Romanelli v. Dep't of Soc. Serv.

317 A.3d 807

226 Conn.App. 131

Antoinetta ROMANELLI, Executor (Estate of Antonio Romanelli)

v.DEPARTMENT OF SOCIAL SERVICES

(AC 45560)

Appellate Court of Connecticut.

Argued November 7, 2023

Officially Released June 11, 2024

Santa Mendoza, for the appellant (plaintiff).

Tanya Feliciano DeMattia, assistant attorney general, with whom, on the brief, was William Tong, attorney general, for the appellee (defendant).

Moll, Cradle and Bear, Js.

BEAR, J.

₁₃₃The plaintiff, Antoinetta Romanelli, executor of the estate of her husband, Antonio Romanelli (applicant), appeals from the judgment of the Superior Court dismissing her appeal from the decision of the defendant, the Department of Social Services, denying long-term care Medicaid benefits to the applicant. The plaintiff claims that (1) certain real property, which was contained in a trust and which the defendant used in its calculations to determine that the applicant was over the asset limit for Medicaid eligibility, was not actually available to the applicant due to his alleged incapacity to revoke the trust and therefore should not have been used to calculate his Medicaid eligibility and (2) the defendant violated due process by failing to provide notice to the applicant and/or his personal representative that the revocability of the trust was at issue in calculating the applicant’s Medicaid eligibility. We disagree and, accordingly, affirm the judgment of the Superior Court.

The following facts, as set forth by the Superior Court, and procedural history are relevant to our resolution of this appeal. On October 15, 2001, the applicant and the plaintiff (collectively, Romanellis) established a Declaration of Trust (trust) of which they were both the grantors and the beneficiaries. At issue in the present case is the real property in Old Lyme that was contained in the trust.¹ In September, 2019, the applicant was admitted to a long-term care facility and, in December, 2019, the applicant and his representative filed an application for long-term care Medicaid benefits (application). The applicant died in August, 2020. On October 14, 2020, the defendant denied the applicant’s ₁₃₄application for Medicaid benefits for the period from December, 2019, through September, 2020.

Santa Mendoza, the plaintiff’s attorney, filed the administrative appeal on behalf of the applicant’s son, Nick Romanelli, from the defendant’s denial of the application for Medicaid benefits and Mendoza was the contact person with respect to that proceeding. The basis for the appeal was that the defendant improperly included the trust assets in the calculation of the applicant’s eligibility although the applicant was incapable of revoking the trust to access the assets. At the February 10, 2021 administrative hearing, Mendoza testified and submitted an affidavit, the substance of which was that the applicant was not competent to revoke the trust because he lacked the mental capacity to transact business beginning in 2013 and continuing thereafter. The hearing officer stated that "[t]he appellant and counsel did not provide any medical evidence of a dementia diagnosis or any third-party testimony or statements that support these claims. Further, these reports were not provided to the [defendant] during the application process although an extension was granted by the [defendant] to dispute the classification of the trust’s accessibility. The [defendant] made the correct determination of the trust’s accessibility based on the information that was provided to [it]." The hearing officer concluded that she "did not find [Mendoza’s] affidavit sufficient verification to make a determination of [the applicant’s] mental capacity …. " The hearing officer instead found that, because the value of the Old Lyme property alone put the Romanellis over the asset limit, the defendant properly denied the applicant Medicaid benefits.

The plaintiff filed an administrative appeal, pursuant to General Statutes § 4-183, in the Superior Court from the defendant’s denial of Medicaid benefits. The court determined that the hearing officer did not err in finding ₁₃₅that Mendoza’s testimony and affidavit failed to prove that the applicant lacked the mental capacity to revoke the trust and access the Old Lyme property. The court dismissed the appeal. This appeal followed.

I

The plaintiff first claims that, according to General Statutes § 17b-261 (c), the Old Lyme property was not "actually available" for purposes of calculating Medicaid eligibility because the applicant was not legally capable of revoking the trust. We are not persuaded.

