Zander v. Adams ( 2010 )


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  •                                                      FIRST DIVISION
    March 15, 2010
    No. 1-09-0979
    BETTE I. ZANDER,                    )     Appeal from the
    )     Circuit Court of
    Plaintiff-Appellant,           )     Cook County.
    )
    v.                            )     No. 08 CH 23123
    )
    CAROL L. ADAMS, Secretary, The      )
    Department of Human Services        )
    CARMELA A. GARDNER, Chief Bureau    )
    of Assistance Hearings, The         )
    Department of Human Services, and   )
    BARRY MARAM, Director, The          )
    Department of Healthcare and        )
    Family Services,                    )     The Honorable
    )     Leroy K. Martin, Jr.,
    Defendants-Appellees.          )     Judge Presiding.
    JUSTICE GARCIA delivered the opinion of the court.
    Plaintiff Bette I. Zander appeals from an administrative
    decision of the Illinois Department of Human Services
    (Department) imposing a penalty period during which the plaintiff
    is ineligible for Medicaid assistance.    The circuit court
    confirmed the Department's decision.    Mrs. Zander, an elderly
    resident of a long-term care facility, assigned her beneficial
    interest in an Illinois land trust to her three daughters more
    than 36 months prior to applying for benefits.    She argues that
    period was sufficiently long to shield her from a penalty for
    transferring her assets under Department regulations.    The
    Department ruled that Mrs. Zander was required to wait 60 months
    before applying for assistance.
    1-09-0979
    We find the Department properly imposed a penalty on Mrs.
    Zander because the transfer of beneficial interest constituted a
    noncash or property disbursement from a revocable trust under
    Department regulations.   Accordingly, we affirm.
    BACKGROUND
    On June 10, 2003, at the age of 79, Mrs. Zander began living
    in a group care facility in Illinois.    On December 4, 2003, Mrs.
    Zander created the Zander Land Trust to which she transferred
    three parcels of real estate she owned in the County of
    McDonough, McComb, Illinois.   One of Mrs. Zander's daughters,
    Karen Kae Skiles, served as trustee of the Zander Land Trust.
    The trust entitled Mrs. Zander to 100% of "the earnings, avails
    and proceeds of said real estate."   However, under the terms of
    the trust, the beneficiary had no "right, title or interest in or
    to any portion of real estate as such, either equitable or
    legal."   Less than two weeks later, on December 16, 2003, Mrs.
    Zander executed an assignment of beneficial interest in the
    Zander Land Trust transferring all of her beneficial interest to
    her three daughters.
    On January 23, 2007, approximately 37 months after the
    beneficial interest in the Zander Land Trust was transferred to
    Mrs. Zander's three daughters, the Department received Mrs.
    Zander's application for Medicaid assistance.   The Department
    found Mrs. Zander eligible for Medicaid, but imposed a penalty
    period of ineligibility from October 1, 2006, to June 30, 2014
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    1-09-0979
    (later adjusted to February 28, 2011), based on the transfer of
    beneficial interest in the trust, which the Department found was
    a nonallowable transfer of assets subject to review within 60
    months of the application.
    Administrative Hearing
    On October 19, 2007, a formal hearing was held on the
    Department's denial of Medicaid assistance to cover the cost of
    Mrs. Zander's nursing home care.       According to Mrs. Zander's main
    brief, "At the time she applied for medical assistance in
    January, 2007, Mrs. Zander believed that her gift to her
    daughters by assignment of beneficial interest would not affect
    her eligibility as it had occurred more than 36 months prior to
    her application."   Before a hearing officer, Ms. Skiles, the
    trustee of the Zander Land Trust, testified she had neither
    collected any income nor distributed any real estate from the
    trust.
    In its decision, the Department set forth provisions of the
    Illinois Administrative Code (Code) (89 Ill. Adm. Code §120.347,
    amended at 22 Ill. Reg. 16291, 16299-301, eff. August 28, 1998;
    89 Ill. Adm. Code §120.387 amended at 
    23 Ill. Dec. 11301
    , 11309-
    12, eff. August 27, 1999), Title XIX of the Social Security Act
    (42 U.S.C. §1396p (2006)), and section 3259 of the State Medicaid
    Manual (State Medicaid Manual, Health Care Financing
    Administration Publication No. 45-3, Transmittal 64, §3259
    (November 1994) (Transmittal 64)).      It found the trust was a
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    revocable trust; Mrs. Zander's assignment constituted a transfer
    of assets from the trust inuring to the assignees' benefit, which
    constituted a "payment" under the State Medicaid Manual
    triggering the 60-month look-back period.    Because Mrs. Zander
    applied for Medicaid assistance after only 37 months, a penalty
    period of ineligibility was triggered based on the nonallowable
    transfer of revocable trust assets.
