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Claudio v. Dowling ; Vera v. Dowling
ALICE CLAUDIO, APPELLANT, v. MICHAEL DOWLING, ET AL.,
RESPONDENTS
1997 N.Y. Int. 22.
February 18, 1997
1 No.2 [NY Int.22]
ELBA VERA, ET AL., APPELLANTS, v. MICHAEL DOWLING,
ET AL., RESPONDENTS.
1997 N.Y. Int. 22
February 18, 1997
1 No. 3 [NY Int.22]
This opinion is uncorrected and subject to revision before
publication in the New York Reports
No.2
Eugene Prosnitz, for Appellant. Kathleen P. Murray, for Respondents.
No. 3:
Steven Godeski, for appellants. Kathleen P. Murray, for Respondents
SMITH, J:
The primary issue in these appeals is whether foster parents
have standing to request a fair hearing from the State when the
City denies or fails to act on a foster parent's request for foster
care maintenance payments 1 at a particular rate and the
children cared for no longer reside with the foster parents at
the time the request for a fair hearing is made. We conclude
that foster parents have standing to request a fair hearing in
these circumstances.
Background
The Federal Adoption Assistance and Child Welfare Act (42 USC
670-676) provides financial assistance to States that provide
foster care and transitional independent living programs to certain
eligible children (42 USC 670) Such assistance is extended to
"states which have submitted, and had approved by the Secretary,
State plans under this part" (id.). By definition, such
plans must include provisions for "assuring that the child receive[s] proper care and that
services are provided to the parents, child and foster parents in order to improve
the conditions in the parents' home, facilitate the return of the child to his
own home or the permanent placement of the child, and address the needs of the
child while in foster care, including a discussion of the appropriateness
of the services that have been provided to the child under the plan." (42
USC 675 [1] [B]).
One of the requirements which must be satisfied by State plans
in order for the State to qualify for Federal funds is the condition
that the plan provide for foster care maintenance payments "with
respect to the child" who meets certain criteria (42 USC
671 [a] [1]; 672). Federal law also provides that foster care
maintenance payments may be made "on behalf of a child"
who is "in the foster family home of an individual, whether
the payments therfor are made to such individual or to a public
or nonprofit child-placement or child-care agency" (42 USC
672 [b] [1]).
New York State reimburses local social
service districts, such as New York City, for expenditures on
foster care programs with funds partially derived from Federal
sources. Accordingly, the Social Services Law provides that after
the "amount of federal funds, if any, properly received or
to be received" for foster care services have been distributed
to local districts, the State will pay varying portions of certain
costs "after first deducting therefrom any federal funds
properly received or to be received on account thereof (Social
Services Law § 153[1]).
The New York State Department of Social Services (State DSS) administers
the reimbursement program in accordance with "Standards of
Payment for Foster Care of Children" promulgated by the Department
(see, 18 NYCRR part 427). These standards provide that, "State
reimbursement must be made only on actual payments to certified
or approved foster parents providing care for children in foster
family boarding homes up to the maximum levels established by
the department for normal, special and exceptional foster care
services" (18 NYCRR 427.6[b]) .
State DSS has also promulgated regulations pertaining to "eligibility
criteria for receipt of federally reimbursable foster care maintenance
payments" (18 NYCRR 426.1 see generally, 18 NYCRR part 426).
Since Federal funds are available for expenditures on some, but
not all, of the children in a State's foster care system, State
DSS regulations acknowledge that only certain payments for foster
care services fall under the Federal Act (see, 18 NYCRR 426.3;
426.4).
While local service districts may set the rates paid
to foster parents (subject to certain ceilings) for the provision
of normal, special and exceptional levels of foster care, reimbursement
for expenditures on such services may occur only after approval
by State DSS (18 NYCRR 427.6[c]; [d]; [e]). State DSS has established
specific criteria relating to the eligibility of foster parents
for such rates and the classification of foster care services
as special or exceptional (id.).
