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:
Preston Jack White vs. HHS

AGENCY:
South Carolina Department of Health and Human Services

PARTIES:
Petitioner:
Preston Jack White

Respondent:
South Carolina Department of Health and Human Services
 
DOCKET NUMBER:
03-ALJ-08-0488-AP

APPEARANCES:
n/a
 

ORDERS:

FINAL ORDER AND DECISION

I. Introduction


This case is an appeal of a decision by the South Carolina Department of Health and Human Services (DHHS) concluding that Preston Jack White (Mr. White) is ineligible for Medicaid benefits due to his wife’s transfer on June 18, 2003, of property worth $63,500 to her son for $5.00. The sole issue is whether the transfer renders Mr. White ineligible for Medicaid benefits.


II. Analysis


In addressing this issue, the Administrative Law Court sits not as a fact-finder, but rather as an appellate body reviewing the factual findings made below. S.C. Code Ann. §1-23-380(A)(6) (Supp. 2003). In reviewing those factual findings, the Court must begin with the presumption that the factual findings are correct. Rodney v. Michelin Tire Co., 320 S.C. 515, 466 S.E.2d 357 (1996). Further, for any disputed question of fact, the ALC is prohibited from re-weighing the evidence and must not substitute its judgment for that of the agency. Grant v. South Carolina Coastal Council 319 S.C. 348,461 S.E.2d 388 (1995). Rather than the Court having the authority to re-weigh the evidence presented below, the duty falls on Mr. White, the party challenging the agency’s factual decisions, to convincingly establish that the decision below is unsupported by substantial evidence. Waters v. South Carolina Land Resources Conservation Comm̓n, 321 S.C. 219,467 S.E.2d913 (1996).


Mr. White cannot show a lack of substantial evidence by seeking to show that the evidence presented below could have produced a different result. Rather, the mere fact that reasonable



minds could differ on the judgment made by the agency does not establish the absence of substantial evidence. Lark v. Bi-Lo, 276 S.C. 130, 276 S.E.2d 304 (1981). Indeed, the fact that the record, when considered as a whole, presents the possibility of drawing two inconsistent conclusions from the evidence does not establish that the decision below is unsupported by substantial evidence. Grant v. South Carolina Coastal Council, 319 S.C. 348, 461 S.E.2d 388 (1995).


Here, the evidence presented below shows that on June 18, 2003, Mrs. White transferred property worth $63,000 to her son for $5.00. On the next day, June 19, 2003, she applied on Mr. White’s behalf for Nursing Home Medicaid benefits for her husband. On June 25, 2003, Mr. White was admitted for nursing home services.


Given these facts, the applicable statute is 42 USC § 1396p(c)(1)(A): Footnote

In order to meet the requirements of this subsection for purposes of section 1396a(a)(18) of this title, the State plan must provide that if an institutionalized individual or the spouse of such an individual (or, at the option of a State, a noninstitutionalized individual or the spouse of such an individual) disposes of assets for less than fair market value on or after the look-back date specified in subparagraph (B)(i), the individual is ineligible for medical assistance for services described in subparagraph (C)(i) (or, in the case of a noninstitutionalized individual, for the services described in subparagraph (C)(ii)) during the period beginning on the date specified in subparagraph (D) and equal to the number of months specified in subparagraph (E). (emphasis added).


This case presents two arguments. Mr. White asserts he should not be penalized for a transfer of property made by his spouse. Such an argument is unavailing. 42 USC § 1396p(c)(1)(A) looks not only to transfers by the individual seeking medical assistance but also to transfers by the individual’s spouse.


Likewise, Mr. White’s equitable argument that the property was not transferred in contemplation of attaining Medicaid eligibility for her husband is also to no avail. The statute does not look to the motive for the transfer but rather to the fact of a transfer for less than fair market value. The facts here establish a transfer for less than fair market value. Further, the fact-finder below found that the timing and sequence of the events did not show convincing evidence that Medicaid eligibility was not a consideration. Such a finding is supported by substantial evidence and will not be reversed.




III. Conclusion


The decision below is supported by substantial evidence and is not affected by any error of law. Therefore, the decision of DHHS is AFFIRMED.


AND IT IS SO DECIDED


_________________________________

RAY N. STEVENS

Administrative Law Judge


Dated: July15, 2004

Columbia, South Carolina


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