DICKSON, Justice.
In this challenge to the Indiana Family and Social Services Administration's (FSSA) automated system of processing claims for Medicaid, Food Stamps, and Temporary Assistance to Needy Families (TANF) benefits, we reverse the judgment of the trial court and hold that the FSSA's denial notices are insufficiently explanatory but that the FSSA may deny an application for Food Stamp benefits when the applicant fails to cooperate in the eligibility determination process. We affirm in part the trial court's grant of Perdue's motion for summary judgment and hold that Sheila Perdue is entitled to reasonable accommodations in applying for benefits but that this does not necessarily require providing a caseworker or case management services.
The plaintiffs brought this class action complaint seeking declaratory and injunctive relief alleging violations of their federal
In the trial court, the plaintiffs moved for summary judgment as to all three claims. The State filed a response requesting that the trial court deny summary judgment to the plaintiffs and instead enter summary judgment in favor of the State as to all three counts in accordance with Indiana Trial Rule 56(B).
The parties do not dispute the underlying facts of this case, which are summarized herein. The FSSA is charged with, among other things, administering the Medicaid, Food Stamp, and TANF programs for the State of Indiana. Each of these programs provide welfare benefits to individuals and families in need of financial assistance in Indiana. To be deemed eligible for a particular program, an individual must be certified as eligible by the FSSA and recertified either annually or semiannually depending on the particular program. The processes for initial certification and recertification are virtually identical, though recertification generally requires less information from the applicant.
The first step in the certification process is an interview between an FSSA caseworker and an applicant, which is scheduled by the FSSA's computer system. The interview is conducted either over the telephone or in-person, depending on the county where the applicant resides. During the interview, the caseworker and the applicant explore potential areas of eligibility for particular programs and discuss the types of information and verification documents necessary to establish eligibility. The applicant then receives State Form 2032 entitled "Pending Verifications for Applicants/Recipients" specifying the particular documentation that is required by the agency to establish eligibility.
If the applicant fails to submit all of the necessary documentation within the designated time period, the application for benefits is denied or, in the case of recertification, the applicant's benefits are discontinued.
We review an appeal of a trial court's ruling on a motion for summary judgment using the same standard applicable to the trial court. Wilson v. Isaacs, 929 N.E.2d 200, 202 (Ind.2010). Therefore, summary judgment is appropriate only if the designated evidence reveals "no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Ind. Trial Rule 56(C). Appellate review of summary judgment is limited to evidence designated to the trial court. Ind. Trial Rule 56(H). All facts and reasonable inferences drawn from the evidence designated by the parties must be construed in the light most favorable to the non-moving party. Mangold ex rel. Mangold v. Ind. Dept. of Natural Res., 756 N.E.2d 970, 973 (Ind.2001). We do not defer to the trial court's determination of the law. Wilson, 929 N.E.2d at 202-03 (citing Freidline v. Shelby Ins. Co., 774 N.E.2d 37, 39 (Ind.2002)).
The plaintiffs in Class A and Sub-class A argue that the notices used by the FSSA to inform class member-applicants that they have been denied Medicaid, Food Stamp, or TANF program benefits violate their rights under the Due Process Clause of the Fourteenth Amendment to the United States Constitution and Title 42, Section 431.205(d) of the Code of Federal Regulations pertaining to Medicaid. They argue that the reason codes fail to adequately explain the agency's reasons for denying benefits. Specifically, they challenge six reason codes:
Appellants' Br. at 12; Plaintiffs' Memorandum of Law in Support of Motion for Summary Judgment, Appellees' App'x at 364-65. The plaintiffs contend that due process requires "notice specifying which specific document or documents [an applicant] is alleged to have failed to provide" so that individuals can make informed decisions about whether to appeal an adverse determination. Appellants' Br. at 31. We agree that due process requires a more detailed explanation of the reasons underlying an adverse determination.
The Due Process Clause of the Fourteenth Amendment declares that no State shall "deprive any person of life, liberty, or property, without due process of law." U.S. Const. amend. XIV, § 1. Due process requires a two-part inquiry: "The first inquiry in every due process challenge is whether the plaintiff has been deprived of a protected interest in `property' or `liberty.' Only after finding the deprivation of a protected interest do we look to see if the State's procedures comport with due process." Am. Mfrs. Mut. Ins. Co. v. Sullivan, 526 U.S. 40, 59, 119 S.Ct. 977, 989, 143 L.Ed.2d 130, 149 (1999) (citing U.S. Const. amend. XIV, § 1 and Mathews v. Eldridge, 424 U.S. 319, 332, 96 S.Ct. 893, 47 L.Ed.2d 18 (1976)) (citations omitted).
Both parties acknowledge that the entitlement benefits at issue in this case (Medicaid, Food Stamp, TANF) are properly characterized as "property" interests within the meaning of the Due Process Clause. Appellants' Br. at 24; Appellees' Br. at 16. We agree. There is no question that these entitlement benefits are "property" entitled to the full panoply of due process protections. See Atkins v. Parker, 472 U.S. 115, 128, 105 S.Ct. 2520, 2528, 86 L.Ed.2d 81, 92 (1985) (recognizing Food Stamp benefits as a protected property interest); Mathews, 424 U.S. at 332, 96 S.Ct. at 901, 47 L.Ed.2d at 31-32 (recognizing Social Security disability benefits as a protected property interest); Goldberg v. Kelly, 397 U.S. 254, 261-62, 90 S.Ct. 1011, 1017, 25 L.Ed.2d 287, 295-96 (1970) (recognizing federal welfare benefits as a protected property interest); see also Sullivan, 526 U.S. at 60, 119 S.Ct. at 990, 143 L.Ed.2d at 150 (recognizing the property interests in Goldberg and Mathews).
