review. My reading of the record suggests otherwise; staff counsel testified—twice—that the preponderance-of-evidence standard
To be sure, the administrative law judge eventually found it more likely than not that Salim violated
Despite my misgivings about this inappropriate e-mail and questionable review by the Department, I am unable to conclude that the Commissioner‘s final order was either made upon unlawful procedure or was arbitrary or capricious. We are charged with
II.
Under the Minnesota Administrative Procedure Act, this court “may affirm the decision of the agency or remand the case for further proceedings; or it may reverse or modify the decision if the substantial rights of the petitioners may have been prejudiced because the administrative finding, inferences, conclusion, or decisions are . . . affected by . . . error of law.”
The Commissioner found by a preponderance of the evidence that Salim failed to “fill in an ‘A‘” as required by the Guide on many occasions, leading to payment of $9,766 in Child Care Assistance Program funds to which Kind Heart was not entitled.
But as the court observed, the statute does not support the Commissioner‘s conclusion as it applies to billings for enrolled children who were absent and for whom Kind Heart had not yet billed 25 absent days. As to those billings, Salim‘s failure to enter
The Commissioner‘s memorandum leaves no doubt that the Commissioner relied heavily on her mistaken interpretation of the law when she analyzed the risk-of-harm factors to determine whether Salim‘s disqualification should be set aside. The Commissioner stated:
I reject Appellant‘s argument that she would have been entitled to the majority of the erroneous payments had the bills correctly identified the absent days. I agree with the [administrative law judge] that the argument is unavailing. Appellant was required to bill the days as absent days[;] because she failed to do so she was not entitled to payment.
. . .
Any one factor set out in Minnesota Statutes section 245C.22, subdivision 4 (2014) can be decisive of whether to set aside a disqualification.
Minn. Stat. § 245C.22, subd. 3 (2014) . Appellant‘s fraudulent billing alone is sufficient to reject her set aside request. The fraudulent billing together with the fact that they were recent and numerous and Appellant‘s refusal to take responsibility for them justify the set aside denial.
Likewise, the Commissioner modified the administrative law judge‘s finding of fact regarding risk of harm to emphasize “the recency, nature, severity and frequency of the erroneous billings.” (Emphasis added.) Thus, the Commissioner‘s findings reflect that she
As to the second factor, the incorrect billings that were actually fraudulent were much less numerous, severe, and frequent than the Commissioner, based on her mistaken interpretation of the law, believed. Thus, the administrative law judge‘s conclusion that because “much of the funds may have been accessible to the Appellant had she ensured proper procedures were followed (e.g., reporting that children were absent . . .), there is little consequence to the County or Department” was correct. And as to the third factor, Salim‘s “refusal to take responsibility for” the incorrect billings was in fact vindicated, at least as to absent days under 25 per child. Accordingly, the Commissioner may well have reached a different decision if she had applied the correct law, especially in light of the recognition by the administrative law judge that Salim‘s billing difficulties were a result of “her over-eager desire to provide safe and necessary services to the children of Somali immigrants and refugees.”
The court does not reach this issue, but I conclude that appellants adequately pressed the issue and we must therefore confront it. In response to appellant‘s petition, we granted review of four issues, including: “When CCAP rules allow payment for 25 absent days per year, does a provider commit fraud under § 256.98 by not identifying an absent day?” That issue is just as relevant to the risk-of-harm/set-aside decision as it is to the disqualification
In their briefs before us, appellants argued that the “Agency Decision,” rather than specifically the disqualification decision or the set-aside decision, was based on a misinterpretation of
In the circumstances of this case, and given our authority to “reverse, affirm or modify the judgment or order appealed from or take any other action as the interest of justice may require,”
CONCLUSION
For these reasons, I respectfully concur in part and dissent in part.
ANDERSON, Justice (concurring in part, dissenting in part).
I join in the concurrence and dissent of Justice Chutich.
