Articles Posted in Public Benefits

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The Department of Social Services (DSS) provided Medicaid benefits to Darlene Hollman while she was in a nursing home. Hollman had an interest in real estate at the time, but DSS did not record a lien on the property for the benefits it had provided until after Hollman died. Hollman’s children challenged the validity of the lien. The circuit court granted summary judgment in favor of DSS, concluding that an enforceable medical assistance lien was created on the property at the time the nursing home assistance was provided and that Hollman’s interest in the property transferred at death to the children subject to the lien. The Supreme Court reversed, holding (1) DSS’s medical assistance lien did not attach to Hollman’s interest in the property before her death, and Hollman’s interest passed to her children immediately upon her death; (2) because the lien had not been recorded at the time of Hollman’s death, Hollman had no interest upon which the lien could attach; and (3) therefore, Hollman’s interest passed to her children free of DSS’s lien. View "Hollman v. S.D. Dep’t of Soc. Servs." on Justia Law

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Appellant, a forty-eight-year-old who lived independently for two decades, had "borderline intellectual functioning," an expressive language disorder, and a learning disorder. Appellant applied for Home and Community Based Services (HCBS), a federal-state Medicaid Waiver program that provides assistance to individuals with developmental disabilities. The South Dakota Department of Human Services (the Department) denied Appellant's application, determining that Appellant was not eligible for HCBS. After a hearing, an ALJ affirmed the Department's denial. The circuit court affirmed. The Supreme Court also affirmed, holding that the ALJ did not clearly err in finding that Appellant did not qualify for benefits, as the evidence indicated that Appellant was a generally independent client who was able to function with little supervision or in the absence of a continuous active treatment program. View "Nelson v. Dep't of Social Servs." on Justia Law

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Pooled Advocate Trust, Inc. (PATI), the managing corporation for a Medicaid pooled trust, brought a declaratory judgment action on Medicaid eligibility issues associated with the trust and named the South Dakota Department of Social Services (DSS) as a necessary party. The circuit court granted declaratory judgment for PATI. Fred and Gladys Matthews transferred assets to the pooled trust. When the Matthews subsequently applied for Medicaid long-term care benefits, DSS imposed a penalty period because they were over age sixty-five at the time of the transfers. PATI petitioned for further relief, seeking a declaration that DSS could not impose penalty periods for transfers made by pooled trust beneficiaries age sixty-five or older. The circuit court granted PATI's petition. The Matthews also appealed DSS's application of a penalty period, but an ALJ upheld the decision and another circuit court affirmed. DSS appealed the circuit court's order granting PATI's petition and the Matthews appealed the other circuit court's affirmance of the ALJ's ruling. The Supreme Court affirmed the administrative appeal and reversed the declaratory judgment, holding that transfers of assets into pooled trusts by beneficiaries age sixty-five or older may be subject to a transfer penalty period for Medicaid eligibility purposes. View "In re Pooled Advocate Trust" on Justia Law