South Carolina              
Administrative Law Court
Edgar A. Brown building 1205 Pendleton St., Suite 224 Columbia, SC 29201 Voice: (803) 734-0550

SC Administrative Law Court Decisions

CAPTION:
Elisher H. Robinson vs. SCDHHS

AGENCY:
South Carolina Department of Health and Human Services

PARTIES:
Appellant:
Elisher H. Robinson

Respondents:
South Carolina Department of Health and Human Services
 
DOCKET NUMBER:
00-ALJ-08-0176-AP

APPEARANCES:
Appellant & Representative: Elisher H. Robinson, Ruth H. Collier

Respondent & Representative: South Carolina Department of Health and Human Services, George R. Burnett, Esquire
 

ORDERS:

ORDER

I. Introduction



Elisher H. Robinson (Robinson) appeals a decision of the Department of Health and Human Services (DHHS) denying her claim for Medicaid benefits provided by the Medical Assistance Only - Nursing Home (MAO-NH) Program. Jurisdiction for this appeal is in the Administrative Law Judge Division. S.C. Code Ann. § 44-6-190 (Supp. 1999). The DHHS decision is affirmed.



II. Background and Standard of Review



On January 28, 1999, Robinson's representative, Ms. Ruth Collier, applied for Medicaid benefits on Robinson's behalf. At that time, Robinson owned non-homestead property which was later determined to be worth $22,500. In May, 1999, Ms. Collier sold the non-homestead property on behalf of Robinson in exchange for a promissory note in the amount of $22,500. The note contained no language indicating that it was not negotiable or not transferable.



In September, 1999, the Charleston County Department of Social Services (CCDSS) determined that the promissory note was negotiable, and therefore it considered the outstanding balance on the note (approximately $22,088) to be a countable resource to Robinson. CCDSS notified Ms. Collier that Robinson's application for benefits was denied based on her available resources. Collier appealed the decision and obtained a hearing before DHHS. After considering the evidence presented and the applicable law, the DHHS hearing officer upheld the decision of CCDSS to deny Robinson's application for benefits. This appeal followed.



When an administrative decision is challenged on appeal, the appellate body must decide if substantial rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions or decisions of the hearing officer are made upon unlawful procedure (see S.C. Code Ann. § 1-23-380(A)(6)(c) (Supp. 1999)) or are clearly erroneous in view of the reliable, probative and substantial evidence on the whole record. (see S.C. Code Ann. § 1-23-380(A)(6)(e) (Supp. 1999). Substantial evidence is evidence which, considering the record as a whole, would allow reasonable minds to reach the conclusion that the administrative agency reached or must have reached in order to justify its action. Bilton v. Best Western Royal Motor Lodge, 282 S.C. 634, 641, 321 S.E.2d 63, 68 (Ct. App. 1984). The possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrations agency's finding from being supported by substantial evidence. Lark v. Bi-Lo, 276 S.C. 130, 276 S.E.2d 304 (1981).



In this appeal, Robinson does not allege that the hearing officer engaged in any unlawful procedure. Robinson only argues that she meets the financial eligibility requirements for the MAO-NH program.

III. Issue



Does substantial evidence support the hearing officer's finding that Robinson is not financially eligible for Medicaid benefits provided by the MAO-NH Program?



IV. Analysis



The question to be resolved is whether the decision below is clearly erroneous in view of the reliable, probative and substantial evidence on the whole record. Whether the evidence of Robinson's financial ineligibility is substantial is found by reviewing the financial eligibility requirements of the MAO-NH program and by reviewing the evidence supporting whether Robinson satisfies those requirements.



Under the MAO-NH program, an applicant's resources may not exceed $2,000 in value after exclusions and deductions have been applied. Medicaid Policy Manual, § 12.02.02. Resources are generally defined as those assets, including both real and personal property, which an individual owns and can use to meet basic needs of food, clothing and shelter. Id. When an applicant holds a note which is negotiable, the value of the note is considered to be a countable resource and must be considered in determining the individual's eligibility for Medicaid benefits. Medicaid Policy Manual, § 12.13.



A writing is negotiable if (1) it is signed by the maker or drawer; (2) contains an unconditional promise or order to pay a sum certain in money and no other promise, order, obligation or power given by the maker or drawer except as authorized by Chapter 3 of Title 36 of the South Carolina Code; (3) is payable on demand or at a definite time; and (4) is payable to order or to bearer. S.C. Code Ann. § 36-3-104(1) (1976). The negotiability of an instrument is always to be determined by what appears on the face of the instrument alone. Official Comment to S.C. Code Ann. § 36-3-119 (1976), cited with approval in Northwestern Bank v. Neal, 271 S.C. 544, 248 S.E.2d 585 (1978). Unless a note contains language indicating that it is non-negotiable or non-transferable, or unless a note relates to a certificate of deposit, it meets the negotiability requirements of § 36-3-104(1). See S.C. Code Ann. 36-3-104(2)(d) (1976).



The note held by Robinson contains no language indicating that it is not negotiable or not transferable. Further, the note meets all of the negotiability requirements of S.C. Code Ann. § 36-3-104(1) (1976). It contains an unconditional promise to pay a fixed sum of money to the order of Robinson within a definite period of time, and the note is signed by the maker. Because Robinson's note is negotiable, the balance due on the note must be considered a countable resource in determining Robinson's financial eligibility for benefits under the MAO-NH program. Medicaid Policy Manual, § 12.13. As of the date of the DHHS hearing, the outstanding balance on Robinson's note was approximately $21,572. Because this amount exceeds the $2,000 resource limit under the MAO-NH program, Robinson is financially ineligible for benefits.

Based on the foregoing, I find that substantial evidence supports the hearing officer's finding that Robinson is not financially eligible for Medicaid benefits provided by the MAO-NH Program.



V. Order



The order of the hearing officer is affirmed.



AND IT IS SO ORDERED



______________________

RAY N. STEVENS

Administrative Law Judge



Dated: November 6, 2000

Columbia, South Carolina


Brown Bldg.

 

 

 

 

 

Copyright © 2022 South Carolina Administrative Law Court