IN THE MATTER OF DENIAL OF WAIVER FOR ALBERTO SANCHEZ (NEW JERSEY DEPARTMENT OF HEALTH)

NOT FOR PUBLICATION WITHOUT THE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-4258-16T4
IN THE MATTER OF
DENIAL OF WAIVER FOR
ALBERTO SANCHEZ.
__________________________
Argued August 14, 2018 – Decided September 4, 2018
Before Judges Sumners and Gilson.
On appeal from the New Jersey Department of
Health, Office of Emergency Medical Services.
Matthew R. Streger argued the cause for
appellant (Keavney & Streger, attorneys;
Matthew R. Streger and Margaret A. Keavney,
of counsel and on the brief).
Stephen J. Slocum, Deputy Attorney General,
argued the cause for respondent (Gurbir S.
Grewal, Attorney General, attorney; Melissa H.
Raksa, Assistant Attorney General, of counsel;
Stephen J. Slocum, on the brief).
PER CURIAM
Appellant Alberto Sanchez appeals the final agency decision
of the Department of Health (DOH) denying his request to waive the
clinical training requirements of the Emergency Medical Services
Act (EMS Act), N.J.S.A. 26:2K-7 to -64, to allow him to sit for
the National Registry of Emergency Medical Technicians-Paramedic
Certification Examination. We affirm because we conclude that the
DOH's decision was consistent with its governing regulations and
was not arbitrary, capricious, or unreasonable.
On February 6, 2014, Sanchez started his didactic training,
the first of the two-phase training process required by N.J.A.C.
8:41A-1.4 to obtain his paramedic certification. Upon starting
the training process, he was required to complete it within thirty-
six months, meaning before February 6, 2017. N.J.A.C. 8:41A-
2.4(h). Sanchez successfully completed the didactic training on
December 18, 2014, well within the eighteen-month requirement of
N.J.A.C. 8:41a-2.4(g). Thereafter, he had another eighteen months
to complete his clinical training requirements. N.J.A.C. 8:41a-
2.4(g). When he was unable to complete his clinical training
within that period, his request for a six-month extension under
N.J.A.C. 8:41A-2.4(g) was granted on July 25, 2016, by the DOH's
Office of Emergency Medical Services (OEMS); giving him until
December 22, 2016, to complete his clinical training. The OEMS
also reminded Sanchez that he had to complete the training process
within thirty-six months of his training start date, but
incorrectly stated that date was February 22, 2017, rather than
February 6, 2017.
Despite obtaining an extension, Sanchez failed to timely
complete his clinical training by not participating in at least
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five cardiac arrest resuscitations and not successfully performing
at least five defibrillations and synchronized cardioversions.
N.J.A.C. 8:41A-2.6(a)(9) and (10). He only participated in three
cardiac arrests, and failed to complete any defibrillations or
cardioversions. On February 28, 2017, he requested a waiver of
these requirements under N.J.A.C. 8:41A-1.4, so that he could
complete several cardiac arrest scenarios requiring unsynchronized
cardiac defibrillations and synchronized cardioversions during a
competency evaluation to be conducted the following week. The
OEMS denied the waiver request on March 6, 2017, because under
N.J.A.C. 8:41A-2.4, his training could not be extended beyond
February 6, 2017 – thirty-six months of his starting date – and
there were public health concerns if he was allowed more time.
A month later, Sanchez applied to the DOH for emergent relief
to obtain a waiver of the requirements of N.J.A.C. 8:41A-2.6(a)(9)
and ten (10) clinical requirements "conditioned on the customary
conditions establishing competence in skill (cardiac arrest
management and defibrillations/synchronized cardioversion)" so
that he could seek to obtain his paramedic certification. In his
supporting affidavit, he claimed that he stopped his training from
February 2015 to July 2016, due to rumors, which the OEMS failed
to squelch, that his training program would be invalidated. He
maintained that he resumed the training program after learning
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that the program was not invalidated,1 and that other students
from his program had achieved their paramedic certification. The
DOH issued a final agency decision denying Sanchez relief; citing
the absence of any contested facts requiring a hearing before the
Office of Administrative Law and Sanchez's failure to complete his
training within thirty-six-months of his start date.
On appeal, Sanchez argues:
POINT I
THE DEPARTMENT OF HEALTH'S DECISION TO DENY
THE REQUESTED WAIVER OF THE MINIMUM NUMBER OF
CARDIAC INTERVENTIONS WAS ARBITRARY,
CAPRICIOUS, OR UNREASONABLE.
A. The Department of Health's Action
Violates Express or Implied Legislative
Polices.
B. The Record Contains No Substantial
Evidence To Support The Findings On Which
The Department Of Health Based Its
Action.
C. The Department Of Health's Denial Of
the Waiver Was Not Reasonably Based On A
Showing Of Any Relevant Factors.
POINT II
THE DEPARTMENT OF HEALTH'S DECISION TO DENY
THE REQUESTED VOLUME WAIVER WAS NOT SUPPORTED
BY SUBSTANTIAL CREDIBLE EVIDENCE IN THE RECORD
AS A WHOLE.