    Mrs. Zander sought timely review of the Department's
    decision in the Circuit Court of Cook County.    Treating the issue
    as one of statutory construction subject to de novo review, the
    circuit court agreed with the Department that Mrs. Zander's
    transfer of her beneficial interest in the Zander Land Trust was
    a payment from a revocable trust under the State and federal
    Medicaid statutes, triggering the penalty period of
    ineligibility, and confirmed the Department's decision.      This
    timely appeal followed.
    ANALYSIS
    An administrative agency's decision is subject to judicial
    review under Illinois Administrative Review Law (735 ILCS 5/3-101
    et seq. (West 2006)).     "When reviewing a decision of an
    administrative agency, the appellate court reviews the decision
    of the agency, not the decision of the circuit court."       Vincent
    ex rel. Reed v. Department of Human Services, 
    392 Ill. App. 3d 88
    , 93, 
    910 N.E.2d 723
    (2009).
    Standard of Review
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    The Department asserts the issue is whether, "for purposes
    of Medicaid eligibility, an assignment of a beneficial interest
    in an Illinois land trust is a non-allowable transfer of assets
    subject to a 60-month look-back."      As framed by Mrs. Zander, the
    issue is whether her assignment "is a transfer of her personal
    property or a payment from a revocable trust under 89 Ill. Admin.
    Code §120.387(e) affecting her eligibility for Medicaid coverage
    of her long term care."   In either regard, the parties submit the
    issue presents a question of law, subject to de novo review.      See
    
    Vincent, 392 Ill. App. 3d at 93
    (whether trust assets were
    available to Medicaid applicant to determine eligibility
    presented a pure question of law).      The Department, though
    charged with determining eligibility for Medicaid assistance,
    does not assert that its interpretation of the term "payment," to
    capture the transfer of beneficial interest in an Illinois land
    trust under its regulations, is entitled to any deference by this
    court.   Cf. County of Du Page v. Illinois Labor Relations Board,
    
    231 Ill. 2d 593
    , 608-09, 
    900 N.E.2d 1095
    (2008) (deference is
    owed to the construction of a statute by the agency charged with
    its interpretation).   Accordingly, we construe the meaning of the
    term "payment" in the Department regulations without regard to
    the Department's interpretation.
    Medicaid Legislation
    In 1965, Congress enacted Title XIX of the Social Security
    Act (42 U.S.C. §1396 et seq. (2006)), commonly known as the
    5
    1-09-0979
    Medicaid Act.    Gillmore v. Illinois Department of Human Services,
    
    218 Ill. 2d 302
    , 304, 
    843 N.E.2d 336
    (2006).     We quote at length
    the supreme court's description of the Medicaid program.
    "This statute created a cooperative program
    in which the federal government reimburses
    state governments for a portion of the costs
    to provide medical assistance to two low
    income groups: the categorically needy and
    the medically needy. The categorically needy
    are persons who are automatically eligible to
    receive cash grants under one of the general
    welfare programs [citations].   The medically
    needy are persons who are ineligible to
    receive cash grants *** because their
    resources exceed the eligibility threshold
    ***, but who still lack the ability to pay
    for medical assistance. See 305 ILCS 5/5-2(2)
    (West 2002); [citation] People who fall into
    the second category are called MANG (Medical
    Assistance-No Grant) recipients. See 89 Ill.
    Adm. Code §120.10(a)   (Conway-Greene CD-ROM
    March 2002). To qualify for Medicaid as a
    MANG recipient, a person must have low income
    and low assets, and the person must 'spend
    down' any resources over the statutory and
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    1-09-0979
    regulatory limits. See 89 Ill. Adm. Code
    §120.10(d) (Conway-Greene CD-ROM March
    2002)."   
    Gillmore, 218 Ill. 2d at 304-05
    .
    To ensure that a MANG applicant's true financial resources
    are considered in determining Medicaid eligibility, Congress
    added look-back provisions to the Medicaid Act to examine assets
    held in trusts.
