IN THE MATTER OF P.A. (DIVISION OF DEVELOPMENTAL DISABILITIES) (RECORD IMPOUNDED) ( 2019 )

RECORD IMPOUNDED
NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the
internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-5521-16T2
IN THE MATTER OF P.A.
________________________
Submitted October 25, 2018 – Decided January 17, 2019
Before Judges O'Connor and Whipple.
On appeal from the New Jersey Department of Human
Services, Division of Developmental Disabilities.
William E. Anderson, appellant pro se.
Gurbir S. Grewal, Attorney General, attorney for
respondent New Jersey Department of Human
Services (Melissa H. Raksa, Assistant Attorney
General, of counsel; James A. McGhee, Deputy
Attorney General, on the brief).
PER CURIAM
P.A. is an adult client of the New Jersey Division of Developmental
Disabilities (Division). He has resided in a Division-funded residential facility
for a number of years. He appeals from the Division's July 11, 2017 final
agency decision, which adopted the recommended decision of an
administrative review officer.
P.A. mounts three principal contentions. He challenges the Division's
authority to require him to contribute toward the cost of his care. He further
claims that, even if he is obligated to contribute, the Division's method of
calculating his contribution is erroneous. Finally, he claims the Division's
method of calculating the amount he must pay for a guardianship fee and a
burial trust fund is erroneous. After reviewing the record and applicable legal
principles, we affirm.
In general, an adult client receiving Division-funded services is
responsible for all necessary costs of his care and maintenance, see N.J.S.A.
30:4-24(6); N.J.A.C. 10:46D-2.1(f), but the Division in fact requires that a
client pay only a percentage share commensurate with his income. See
N.J.S.A. 30:4-60a; N.J.A.C. 10:46D-2.2(c) and (d); N.J.A.C. 10:46D-3.1.
P.A. receives unearned income in the form of Social Security benefits
(benefits). Consistent with N.J.A.C. 10:46D-3.1, the Division has required and
P.A. has contributed only a portion of his benefits to the Division to pay for
the cost of his care. N.J.A.C. 10:46D-3.1 provides a formula the Division is to
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use to calculate what an adult client who does not have dependents must
contribute; P.A. does not have any dependents.
Specifically, N.J.A.C. 10:46D-3.1(b) mandates such an adult client
contribute seventy-five percent of his disposable monthly income toward the
cost of his care. Further, as much as six percent of his total gross annual
income may be used toward a guardianship fee. See N.J.A.C. 10:46D-3.1(f).
P.A.'s parents serve as his guardians. N.J.A.C. 10:46D-3.1(g) provides that an
individual may contribute as much as ten percent per month of his disposable
income toward a burial trust until the burial contract is paid in full.
In September 2016, P.A. submitted an appeal letter to the Division
contesting the method used to determine his contribution to the cost of his
care. Unsatisfied with the Division's response, in November 2016, P.A.'s
guardians and Division representatives met to discuss the cost of P.A.'s care in
an informal conference. During the conference, the guardians also asserted the
Division incorrectly calculated P.A.'s contribution to his guardianship fee.
The Division staff advised the guardians that, first, in accordance with
N.J.A.C. 10:46D-3.1(b), seventy-five percent of P.A.'s disposable monthly
income was being used toward the cost of his care. Second, consistent with
N.J.A.C. 10:46D-3.1(f), P.A. was permitted to use up to six percent of his total
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gross annual income for the provision of a private guardianship. In 2016,
P.A.'s total gross annual income was $15,564.
To determine the specific contributions P.A. was required to pay
pursuant to N.J.A.C. 10:46D-3.1(b) and (f), the Division staff subtracted from
P.A.'s monthly gross income of $1297 a six percent guardianship fee of $77.82
($1297 x .06), as well as his monthly personal needs allowance of $40, leaving
P.A. a monthly disposable income of $1179.18. From the latter figure, the
Division determined P.A. owed $884.38 per month to the Division for his care
($1179.18 x 75%), and P.A. retained $412.62 per month for himself.
During the conference, the guardians asserted the guardianship fee
should have been calculated after deducting from P.A.'s gross monthly income
his personal needs allowance and his contribution toward his care, which
would have resulted in him retaining $432.07 per month for himself. The
guardians also claimed the Division lacked any authority to require P.A. to
contribute to his care; it is not clear from the record what the guardians' basis
was for this claim. The guardians demanded P.A. be refunded for any
contributions he made for his care during the previous decade.