[1–3] "[R]eview of an administrative agency decision requires a court to determine whether there is substantial evidence in the administrative record to support the agency’s findings of basic fact and whether the conclusions drawn from those facts are reasonable. … Neither [the appellate] court nor the trial court may retry the case or substitute its own judgment for that of the administrative agency on the weight of the evidence or questions of fact. … Our ultimate duty is to determine, in view of all the evidence, whether the agency, in issuing its order, acted unreasonably, arbitrarily, illegally or in abuse of its discretion." (Internal quotation marks omitted.) Miller v. Dept. of Agriculture, 168 Conn. App. 255, 265-66, 145 A.3d 393, cert. denied, 323 Conn. 936, 151 A.3d 386 (2016); see also General Statutes § 4-183 (j).

"The [Medicaid] program, which was established in 1965 as Title XIX of the Social Security Act and is codified at 42 U.S.C. § 1396 et seq. ([M]edicaid act), is a joint federal-state venture providing financial assistance to persons whose income and resources are inadequate to meet the costs of, among other things, medically necessary nursing facility care. … The federal government shares the costs of [M]edicaid with those states that elect to participate in the program, and, in ₁₃₆return, the states are required to comply with requirements imposed by the [M]edicaid act and by the [S]ecretary of the Department of Health and Human Services. … Specifically, participating states are required to develop a plan … containing reasonable standards … for determining eligibility for and the extent of medical assistance to be provided. … Connecticut has elected to participate in the [M]edicaid program and has assigned to the [defendant] the task of administering the program. … Pursuant to General Statutes §§ 17b-262 and 17b-10, the [defendant] has developed Connecticut’s state [M]edicaid plan and has promulgated regulations that govern its administration. … The [M]edicaid act, furthermore, requires participating states to set reasonable standards for assessing an individual’s income and resources in determining eligibility for, and the extent of, medical assistance under the program." (Citations omitted; internal quotation marks omitted.) Pikula v. Dept. of Social Services, 321 Conn. 259, 264-66, 138 A.3d 212 (2016).

[4] Section 17b-261 (c) provides in relevant part that, "[f]or the purposes of determining eligibility for the Medicaid program, an available asset is one that is actually available to the applicant or one that the applicant has the legal right, authority or power to obtain or to have applied for the applicant’s general or medical support. …" Section 17b-198-8 (l) (2) of the Regulations of Connecticut State Agencies provides in relevant part that "[t]he corpus of a trust shall be treated as a counted asset of a person … if the terms of the trust permit such person to revoke the trust and receive the corpus of the trust upon revocation."

Section 11 of the trust provides that the Romanellis retained during their lifetime "[t]he right to withdraw all or any part of the trust property and to revoke this agreement entirely and the trust hereby created" and further provides that this right to withdraw could be ₁₃₇exercised "[i]f both grantors are alive and competent, severally, only with respect to each grantor’s separate share." Section 11 further provides that, "[i]n the event of the incapacity of one or both of the grantors, this trust may not be revoked by any legal or personal representative of an incapable grantor." Accordingly, the trust would be irrevocable, and the Old Lyme property would not be available as an asset for determining Medicaid eligibility if the applicant were incapacitated at the time of the filing of the application.

At the administrative hearing, Mendoza testified that she was the Romanellis’ attorney, that she visited the Romanellis once or twice each year to handle issues such as taxes, and that, by 2013, when the applicant was approximately ninety-two years old, he "was not capable of any financial dealings," including revoking the trust. She further stated that the applicant was in a long-term care facility "because he is completely incapable …." In her affidavit, Mendoza stated that the applicant had dementia after 2012 and that, by 2013, he was not competent to revoke the trust. The hearing officer concluded that the defendant correctly had denied the applicant’s application because the value of the Old Lyme property had placed him over the asset limit allowable for Medicaid coverage for long-term care. The hearing officer reasoned that no medical evidence of a dementia diagnosis, third-party testimony, or statements in support of the applicant’s incapacity was presented at the hearing and that Mendoza’s affidavit did not provide "sufficient verification to make a determination of his mental capacity …." The hearing officer further noted that the defendant was not made aware of any questions regarding the applicant’s mental capacity during the application process and that the defendant made the correct determination of the trust’s accessibility on the basis of the information that had been provided.

₁₃₈The court noted that the hearing officer, who was in the best position to evaluate and weigh the evidence, found the evidence offered at the...