    "In 1993, Congress sought to combat the
    rapidly increasing costs of Medicaid by
    enacting statutory provisions to ensure that
    persons who could pay for their own care did
    not receive assistance.    Congress mandated
    that, in determining Medicaid eligibility, a
    state must 'look-back' into a three- or
    five-year period, depending on the asset,
    before a person applied for assistance to
    determine if the person made any transfers
    solely to become eligible for Medicaid.      See
    42 U.S.C. §1396p(c)(1)(B) (2000).    If the
    person disposed of assets for less than fair
    market value during the look-back period, the
    person is ineligible for medical assistance
    for a statutory penalty period based on the
    value of the assets transferred.    See 42
    U.S.C. §1396p(c)(1)(A) (2000).    Congress also
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    1-09-0979
    mandated that a state plan for medical
    assistance must comply with, inter alia, the
    provisions of section 1396p with respect to
    'transfers of assets[] and treatment of
    certain trusts.' 42 U.S.C. §1396a(a)(18)
    (2000).   That is, any assets disposed of
    during the look-back period are 'countable'
    toward the Medicaid limits and subject to the
    spend-down requirement, if the person's
    resources are over those limits."   
    Gillmore, 218 Ill. 2d at 306-07
    .
    As the supreme court explained in Gillmore, an applicant
    seeking Medicaid under MANG may qualify either by a "spend down"
    of resources or, under the circumstances present in this case
    where a transfer of trust assets occurred, by delaying an
    application for the corresponding look-back period.       
    Gillmore, 218 Ill. 2d at 305
    .     "Thus, the Medicaid Act expresses an intent
    by Congress that '[i]ndividuals are expected to deplete their own
    resources [or engage in transfer of assets sufficiently in
    advance] before obtaining assistance from the government.' "
    
    Vincent, 392 Ill. App. 3d at 94
    , quoting Lebow v. Commissioner of
    the Division of Medical Assistance, 
    433 Mass. 171
    , 172, 
    740 N.E.2d 978
    , 980 (2001).     If an application is submitted within
    the corresponding look-back period following a transfer of assets
    from a trust, the transfer may trigger a statutory penalty period
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    1-09-0979
    of ineligibility.
    When Illinois elected to participate in the Medicaid
    program, the Department implemented a program consistent with the
    federal guidelines.     Gillmore v. Department of Human Services,
    
    354 Ill. App. 3d 497
    , 500-01, 
    822 N.E.2d 882
    (2004), aff’d, 
    218 Ill. 2d 302
    , 
    843 N.E.2d 336
    (2006).    Illinois now essentially
    administers its own Medicaid program.    See West Virginia
    University Hospitals, Inc. v. Casey, 
    885 F.2d 11
    , 15 (3d Cir.
    1989) (Medicaid " 'is basically administered by each state within
    certain broad requirements and guidelines' "), quoting Data On
    the Medicaid Program: Eligibility, Services, Expenditures Fiscal
    Years 1967-77 Before the H. Subcomm. On Health and the
    Environment, H.R. Rep. No. 10, 95th Cong., 1st Sess. 1 (1999).
    Transfer of Assets
    Mrs. Zander sought Medicaid assistance under MANG.      She does
    not contend her transfer of beneficial interest in the Zander
    Land Trust to her daughter was not a transfer of assets under the
    Department regulations.    To the contrary, she contends the 36-
    month period applies to the transfer given the nature of the
    interest transferred.    She asserts the assignment of beneficial
    interest in the Zander Land Trust was a "transfer of her personal
    property, *** not a payment from a revocable trust, *** [and,
    therefore,] subject to the general 36 month look-back period
    imposed on transfers of personal property."    (Emphasis added.)
    The Department found the transfer was subject to a look-back
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    period of 60 months.
    The parties agree that the State Medicaid Manual
    (Transmittal 64) is an essential authority on transfer of assets
    as our supreme court recognized in Gillmore.       Gillmore, 
    218 Ill. 2d
    at 306-07, quoting 42 U.S.C. §1396a(a)(18)(2000) (Transmittal
    64 is a policy document promulgated to comply with "the
    provisions of section 1396p with respect to 'transfer of assets[]
    and treatment of certain    trusts' ").     Mrs. Zander does not
    contend that the Zander Land Trust is exempt from the provisions
    of Transmittal 64 addressing revocable trusts.
    Transmittal 64 provides:
    "Payment - For purposes of this section
    a payment from a trust is any disbursal from
    the corpus of the trust or from income
    generated by the trust which benefits the
    party receiving it.   A payment may include
    actual cash, as well as noncash or property
    disbursements, such as the right to use and
    occupy real property."     State Medicaid
    Manual, Health Care Financing Administration
    Publication No. 45-3, Transmittal 64,
    §3259.1(A)(8) (November 1994).