Matter of Claudio v Dowling
In September 1991, the New York City Department of
Social Services (City DSS) placed three children adjudged abused
or neglected pursuant to Article 10 of the Family Court Act with
appellant, a licensed foster care provider. Appellant received
the standard, "normal" foster care reimbursement rate
for these children.
Three weeks after the children were placed in her
home and while the children were in her care, appellant requested
foster care benefits at the higher rate of reimbursement available
for special needs children. However, it was not until several
months into the placement that two of the children were evaluated
by a psychiatrist who found that one child was emotionally disturbed
and that the other was learning disabled. Appellant received payment
at the higher special needs rate for one child for a period of
one month. All three children left appellant's household on October
29, 1992 and reunited with their biological parents.
Since City DSS had not responded to her requests
and because of the special expenditures incurred in caring for
these children, appellant continued to seek reimbursement at the
higher special needs rate after the children were returned to
their biological parents. Finally, on August 13, 1993, after failing
to receive a response from the City, appellant requested a fair
hearing from the State to review the adequacy of the foster care
maintenance payments.
Vera v Dowling
On May 10, 1988, City DSS placed two children
with appellant Vera, a licensed foster care provider. These children
had been adjudged abused or neglected pursuant to Article 10 of
the Family Court Act, and resided with the appellant for two and
a half years. Shortly after the placement, appellant observed
that the children had behavioral problems and they were referred
for psychological evaluation. A psychologist determined that both
children had serious emotional and behavioral problems. Appellant
received the standard rate of reimbursement for the duration of
the placement except for a four month period during which she
received the special needs rate for one child.
On November 21, 1990, the children were removed from
appellant's home and returned to their biological parents. Thereafter,
appellant learned of the higher reimbursement rate for care provided
to special needs children and she requested the higher rate for
the entire period she had the children under her care. Appellant
Vera requested a fair hearing to review the adequacy of the City's
payments on February 23, 1993.
City DSS placed five children who had been adjudged
abused or neglected under Article 10 of the Family Court Act with
appellant Velez, a licensed foster care provider. Three of the
children suffered from sickle cell anemia and severe asthma.
For one of the sick children, appellant received the special needs
rate from June 15, 1989 to June 15, 1990 because the child entered
foster care directly from a hospital (see, 18 NYCRR 427.6[d]).
Appellant received the standard rate of reimbursement for the
remaining children.
Two of the children left appellant's care in the
spring of 1989. A third child left in May 1991 and the two remaining
children were removed from foster care on March 27, 1991. On February
23, 1993, appellant requested a fair hearing from the State to
review the adequacy of the City's payments for the level of care
rendered to all five of these children.
Procedural History
Separate fair hearings were conducted for
each appellant. In each case, the Commissioner of State DSS determined
that since the children no longer resided with the foster parents
at the time the fair hearing was requested, the agency was without
jurisdiction to determine the adequacy of the reimbursement. Appellant
Claudio brought an Article 78 proceeding challenging the Commissioner's
disclaimer of jurisdiction. Supreme Court granted appellant's
petition to the extent of remanding the matter for an administrative
hearing on the merits of appellant's claim. The court held that
since the foster care services had already been rendered, the
character of the services provided would not change solely because
the children no longer resided with appellant, and that appellant
had standing to seek reimbursement at the higher special needs
rate. The court also observed that Federal law required that administrative
hearings be provided to foster parents in these circumstances.
Appellants Vera and Velez challenged the Commissioner's
determination in a class action lawsuit which sought a declaratory
judgment under CPLR 3001. Supreme Court granted summary judgment
to the respondents and dismissed the action on the ground that
appellants had no standing to seek review of the reimbursement
rate once the children in their care had been removed.
On appeal, the Appellate Division, which considered
the cases together, reversed in Claudio and affirmed in Vera.
The court concluded that "former foster parents" lack
standing to seek review of foster care reimbursement rates once
the children have been removed from their foster homes. The Appellate
Division also concluded that Federal law required that foster
parents be provided with a fair hearing only if the foster child
resided in the foster care household at the time the request for
a fair hearing is made. We granted appellants leave to appeal
to this Court.
