Calderon v. Anderson (45 Cal. App. 4th 607, 1996)

Opinion

KITCHING, J.

The California Department of Social Services (Department), by its Director Eloise Anderson, respondent below, appeals from a judgment granting a peremptory writ of administrative mandamus ordering the Department to set aside a May 19, 1992 administrative decision denying Jose Calderon (Calderon), petitioner below, benefits for protective supervision services under the In-Home Supportive Services Program (IHSS).

We find the trial court erred in determining Calderon met the eligibility requirements for protective supervision services set forth in the Departments Manual of Policies and Procedures (MPP), section 30-757.17, and interpreted in Marshall v. McMahon (1993) 17 Cal.App.4th 1841 [22 Cal.Rptr.2d 220]. Accordingly, we reverse the judgment and order the trial court to enter a new and different judgment denying the writ petition.

Factual and Procedural Background

This appeal involves the interpretation of MPP section 30-757.17 and the scope of the protective supervision service offered by California’s IHSS, a state and federally funded program developed to permit persons with disabilities to live safely in their own homes. (Welf. & Inst. Code, § 12300.) Services and program benefits are administered through the Los Angeles County Welfare Department (County). Among the services provided is one for protective supervision, described as monitoring behavior and safeguarding non-self-directing, confused, mentally impaired, or mentally ill persons against injury, hazard, or accident. (§ 12300; MPP, § 30-757.17.)

Neither the facts nor the extent of Calderon’s medical condition is in dispute.

Ofelia Ramos (Ramos) is the provider for her son Jose Calderon, who at 35 years old suffers from severe mental retardation, physical deformities, and cerebral palsy, which render him completely bedridden. Calderon functions at the cognitive level of a one-year-old child. He has no use of his extremities, which remain in a fixed position, cannot move his head, is nonverbal, and is unable to care for himself. Under IHSS, Calderon receives 169.6 hours per month of nonmedical personal services benefits, which include, inter alia, feeding, bowel and bladder care, bathing, and dressing. These hours do not include protective supervision benefits.

In April 1991, after a series of home visits, County determined Calderon’s benefits should remain at 169.6 hours per month, without authorization for protective supervision services. In April 1992, after an unsuccessful administrative review, Calderon appealed the decision and requested a hearing with the Department on the issue of protective supervision benefits.

On May 13, 1992, an administrative law judge (ALJ) heard testimony and received evidence, including up-dated medical information, regarding Calderon’s need for protective supervision services. On May 19, 1992, the ALJ issued a written decision denying Calderon’s request and affirming the Department’s (County’s) position. The ALJ considered Calderon’s physical condition and stated, in pertinent part, that “Los Angeles County correctly determined that the . . . (IHSS) beneficiary does not require Protective Supervision services, as defined by the IHSS Program, since the described need is not to monitor the behavior of the mentally impaired beneficiary. . . .” “The definition of Protective Supervision is to ‘monitor the behavior’ of nonself-directing, confused, mentally impaired persons. However, in this case, there is no monitoring of behavior required. The IHSS beneficiary has been completely bedridden for the last five years and has no use of either of his upper or lower extremities, which cannot be moved out of their fixed positions. The claimant is seeking Protective Supervision to safeguard the beneficiary against catastrophic events such as a home fire. While such action may be warranted in light of his immobility and mental retardation, this type of ‘safeguard’ is not to monitor his behavior. Thus, it is not covered under the IHSS Program.” Calderon’s request for a rehearing was denied.

On May 18, 1993, Calderon filed a petition for writ of mandate and complaint for declaratory relief in the superior court, seeking to compel the Department to provide protective supervision services. Calderon contended the Department abused its discretion because the medical evidence at the administrative hearing supported a finding he was non-self-directing and mentally impaired, in need of total care, and, therefore, eligible for such services. Calderon further contended he was entitled to protective supervision because he would be unable to summon assistance in the event of fire, environmental hazards, a need for water, or interference with his breathing. In support of his petition, Calderon submitted a copy of the administrative record, with medical information attachments, and a copy of MPP section 30-757.

In opposition, the Department argued the ALJ correctly determined Calderon was ineligible for protective supervision because the purpose of the service was to observe the behavior of, and protect, mentally impaired individuals who were inherently incapable of understanding everyday hazards and, therefore, put themselves at risk. Furthermore, the Department argued, medical evidence supported the conclusion that Calderon, because of his condition, was unable to engage in any type of behavior that could result in injury or hazard within the meaning of MPP section 30-757.17.

On March 25, 1994, the superior court heard argument, and on April 20, 1994, granted Calderon’s petition after an independent evaluation of all the evidence. In a written statement of decision, the court determined the ALJ failed to properly consider the evidence of Calderon’s severe mental disability, and that under Marshall v. McMahon, supra, 17 Cal.App.4th 1841, the only eligibility requirement for protective supervision services was that the IHSS beneficiary be non-self-directing. The court reasoned, in relevant part: “Petitioner has physical as well as mental impairments but, contrary to the ALJ’s decision, ‘[applicants lacking the ability to “self-direct” are eligible for protective supervision whether or not they have physical impairments. . . . [T]he regulations do not draw a bright line between those who are physically and those who are mentally incapacitated. The line is drawn between those who have the practical capacity to know when they are in trouble and those who do not.’ Marshall, 22 Cal.Rptr.2d at 228. Petitioner is mentally incapacitated and lacks the practical capacity to know when he is in trouble and therefore is eligible for protective supervision.”