    The Department promulgated section 120.387 of Title 89 of
    the Code to comply with the requirement for look-back provisions
    of the 1993 amendment to the Medicaid Act.       Section 120.387(d)
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    1-09-0979
    provides:
    "A transfer of assets occurs when an
    institutionalized person *** gives away real
    or personal property ***.   Changing ownership
    of property to a life estate interest is an
    asset transfer ***.   For assets held in joint
    tenancy, tenancy in common or similar
    arrangement, a transfer occurs when an action
    by any person reduces or eliminates the
    person's ownership or control of the asset.
    A transfer occurs when an action or actions
    are taken which would cause an asset or
    assets not be received ***."   89 Ill. Adm.
    Code §120.387(d), amended at F23 Ill. Reg.
    11301, 11310, eff. August 27, 1999.
    Section 120.387(e) determines the circumstances when the 60
    month look-back period applies:
    "(A) the 60 month period applies to
    payments from a revocable trust that are not
    treated as income (as described in Section
    120.347) ***."   89 Ill. Adm. Code
    §120.387(e)(1)(A), amended at 23 Ill. Reg.
    11310, eff. August 27, 1999.
    As a matter of convenience to assist in our review of the
    imposition of the statutory penalty, we read section 120.387(e)
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    1-09-0979
    to require three elements before the 60-month period is
    triggered: (1) a transfer from a revocable trust; (2) the
    transfer from the trust is not an income payment under section
    120.347(f)(2); and (3) the transfer is a payment, other than an
    income payment.
    Mrs. Zander concedes that the Zander Land Trust is a
    revocable trust, satisfying the first element.
    There is also no dispute that the second element is
    satisfied--the Department could not treat the transfer of
    beneficial interest from Mrs. Zander to her daughters as an
    income payment under section 120.347(f)(2).   A transfer is
    treated as an income payment only if it is "made to or for the
    benefit of" the Medicaid applicant, Mrs. Zander.   89 Ill. Adm.
    Code §120.347(f)(2), amended at 22 Ill. Reg. 16300, eff. August
    28, 1998.
    The disagreement between the parties centers on whether Mrs.
    Zander's transfer of her beneficial interest in the Zander Land
    Trust to her daughters constituted a payment (other than an
    income payment), the third element of section 120.387(e)(1)(A).
    Under Transmittal 64, only if the transfer qualifies as a
    "payment" from the revocable trust would the 60-month look-back
    period apply; by contrast, the 36-month period would apply if the
    transfer were merely a gift of personal property, as Mrs. Zander
    contends.   At the formal hearing, the Department acknowledged
    that had the transfer been of a "savings account, stock
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    1-09-0979
    certificates or savings bonds," the look-back would be 36 months.
    Mrs. Zander puts forth several interrelated arguments
    against the Department's decision that the assignment was a
    nonallowable transfer of trust assets within 60 months of her
    Medicaid application to trigger the statutory penalty period.
    Common to each of her arguments is the contention that Mrs.
    Zander's assignment of beneficial interest is irreconcilable with
    the term "payment" in the Department regulations.
    Penal Regulation
    In challenging the Department's decision, Mrs. Zander makes
    note that the Department imposed a penalty of ineligibility for
    Medicaid assistance because the Department found a nonallowable
    transfer of assets from the Zander Land Trust under section
    120.387.    Based on the "penal" nature of section 120.387 as to
    Medicaid eligibility, Mrs. Zander argues that the section "must
    be strictly construed and the definition of 'payment' may not be
    extended to include an assignment of beneficial interest."    She
    cites various cases strictly construing penal statutes as
    authority.    In her reply brief, Mrs. Zander notes, "The
    Department did not refute Mrs. Zander's assertion that the
    applicable regulation is punitive and therefore subject to strict
    construction."
    At oral argument, the Department asserted that the
    characterization of section 120.387 as punitive did not warrant a
    written response because characterizing the regulation as
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    1-09-0979
    "punitive" does not aid in interpreting the controlling
    regulations of the Department.    According to the Department, the
    underlying question before us is whether the assignment of
    beneficial interest in the Zander Land Trust qualifies as a
    "payment" under the plain and clear language in Transmittal 64
    and the Department regulations.    From the Department's
    perspective, there is little in the definition of "payment" that
    lends itself to be strictly construed.