Appellants contend that foster parents have standing
to seek a fair hearing on the adequacy of the City's reimbursement
for expenses incurred in providing foster care services, even
if the child no longer resides in the foster care household. Respondents
contend that the State lacks standing to review the adequacy of
such reimbursements unless the child resides with the foster parent
at the time a request for a fair hearing is made.
Analysis
Appellants' contention that they have standing to
request a fair hearing from the State under the circumstances
here is supported by both Federal and State law.
The Federal aid program provides that a State must
grant "an opportunity for a fair hearing before the State
agency to any individual whose claim for benefits available pursuant
to [the Federal Adoption Assistance and Child Welfare Act] is
denied or is not acted upon with reasonable promptness" (42
USC § 671 [a][12]). The plain meaning of this statute provides
for fair hearings to foster parents who, like appellants, seek
review of alleged underpayments of foster care benefits.
The Sixth Circuit Court of Appeals has held that
foster parents are included in the category of "any individual"
in section 671(a)(12) and that the benefits referred to in that
section "include foster care maintenance payments to licensed
foster parents" (Timmy S. v Stumbo, 916 F2d
312, 315). Although Timmy S. is instructive on the matter
before us, we conduct our own analysis of the applicable statutory
and regulatory schemes.
Under the Federal aid program, a State's case plan
provides "services" to foster parents (42 USC §
675[1][B]). Such a plan must also provide for the payment of foster
care maintenance payments with respect to certain children (42
USC §§ 671[a][1], 672). Because foster parents are a
category of beneficiaries in case plans appellants fall within
the category of "any individual." As these disputes
concern foster care maintenance payments, they arguably concern
"benefits available" pursuant to the Federal Act. Moreover,
nowhere does the statute limit the time in which such a hearing
can be requested,2 and nowhere does the statute
exclude foster parents, such as appellants, from the class of
"individuals."
The legislative history of the Act also indicates
that Congress intended the mandatory Federal regulations pertaining
to fair hearings in the Federal Aid to Families with Dependent
Children program, which encompassed foster care payments under
the previous statutory scheme, be applicable under the Act (HR
Conf Rep No. 900, 96th Cong, 2nd Sess, reprinted in 1980 US Code
Cong & Admin News 1561, 1563, 1565). The regulations of the
Federal Department of Health and Human Services, the agency charged
with enforcement of the Act, further provide that "[a]n opportunity
for a hearing shall be granted to any applicant who requests a
hearing because his or her claim for financial assistance * *
* is denied, or is not acted upon with reasonable promptness,
and to any recipient who is aggrieved by any agency action"
(45 CFR § 205.10[a][5]; § 1356.20[a]; § 1355.30[p][2];
see also, § 205.10[a][2] [providing that "the State
shall assure that the applicant or recipient is afforded all rights
as specified in this section"]).
Finally, under Federal law, foster parents in appellants'
circumstances could be considered recipients entitled to a fair
hearing. Since foster care payments always are made as reimbursements,
the foster parent may logically be considered the recipient of
"payments to cover the cost of * * * food, clothing, shelter,
daily supervision, school supplies, a child's personal incidentals
[etc.]" (42 USC § 675[4][A]) and thus entitled to a
fair hearing.
The State's reimbursement program additionally provides
support for the conclusion that appellants have standing to seek
a fair hearing on the payment issue here, that is, whether the
foster parents received the proper rate of reimbursement for the
level of care actually provided to the children.
