Nicholas v. Myers

California Court of Appeal Dec 5, 1980 No. Civ. 58822Published

Before: Fleming

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Holding. The court held that the petitioner failed to establish the elements of equitable estoppel against the state, as the petitioner's ineligibility for Medi-Cal benefits resulted from the increased value of her property rather than reliance on the County's advice.

Issues

Whether the County is estopped from denying Medi-Cal benefits based on the petitioner's reliance on the County's advice to reconvey property.
Whether California's transfer-of-assets rule conflicts with federal Medicaid statutes and constitutional guarantees.

Disposition. affirmed

Quotations verified verbatim against the opinion

“The doctrine of estoppel is applicable only when the party asserting the doctrine has been injured by his reliance upon some conduct of the party he is seeking to estop.”

“To the extent that petitioner herein was injured at all, the injury was caused by her own conduct—i.e., her transfer of the income-producing property to her children, and not by any conduct of the County.”

“The short answer is that estoppel does not encompass necromancy.”

Opinion

FLEMING, J.

Appeal from the superior court’s denial of a writ of mandate compelling the award of Medi-Cal benefits to Mary Olivarez. We affirm.

[990]

Medi-Cal, California’s Medicaid program, is a cooperative federal-state venture in which the state is partially reimbursed for sums expended for the medical care of individuals who qualify for assistance. (42 U.S.C. § 1396 et seq.; Welf. & Inst. Code, § 14000 et seq.) In order to receive the federal funds, participating states must comply with various federal statutes and regulations. (42 U.S.C. § 1396a.) Among other things, the states must provide benefits to persons (the categorically needy) who are receiving or are eligible for cash (welfare) benefits under either the aid to families with dependent children program (AFDC) or the supplemental security income for the aged, blind, and disabled program (SSI). (42 U.S.C. § 1396a(a)(10)(A).) States which choose to do so may also provide benefits to persons (the medically needy) who, although otherwise qualified for AFDC or SSI, are ineligible for those programs due to excessive incomes or resources. (42 U.S.C. § 1396a(a)(10)(C).) California included the “medically needy” in its Medi-Cal program and established certain eligibility requirements for them. The instant cause involves certain of those “eligibility” provisions: First, an individual applicant, such as the petitioner at bench, is ineligible for Medi-Cal benefits if his or her assets (“property reserve”) exceed $1,500 in value. (Cal. Admin. Code, tit. 22, § 50420.) However, an applicant’s residence, income producing real property worth $25,000 or less, and certain other items (not relevant here) are not included in the property reserve. (Welf. & Inst. Code, § 14006; Cal. Admin. Code, tit. 22, §§ 50418, 50425, 50427, 50416.) Second, an applicant ordinarily is ineligible if he has transferred property for less than adequate consideration within two years prior to his application. (Welf. & Inst. Code, § 14015; Cal. Admin. Code, tit. 22, §§ 50409, 50408.) It is presumed that any such transfer was made for the purpose of establishing eligibility, and the applicant bears the burden of overcoming the presumption by objective facts. (Cal. Admin. Code, tit. 22, § 50409(b)(2).) This rule is known as the “transfer of assets” rule.

Nicholas v. Myers

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FLEMING, J.

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