    Because we agree that characterizing the regulation as
    "punitive" does not aid in the interpretation of the Department
    regulations, we do not address whether the term "payment" is
    subject to strict construction.    See Sylvester v. Industrial
    Comm'n, 
    197 Ill. 2d 225
    , 232, 
    756 N.E.2d 822
    (2001) (the primary
    goal in construing the meaning of a statute, "to which all other
    rules are subordinate, is to ascertain and give effect to the
    intention of the legislature").    While section 120.387 explicitly
    labels the period of ineligibility a "penalty" for nonallowable
    transfers of assets of revocable trusts during the controlling
    look-back period (89 Ill. Adm. Code §120.387(f), amended at 23
    Ill. Reg. 11312, eff. August 27, 1999), we must affirm the
    Department's decision if the assignment of beneficial interest
    constitutes a "payment" under the plain and clear language of
    Transmittal 64 and the Department regulations, a question we
    examine de novo.   See 
    Gillmore, 354 Ill. App. 3d at 500
    (we look
    to the clear and plain meaning of the regulation to determine
    14
    1-09-0979
    whether the Department's interpretation is correct).
    Beneficial Interest as Personal Property
    Fundamental to Mrs. Zander's arguments is her contention
    that it is "well settled Illinois law that the beneficiary of an
    Illinois land trust holds a personal property interest in the
    land trust."    See 765 ILCS 405/1 (West 2006); Klein v. La Salle
    National Bank, 
    155 Ill. 2d 201
    , 207, 
    613 N.E.2d 737
    (1993)
    (beneficiaries' interest in Illinois land trust "is personal
    property").    Mrs. Zander contends that because the interest she
    assigned to her daughters is considered "personal property" under
    Illinois law, this characterization controls the nature of the
    asset transferred from the Zander Land Trust notwithstanding that
    the Zander Land Trust was established with the conveyance of real
    property.    Premised on the transfer of beneficial interest as a
    transfer of personal property, Mrs. Zander argues that the
    transfer here cannot constitute a "payment from the trust."
    (Emphasis added.)    She contends the "personal property interest
    was never a part of the corpus of the Land Trust and, therefore,
    could not be paid from the Zander Land Trust."
    We do not agree that the legal characterization of
    beneficial interest as "personal property" under Illinois land
    trust law controls the Department's review of Mrs. Zander's
    transfer of beneficial interest from the Zander Land Trust to her
    daughters.    As our supreme court noted, Congress made clear in
    its 1993 amendment to the Medicaid Act with the addition of
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    1-09-0979
    section 1396p that persons able to pay for their own care could
    not avoid doing so by the " 'transfer of assests[] and treatment
    of certain trusts.' "    Gillmore, 
    218 Ill. 2d
    at 307, quoting 42
    U.S.C. §1396a(a)(18) (2000).    We are unpersuaded that the legal
    characterization of beneficial interest in an Illinois land trust
    as personal property should necessarily exclude from the term
    "payment" a transfer of assets from a revocable trust under the
    Department regulations mandated by section 1396p of the Medicaid
    Act.    Cf. 
    Vincent, 392 Ill. App. 3d at 95
    (Medicaid Act
    established that specially designed trusts "were 'no longer a
    permissible means to shelter assets for purposes of Medicaid
    eligibility' "), quoting Ramey v. Reinertson, 
    268 F.3d 955
    , 959
    (10th Cir. 2001).
    Further supporting our conclusion is Mrs. Zander's
    observation in her main brief that "[t]he Illinois land trust is
    '*** a legal fiction whereby an individual converts his ownership
    interest in real property to ownership in personal property.'
    [Quoting] Smith v. First National Bank of Danville, 
    254 Ill. App. 3d
    251, 264, 
    624 N.E.2d 899
    (1993)."    Mrs. Zander offers no
    compelling reason that this "legal fiction" should be carried
    over to Medicaid eligibility when Congress, in an effort to
    address the "increasing costs of Medicaid," mandated that state
    plans consider the true resources of Medicaid applicants by
    looking back into transfers of trust assets.    Gillmore, 
    218 Ill. 2d
    at 307.
    16
    1-09-0979
    In any event, under section 120.387(d), a transfer of
    assets, subject to a look-back period, "occurs when an
    institutionalized person *** gives away real or personal property
    ***."   89 Ill. Adm. Code §120.387(d), amended at 23 Ill. Reg.
    11310 eff. August 27, 1999.    As the title to section 120.387
    makes clear, consistent with the mandate from Congress, the focus
    is on "Property Transfers Occurring On or After August 11, 1993."
    (Emphasis added.)   89 Ill. Adm. Code §120.387, amended at 23 Ill.
    Reg. 11309, eff. August 27, 1999.     We find unpersuasive Mrs.