The State provides the right to a fair hearing "to
challenge determinations or actions of a social services agency
or such agency's failure to act with reasonable promptness or
within the time periods required" (18 NYCRR 3583.1[a])
to an applicant or recipient of "assistance, benefits, or
services" (18 NYCRR 358-3.1[b]). Upon approval by the State,
the City's payments for special and exceptional foster care services
"made on behalf of foster children" are eligible for
reimbursement (18 NYCRR 427.6[c] and [d]). State regulations further
provide that reimbursements are available for payments made by
social services districts "for special or exceptional foster
care services made to foster parents" who meet certain criteria
(18 NYCRR 427.6[e]). "[C]ertified and approved foster care
parents must be reimbursed for each such child to whom they provide
foster care according to the standards established in Part 427
[of the Department of Social Services regulations]" (18 NYCRR
443.3[v]). Moreover, such reimbursements are limited to "actual
payments to certified or approved foster parents" (18 NYCRR
427.6[b]). Given that the language of 18 NYCRR 443.3 (v) is mandatory,
the proper course under the statute is to reimburse foster parents
according to the correct rate of benefits. Affording foster parents
a fair hearing to review the correctness of their benefits furthers
this important State policy.
It is evident from the foregoing that under the State's
regulatory scheme reimbursements to the City arise out of payments
for foster care services rendered on behalf of a child. However,
such payments are made to foster parents, and only for those services
which have been actually rendered. Thus, foster parents may properly
be considered applicants or recipients of assistance, benefits
or services provided by a social services agency and are entitled
to a fair hearing.3 It is irrational to require
a child to be in the foster care boarding home at the moment that
a fair hearing is requested.
Since no reimbursements to the foster parent, the
City or the State may occur for expenditures on foster care services
until such services have been actually provided to the child,
any dispute over the proper rate of reimbursement inevitably occurs
after such services have already been rendered. The State has
recognized that "foster care rates are an important ingredient
in enabling social services districts to place children in the
least restrictive setting appropriate to the needs of the child
and to attract a sufficient number of qualified foster parents
to serve as placement resources for such children" (Local
Commissioner's Memorandum, 92 LCM162 [October 21, 1992]).
To deny appellants standing for a fair hearing with respect to
the proper rate of reimbursement for foster care provided to the
children is at odds with these statutory and regulatory purposes.
Finally, we note that in providing foster parents
with the opportunity for a fair hearing, procedural matters relating
to the administration of such hearings may be prescribed by statute
or appropriate regulation.
Accordingly the order of the Appellate Division in
Matter of Claudio v Dowling should be reversed, with costs,
and the order of the Supreme Court New York County reinstated.
In Vera v Dowling, the order of the Appellate Division
should be reversed, with costs, and the State defendants' motion
for summary judgment denied.
FOOTNOTES
1. Under Federal law, foster care maintenance payments are defined as,
"payments to cover the cost of (and the cost
of providing) food, clothing, shelter, daily supervision, school
supplies, a child's personal incidentals, liability insurance
with respect to a child, and reasonable travel to the child's
home for visitation" (42 USC § 675 [4] [A]).
New York State defines "foster care maintenance"
as "federally reimbursable payments which, for children in
foster care, cover the cost of" the various items and services
designated in the Federal statute (18 NYCRR § 462.2[c]).[return
to text]
2. Nothing in this opinion should be construed to
limit the State's ability to set reasonable time limits for applicants
and recipients seeking a fair hearing. [return to texts
3. Moreover, the State provides fair hearings to
sponsors (18 NYCRR 3583.1[c]) relatives or friends (18 NYCRR
3583.1[d]), and spouses (18 NYCRR 3583.1[9]) in certain
circumstances even though they are not technically applicants
or recipients. Surely, the Legislature could not have intended
these individuals, but not appellants, to have standing to seek
fair hearings. [return to text]
No. 2: Order reversed, with costs, and order of Supreme
Court, New York County, reinstated. Opinion by Judge Smith. Chief
Judge Kaye and Judges Titone, Bellacosa, Levine, Ciparick and
Wesley concur.
No. 3: Order reversed, with costs, and the State
defendants' motion for summary judgment denied. Opinion by Judge
Smith. Chief Judge Kaye and Judges Titone, Bellacosa, Levine,
Ciparick and Wesley concur.
Decided February 18, 1997