1
OEMS issued a Proposed Notice of Revocation to the training
program, but it was never revoked.
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POINT III
THE COMPLETE DENIAL OF MR. SANCHEZ'S ACCESS
TO THE LICENSING EXAM IS SO DISPROPORTIONATE
TO THE TECHNICAL ISSUE OF MISSING AN
ADMINISTRATIVE DEADLINE THAT IT MEETS THE
JURISPRUDENTIAL GROUND FOR REVERSAL.
POINT IV
MR. SANCHEZ HAS BEEN DENIED DUE PROCESS AFTER
HE WAS TERMINATED FROM THE DEPARTMENT
REGULATED TRAINING PROCESS.
A. The Department's Denial Of This
Waiver Is Tantamount To A Sanction On Mr.
Sanchez Personally. (Not in record)
B. The Department's History Of
Granting Training Centers' Requests For
Waiver Of The Required Number Of Patient
Encounters As A Matter Of Course Raises
It To The Level Of The Default Standard.
(Not in record)
C. The Department Denied A Waiver
Request That Was Never Made, Precluding
Any Process At All.
POINT V
THE DEPARTMENT ERRED IN DENYING ITS
JURISDICTION TO WAIVER THE 36-MONTH LIMIT.
(Not in record)
Appellate review of the DOH's decision is limited. Barone
v. Dep't of Human Servs., Div. of Med. Assistance & Health Servs.,
210 N.J. Super. 276, 285 (App. Div. 1986). We have held that
"[w]here [an] action of an administrative agency is challenged,
'a presumption of reasonableness attaches to the action of an
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administrative agency[,] and the party who challenges the validity
of that action has the burden of showing that it was arbitrary,
unreasonable or capricious.'" Barone, 210 N.J. Super. at
285(quoting Boyle v. Riti, 175 N.J. Super. 158, 166 (App. Div.
1980)). "Delegation of authority to an administrative agency is
construed liberally when the agency is concerned with the
protection of the health and welfare of the public." Ibid. Thus,
this court's task is limited to deciding
(1) whether the agency's decision offends the
State or Federal Constitution; (2) whether the
agency's action violates express or implied
legislative policies; (3) whether the record
contains substantial evidence to support the
findings on which the agency based its action;
and (4) whether in applying the legislative
policies to the facts, the agency clearly
erred in reaching a conclusion that could not
reasonably have been made on a showing of the
relevant factors.
[A.B. v. Div. of Med. Assistance & Health
Servs., 407 N.J. Super. 330, 339 (App. Div.
2009) (citation omitted).]
"A reviewing court 'may not substitute its own judgment for
the agency's, even though the court might have reached a different
result.'" In re Stallworth, 208 N.J. 182, 194 (2011) (quoting In
re Carter, 191 N.J. 474, 483 (2007)). "This is particularly true
when the issue under review is directed to the agency's special
'expertise and superior knowledge of a particular field.'" Id.
at 195 (quoting In re Herrmann, 192 N.J. 19, 28 (2007)). However,
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"an appellate court is 'in no way bound by the agency's
interpretation of a statute or its determination of a strictly
legal issue.'" Carter, 191 N.J. at 483 (quoting Mayflower Sec.
Co. v. Bureau of Sec., 64 N.J. 85, 93 (1973)). Indeed, an agency's
"interpretation of the law and the legal consequences that flow
from established facts are not entitled to any special deference."
Manalapan Realty, L.P. v. Twp. Comm. of Manalapan, 140 N.J. 366,
378 (1995).
The EMS Act provides broad authorization for the DOH to
institute regulations concerning the training requirements for
paramedic certification. N.J.S.A. 26:2K-8. In its written
decision denying Sanchez a waiver of the clinical requirements for
paramedic training, the DOH determined that, under N.J.S.A. 26:2K-
9 and state and federal constitutions, there was no right to a
hearing to contest its denial of a request to waive requirements
of the paramedic training program. Nonetheless, the DOH addressed
the merits of the waiver request. The DOH recognized that the
OEMS mistakenly stated that Sanchez's thirty-six-month training
period expired on February 22, 2017, instead of the correct date
of February 6, 2017, but even with the former date, Sanchez's
waiver request on February 28, 2017, was after the correct
expiration date. In addition, the DOH ruled:
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Not only is a waiver of the 36-month training
period prohibited by regulation, the waiver
was also contrary to public health and safety.
The waiver was detrimental to public health
because the skills and training Mr. Sanchez
acquired during his three years of training
have not been put into practice, thereby
causing the retention of the skills and
training to erode.
Applying the governing standards of review and legal
principles, we conclude there exists substantial credible evidence
in the record to support the DOH's findings, and that the final
agency decision was not arbitrary, capricious, or unreasonable.
We further add that we do not consider Sanchez's argument
challenging the reasonableness of the thirty-six-month period
under N.J.A.C. 8:41A-2.4(h) to complete his training because the
argument was not raised before the DOH and it is not jurisdictional
in nature nor does it substantially implicate the public interest.
Zaman v. Felton, 219 N.J. 199, 226-27 (2014) (citation omitted).
Affirmed.
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