    Zander's position that a transfer of beneficial interest from the
    Zander Land Trust is, by its very nature, irreconcilable with the
    term "payment" to trigger the 60-month look-back period for
    transfers from a revocable trust.     We reject Mrs. Zander's
    position that the term "payment" cannot apply to the transfer of
    beneficial interest in an Illinois land trust simply because,
    under Illinois law, the focus is on the beneficial interest
    rather than the real property, which forms the principal of the
    land trust.
    Corpus of Trust
    Mrs. Zander next contends that because the assignment of
    beneficial interest in the Zander Land Trust only changed the
    persons that are entitled to benefit from the "the earnings,
    avails and proceeds of said real estate," the corpus of the land
    trust remained unaffected.    The argument is that because the
    corpus of the land trust remained intact, her "assignment of the
    17
    1-09-0979
    beneficial interest was simply a transfer of personal property by
    Bette Zander to her daughters and not a payment from the trust."
    (Emphasis added.)   Once again, we reject Mrs. Zander's position
    that a payment from a trust cannot capture the transfer of
    beneficial interest of a land trust simply because the personal
    property interest she conveyed in the assignment was not a part
    of the corpus of the land trust.     We reject Ms. Zander's solitary
    focus on the "personal property" nature of the interest
    transferred from the Zander Land Trust to drive our analysis.
    We emphatically reject Mrs. Zander's claim that "Mrs.
    Zander's beneficial interest was not an asset of the Zander Land
    Trust" by virtue of Illinois land trust law that treats the
    beneficial interest in the land trust as personal property.    We
    reject Mrs. Zander's implicit claim that the principal of the
    land trust and the beneficial interest in the trust are wholly
    unrelated.   That this claim borders on fiction is readily
    discernable given that the holder of beneficial interest in an
    Illinois land trust also has the power to dissolve the trust and
    sell the real estate, as Mrs. Zander conceded at oral argument.
    See IMM Acceptance Corp. v. First National Bank & Trust Co., 
    148 Ill. App. 3d 949
    , 954, 
    499 N.E.2d 1012
    (1986) ("While referred to
    as personal property, every attribute of real property ownership,
    except title, is retained by the beneficiary under [an Illinois
    land] trust agreement").
    In accordance with the congressional mandate that the
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    1-09-0979
    Illinois Medicaid program take into account the full resources of
    Medicaid applicants, the Department regulations focus on
    transfers of assets from a trust.     We note that had no transfer
    of beneficial interest occurred prior to Mrs. Zander's
    application for Medicaid assistance, the Department was required
    to treat the real property in the Zander Land Trust "as an
    available asset" under section 120.347(f)(1) regardless of the
    restrictions in the land trust documents.    See Vincent, 392 Ill.
    App. 3d at 93-96 (court upheld Department's determination that
    "trust assets were available for [Medicaid applicant] under
    federal medicaid law, notwithstanding the trust language to the
    contrary").   There is no suggestion by Mrs. Zander that this is
    not so.
    If the parcels of real property conveyed to the Zander Land
    Trust constituted an available asset of Mrs. Zander prior to the
    assignment of beneficial interest, we find no basis for the
    available asset in the trust to effectively disappear by the
    conveyance of beneficial interest of the Zander Land Trust to her
    daughters.    We are unpersuaded that the assignment could not fall
    within "other payments from the trust as transfers of assets by
    [the Medicaid applicant] (subject to the provisions of Section
    120.387)" (89 Ill. Adm. Code §120.347(f)(3), amended at 22 Ill.
    Reg. 16300, eff. August 28 1999), simply because the use of the
    term "payment" is contrary to Mrs. Zander's notion of conveyance
    of personal property.
    19
    1-09-0979
    Final Administrative Decision
    In her main brief, Mrs. Zander complains that the "Final
    Administrative Decision contained no analysis as to why Mrs.
    Zander's assignment of beneficial interest in the Zander Land
    Trust was treated as a 'payment' from a revocable trust."      We
    offer the following analysis for the Department's decision
    specific to Mrs. Zander's circumstances.
    On December 4, 2003, after Mrs. Zander became a resident of
    a care facility, Mrs. Zander established the Zander Land Trust,
    to which assets of Mrs. Zander were conveyed in the form of
    several parcels of real estate.    Mrs. Zander concedes the Zander
    Land Trust was a revocable trust.      The Zander Land Trust fell
    subject to section 120.347 (Treatment of Trusts) because "assets
    of [Mrs. Zander] were used to form *** the principal of the
    trust."   89 Ill. Adm. Code §120.347(c), amended at 22 Ill. Reg.