Judgment was filed on April 20, 1994, and entered on or about May 11, 1994, in favor of Calderon, setting aside the Department’s May 19, 1992, decision, and ordering the Department to find Calderon eligible for protective supervision services.

On May 1, 1994, the Department filed a notice of appeal.

Contentions

The Department contends the trial court erred in determining Calderon was entitled to hours for protective supervision because its decision is not supported by the statutes, regulations, or case law governing the IHSS program.

Discussion

The Trial Court Erred in Granting Calderon’s Petition for Writ of Mandate.

a. Standard of Review

“The procedures in [Code of Civil Procedure] section 1094.5 are the means for judicially reviewing final decisions of administrative agencies. [Citation.]” (Elizabeth D. v. Zolin (1993) 21 Cal.App.4th 347, 353 [25 Cal.Rptr.2d 852].) “ ‘[W]hen a trial court has made its own determination on all material facts and made findings using its own independent judgment . . . , it will be the trial court’s findings and not those of the administrative agency that will be reviewed on appeal. [Fn. omitted.] [Citations.] The appellate court will only reverse the judgment of the superior court if it is based on an erroneous conclusion of law. [Citation.] When the facts do not conflict and the issues involve proper application of a statute or administrative regulation, a reviewing court is not bound by the trial court’s determination. [Citation.]’ [Citation.]” (Webb v. Miller (1986) 187 Cal.App.3d 619, 625 [232 Cal.Rptr. 50].)

We also acknowledge that the Department’s interpretations of the statutes and regulations governing the IHSS program are entitled to great weight and deference. (Ralphs Grocery Co. v. Reimel (1968) 69 Cal.2d 172, 176, 179-180 [70 Cal.Rptr. 407, 444 P.2d 79].) The courts have held that an agency’s interpretation of its own regulations is the “ ‘ultimate criterion . . . which becomes of controlling weight unless it is plainly erroneous or inconsistent with the regulation.’” (United States v. Larionoff (1977) 431 U.S. 864, 872 [53 L.Ed.2d 48, 56, 97 S.Ct. 2150].) Similarly, our Supreme Court has held that “. . . a court may not substitute its independent judgment for that of the administrative agency on the facts or on the policy considerations involved.” (Credit Ins. Gen. Agents Assn. v. Payne (1976) 16 Cal.3d 651, 657 [128 Cal.Rptr. 881, 547 P.2d 993].)

In light of these principles of law, we consider the trial court’s ruling.

b. Calderon Was Ineligible for Protective Supervision Services.

We analyze Calderon’s eligibility for protective supervision benefits by considering the legislative scheme (§ 12300 et seq.) and regulations (MPP, § 30-757.17) that provide this in-home support service, and their interpretation in Marshall v. McMahon, supra, 17 Cal.App.4th 1841.

“In 1973 the Legislature enacted the In-Home Supportive Services . . . program to enable aged, blind or disabled poor persons to avoid institutionalization by remaining in their homes with proper supportive services. (§ 12300 et seq.)” (Marshall v. McMahon, supra, 17 Cal.App.4th at p. 1844, fn. omitted; Miller v. Woods (1983) 148 Cal.App.3d 862, 867 [196 Cal.Rptr. 69].) “IHSS is an alternative to out-of-home care. Eligibility and services are limited by the availability of funds.” (MPP, § 30-700.)

“The Department and its director are responsible for administering the IHSS program in compliance with state and federal laws. [Citations.] The Department promulgates regulations to implement the statutes [citations] while the county welfare departments administer the program under the state’s general supervision. The county departments process applications for IHSS assistance [citations], determine the individual’s needs and authorize services. [Citation.]” (Miller v. Woods, supra, 148 Cal.App.3d at p. 868; see also County of Sacramento v. State of California (1982) 134 Cal.App.3d 428, 430-431 [184 Cal.Rptr. 648].)

“The Legislature authorized a broad range of support services to eligible persons.” (Miller v. Woods, supra, 148 Cal.App.3d at p. 868.) Section 12300, subdivision (b) provides: “Supportive services shall include domestic services and services related to domestic services, heavy cleaning, personal care services, accompaniment by a provider when needed during necessary travel to health-related appointments or to alternative resource sites, yard hazard abatement, protective supervision, teaching and demonstration directed at reducing the need for other supportive services, and paramedical services which make it possible for the recipient to establish and maintain an independent living arrangement." (Italics added; see also MPP, § 30-757.)

In 1979, the Department established the protective services regulations (MPP, §30-757), which provide, in relevant part: “.17 Protective supervision consisting of observing recipient behavior in order to safeguard the recipient against injury, hazard, or accident. ['JO .171 This service is available for monitoring the behavior of nonself-directing, confused, mentally impaired, or mentally ill persons, with the following exceptions: [*JD (a) Protective supervision does not include friendly visiting or other social activities. [U (b) Supervision is not available when the need is caused by a medical condition and the form of the supervision required is medical. [