Following the conference, P.A. requested he be permitted to contribute
to a burial trust fund, pursuant to N.J.A.C. 10:46D-3.1(g)(4). The Division
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approved, allowing P.A. to contribute up to ten percent of his disposable
monthly income to a burial trust fund. An irrevocable burial trust fund was
subsequently opened on his behalf. P.A. thereafter claimed the Division was
deducting too much from his income to fund this trust. Notwithstanding
N.J.A.C. 10:46D-3.1(g)(4) states a burial trust fund allowance is to be
deducted before the contribution to care amount is calculated and removed,
P.A. contended the burial trust fund allowance should have been calculated by
taking ten percent of P.A.'s disposable income after the amount he was to
contribute toward his care had been deducted.
In December 2016, a Community Services Administrative Practice
Officer of the Division issued a report rejecting all of P.A.'s contentions. In
April 2017, a Division administrative review officer submitted a recommended
opinion, in which it found the Division correctly calculated P.A.'s
contributions to his care, guardianship fee, and burial trust fund, finding all
calculations adhered to applicable regulations. The recommended opinion was
adopted as a final agency decision by the assistant commissioner of the
Division of Developmental Disabilities. This appeal ensued.
On appeal, P.A. contends N.J.S.A. 30:4-60(b) precludes the Division
from requiring P.A. to contribute toward his care, because there was no "prior
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annual formula promulgated by the Department of the Treasury." He seeks the
return of all money he has paid toward his care. He also contends the
guardianship fee and the contribution to the burial trust fund must be
determined by calculating these costs "last."
"Appellate courts have 'a limited role' in the review of [agency]
decisions." In re Stallworth, 208 N.J. 182, 194 (2011) (quoting Henry v.
Rahway State Prison, 81 N.J. 571, 579 (1980)). To reverse, an appellate court
must find that the agency decision was arbitrary, capricious, or unreasonable.
In re Proposed Quest Acad. Charter Sch. of Montclair Founders Grp., 216 N.J.
370, 385 (2013). A court may intervene where it is "clear that the agency
action is inconsistent with its mandate," or if the agency's decision is
unsupported by substantial evidence in the record. Ibid. (quoting In re
Petitions for Rulemaking, N.J.A.C. 10:82-1.2 & 10:85-4.1, 117 N.J. 311, 325
(1989)).
N.J.S.A. 30:4-60 provides in pertinent part:
b. If the Department of Human Services determines
that the person has a developmental disability and is
eligible for functional services from the Division of
Developmental Disabilities, the department, using a
formula of financial ability to pay as promulgated
annually by the Department of the Treasury, shall
determine if the person with a developmental
disability has sufficient income, assets, resources or
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estate to pay for the person's maintenance as fixed by
the department, or is able to make any payment
towards the person's maintenance, or if the person's
chargeable relatives or other persons chargeable by
contract are able to pay the person's maintenance or
make any payment toward the person's maintenance
on the person's behalf.
[(emphasis supplied).]
P.A. asserts that, since 2010, in contravention of N.J.S.A. 30:4-60(b), the
Department of Treasury has not promulgated a formula of financial ability to
pay. Therefore, P.A. reasons, because the Division has not had a formula to
determine how much an adult client must contribute toward his care, the
Division lacked authority to assess any costs against him, entitling him to a
refund of any contribution he has made toward his care. We disagree.
N.J.S.A. 30:4-60a states the Department of Human Services shall adopt
regulations pursuant to the Administrative Procedure Act, N.J.S.A. 52:14B-1
to -31, "concerning the . . . determination of patient liability to contribute to
the cost of care and maintenance pursuant to [N.J.S.A.] 30:4-60." In
accordance with N.J.S.A. 30:4-60a, the Division adopted various regulations,
one of which establishes the formula to calculate an adult client's contribution
to his care, including the client's contribution toward his guardianship fee and
a burial trust fund. See N.J.A.C. 10:46D-3.1. In accordance with the authority
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this regulation provided to it, the Division properly assessed the subject costs
and contributions about which P.A. complains.
We have considered P.A.'s claim the Division did not calculate these
costs and contributions in accordance with the regulatory formula, and have
determined his arguments are without sufficient merit to warrant discussion in
a written opinion. R. 2:11-3(e)(1)(E).
Affirmed.
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