    16299, eff. August 28, 1998.
    On December 16, 2003, Mrs. Zander assigned her beneficial
    interest in the Zander Land Trust to her three daughters.      When
    Mrs. Zander applied for Medicaid assistance, the Department had
    "to determine if [Mrs. Zander] made any transfers solely to
    become eligible for Medicaid."    Gillmore, 
    218 Ill. 2d
    at 306.       In
    accordance with the congressional mandate on examining assets
    held in trust, the Department had to treat the principal of the
    Zander Land Trust as an available asset of Mrs. Zander.      The
    Department then had to determine whether the assignment of
    20
    1-09-0979
    beneficial interest fell within the provision requiring that "any
    other payments from the trust [be treated] as transfers of assets
    by [Mrs. Zander] (subject to provisions of Section 120.387)."     89
    Ill. Adm. Code §120.347(f)(3), amended at 22 Ill. Reg. 16300,
    eff. August 28, 1998.
    If the assignment constituted a "payment" from a revocable
    trust as contemplated by section 120.387(e)(1)(A), then the 60-
    month look-back period applied to Mrs. Zander's transfer of
    assets to her daughters by way of assignment of beneficial
    interest in the Zander Land Trust.   89 Ill. Adm. Code
    §120.347(f)(3), amended at 22 Ill. Reg. 16300, eff. August 28,
    1998; 89 Ill. Adm. Code §120.387(e)(1)(A), amended at 23 Ill.
    Reg. 11310, eff. August 27, 1999.
    Section 120.347(f)(2) requires that the Department "treat as
    income[,] payments from the trust that are made to or for the
    benefit of [Mrs. Zander]"; however, no such income payments were
    ever made.   89 Ill. Adm. Code §120.347(f)(2), amended at 22 Ill.
    Reg. 16300, eff. August 27, 1998.    Section 120.347(f)(3) requires
    that the Department "treat any other payments from the trust as
    transfers of assets by [Mrs. Zander]."   (Emphasis added.)   89
    Ill. Adm. Code §120.347(f)(3), amended at 22 Ill. Reg. 16300,
    eff. August 28, 1998.
    There is no distinction in the use of "payments" in sections
    120.347(f)(2) and (f)(3).   "Payment" is also used in section
    120.387(e)(1)(A) ("the 60 month period applies to payments from a
    21
    1-09-0979
    revocable trust") (emphasis added), 89 Ill. Adm. Code
    §120.387(e)(1)(A), amended at 23 Ill. Reg. 11310, eff. August 27,
    1999.   We perceive no difference in the meaning of "payment" used
    in the Treatment of Trusts section (section 120.347) and the
    meaning of "payment" used in the section titled Property
    Transfers Occurring On or After August 11, 1993 (section
    120.387).   The term "payments" in section 120.387(e)(1)(A)
    conveys precisely the same action conveyed in sections
    120.347(f)(2) and (f)(3), that is, a transfer of assets from a
    trust, either as "income payments" or, more broadly, as "any
    other payments."   See McMahan v. Industrial Comm'n, 
    183 Ill. 2d 499
    , 513, 
    702 N.E.2d 545
    (1998) ("Under basic rules of statutory
    construction, where the same words appear in different parts of
    the same statute, they should be given the same meaning unless
    something in the context indicates that the legislature intended
    otherwise").
    That the term "payment" is repeatedly used in the Department
    regulations is simply a matter of convenience expressing a
    transfer of trust assets either to or by a Medicaid applicant.
    It is the transfer of assets, which constitutes a "payment," that
    bears scrutiny under the Department regulations: "A transfer of
    assets occurs when an institutionalized person *** buys, sells or
    gives away real or personal property ***."   89 Ill. Adm. Code,
    §120.387(d), amended at 23 Ill. Reg. 11301, eff. August 27, 1999.
    Mrs. Zander gave away her beneficial interest in the Zander Land
    22
    1-09-0979
    Trust to her daughters.   We find no basis to exclude this
    transfer of assets from scrutiny under the Department regulations
    regarding property transfers from trusts for Medicaid eligibility
    simply because the conveyance is considered under Illinois law to
    be that of personal property, a conveyance which Mrs. Zander
    contends is at odds with the common understanding of the term
    "payment."   "Payment" as used in the Department regulations
    simply captures the transfer of assets from a revocable trust,
    which occurred when Mrs. Zander assigned the beneficial interest
    in the Zander Land Trust to her daughters.
    Against this reading of "payment" in the Department
    regulations to capture the transfer of assets from a revocable
    trust, Mrs. Zander contends that "payment" under the definition
    in Transmittal 64 is restricted to a "disbursal from the corpus
    of the trust or from income generated by the trust."   Transmittal
    64, §3259.1(a)(8).   We are not persuaded that the quoted language
    controls the meaning of "payment."
    Transmittal 64 further provides that "payment" "may include
    *** noncash or property disbursements, such as the right to use
    and occupy real property."   Transmittal 64, §3259.1(a)(8).    That
    broader definition of "payment" in Transmittal 64 fits precisely
    the situation present in this case.   Mrs. Zander's assignment of
    beneficial interest in the Zander Land trust was either a noncash
    disbursement (if Mrs. Zander persists in her claim that
    assignment was of "personal property") or a property
    23
    1-09-0979
    disbursement, giving her daughters the right to use and occupy
    the real property constituting the principal of the trust.    The
    right to use and occupy is much like the right granted by the
    Zander Land Trust Agreement to the beneficiaries, which includes
    the "power of direction to deal with the title to said property
    and to manage and control said property *** and *** to receive
    the proceeds from rentals and from mortgages, sales or other
    disposition of said premises."    With the assignment of beneficial
    interest, Mrs. Zander's three daughters were given the right to
    use and occupy the principal of the trust, no less so than Mrs.
    Zander had the right to use and occupy the parcels of real estate
    prior to establishing the Zander Land Trust.   See IMM Acceptance
    
    Corp., 148 Ill. App. 3d at 954
    .
    By their clear and plain language, Transmittal 64 and
    section 120.347 and section 120.387 provide a consistent meaning
    of "payment," which captures an assignment of beneficial interest
    because it involves a transfer of assets from the revocable
    Zander Land Trust.   Transmittal 64, §3259.1(a)(8); 89 Ill. Adm.
    Code §120.347, amended at 22 Ill. Reg. 16299, eff. August 28,
    1998; 89 Ill. Adm. Code §120.387, amended at 23 Ill. Reg. 11309,
    eff. August 27, 1999.
    As matter of law, Mrs. Zander's assignment of her beneficial
    interest in the Zander Land Trust was subject to the 60-month
    look-back period to determine Medicaid eligibility.   Because Mrs.
    Zander applied for Medicaid after only 37 months following her
    24
    1-09-0979
    transfer of the assets of the Zander Land Trust to her daughters,
    she was subject to a statutory period of ineligibility.
    CONCLUSION
    Mrs. Zander's transfer of her beneficial interest in the
    Zander Land Trust constituted a "payment" from a revocable trust
    because it was a noncash disbursement or a disbursement of
    property rights regarding the parcels of real property
    constituting the principal of the Zander Land Trust.   The 60-
    month look-back period therefore applied to Mrs. Zander's
    Medicaid application.   Because she transferred her beneficial
    interest in the Zander Land Trust within 60 months of the
    application, the Department properly imposed the statutory
    penalty period for Medicaid assistance.
    Affirmed.
    PATTI and LAMPKIN, JJ., concur.
    25
    1-09-0979
    REPORTER OF DECISIONS - ILLINOIS APPELLATE COURT
    ____________________________________________________________________
    BETTE I. ZANDER,
    Plaintiff-Appellant,
    v.
    CAROL L. ADAMS, Secretary, The Department of Human Services,
    CARMELA A. GARDNER, Chief Bureau of Assistance Hearings, The
    Department of Human Services, and BARRY MARAM, Director, The
    Department of Healthcare and Family Services,
    Defendants-Appellees.
    ________________________________________________________________
    No. 1-09-0979
    Appellate Court of Illinois
    First District, First Division
    Filed: March 15, 2010
    _________________________________________________________________
    JUSTICE GARCIA delivered the opinion of the court.
    PATTI and LAMPKIN, JJ., concur.
    _________________________________________________________________
    Appeal from the Circuit Court of Cook County
    Honorable Leroy K. Martin, Jr., Judge Presiding
    _________________________________________________________________
    For PLAINTIFF-           Janna Dutton
    APPELLANT                Janna Dutton & Associates, PC
    One N. LaSalle Suite 1700
    Chicago, IL 60602
    For DEFENDANT-           Lisa Madigan, Attorney General, State of Illinois
    APPELLEE                 Michael A. Scodro, Solicitor General
    Carl J. Elitz
    Assistant Attorney General
    100 W. Randolph Street, 12th Floor
    Chicago, IL 60601
    26