Turning next to the question of what process is due, the fundamental requirement of procedural due process is the opportunity to be heard at a meaningful time and in a meaningful manner. Goldberg, 397 U.S. at 267, 90 S.Ct. at 1020, 25 L.Ed.2d at 299. When a deprivation is contemplated, "these principles require that a recipient have timely and adequate notice detailing the reasons for a proposed termination, and an effective opportunity to defend by confronting any adverse witnesses and by presenting his own arguments and evidence orally." Id. at 267-68, 90 S.Ct. at 1020-21, 25 L.Ed.2d at 299 (emphasis added).
Here, the plaintiffs challenge the denial of their benefits on grounds that they have failed to cooperate in the certification process or failed to submit certain required information. Neither the plaintiffs nor the State contend that the deprivations (i.e., the denials of benefits) were in any way inadvertent or accidental. Instead, the plaintiffs allege that at least some of these deprivations were intentional but based on erroneous information. As such, Atkins's "inadvertent error" exception does not apply to the notices at issue in this case because they were not accidental. We must, therefore, continue our analysis under the more strenuous notice requirement of Goldberg.
In a trio of cases, the Seventh Circuit defined the contours of Goldberg's adequate notice requirement. See Vargas v. Trainor, 508 F.2d 485 (7th Cir.1974), cert. denied, 420 U.S. 1008, 95 S.Ct. 1454, 43 L.Ed.2d 767 (1975); Banks v. Trainor, 525 F.2d 837 (7th Cir.1975), cert. denied, 424 U.S. 978, 96 S.Ct. 1484, 47 L.Ed.2d 748 (1976); Dilda v. Quern, 612 F.2d 1055 (7th Cir.1980), cert. denied, 447 U.S. 935, 100 S.Ct. 3039, 65 L.Ed.2d 1130 (1980).
One year later, in Banks, the Seventh Circuit elaborated more precisely the due process requirement, first articulated in Vargas, to inform applicants of the reasons for an adverse determination. Banks involved a reduction in benefits to existing recipients precipitated by a change to the method by which benefits were calculated. 525 F.2d at 839. The Illinois Department of Public Aid sent affected beneficiaries a notice informing them that their benefits would be reduced as a result of the change. Id. The notice stated that the recipient's benefits would be reduced and provided only the recipient's income, the benefit amount under the old method, and the benefit amount under the new method. Id. The court found the notice "deficient" under Goldberg and Vargas because it "did not contain a breakdown of income and deductions so that recipients could determine the accuracy of the computations." Id. at 841-42. Without notice of the individualized factors (e.g., income, deductions, etc.) underlying the calculations, the court reasoned, recipients lacked protection against "agency error and arbitrariness." Id. at 842.
The Seventh Circuit reaffirmed Vargas and Banks in Dilda, holding that due process requires more than a statement of the "ultimate reason" for the adverse state
We are persuaded that the Seventh Circuit's approach should be applied in this case. Providing affected individuals with notice explaining in detail the reasons underlying the state's adverse decision empowers individuals to protect their own interests and complements the state's efforts to achieve accuracy. "The touchstone of due process is protection of the individual against arbitrary action by government." Wolff v. McDonnell, 418 U.S. 539, 558, 94 S.Ct. 2963, 2976, 41 L.Ed.2d 935, 952 (1974) (citing Dent v. West Virginia, 129 U.S. 114, 123, 9 S.Ct. 231, 233, 32 L.Ed. 623 (1889)). Toward this end, the Supreme Court has repeatedly singled out the right to a meaningful hearing as the most reliable bulwark against such arbitrariness. See, e.g., Zinermon v. Burch, 494 U.S. 113, 127, 110 S.Ct. 975, 984, 108 L.Ed.2d 100, 115 (1990); Mathews, 424 U.S. at 333, 96 S.Ct. at 902, 47 L.Ed.2d at 32; Goldberg, 397 U.S. at 267, 90 S.Ct. at 1020, 25 L.Ed.2d at 299. Yet, in the absence of an explanation of the reasons underlying the state's action, it is implausible to expect that an individual could prepare, let alone present, a sound defense. The inability to prepare a defense correspondingly undermines the effectiveness of any judicial remedy because it is less likely that a complete record of the issue will be developed for judicial review.
With these principles in mind, we now turn to the actual notices at issue in this case. The brief explanations contained in the reason codes employed by the State fail to provide any insight into the factual bases for the State's adverse benefit determinations. The reason codes do provide some information to applicants in that the codes offer, in brief and general terms, the intermediate conclusions necessitating a denial. Yet, these are merely the "ultimate reasons" for the denial. Like the notices at issue in Dilda, 612 F.2d at 1056, the FSSA's notices fail to provide any explanation of how this "ultimate reason" was reached. Vargas, Banks, and Dilda make clear that a constitutionally adequate explanation must include the individualized factual bases underlying an adverse determination. See Dilda, 612 F.2d at 1057 (holding that a notice of adverse action is constitutionally inadequate if it lacks the individualized calculations underlying the
Ortiz v. Eichler is instructive here. 616 F.Supp. 1046 (D.Del.1985), aff'd, 794 F.2d 889 (3d Cir.1986).
Id. at 1061-62. There is little difference between the notices struck down in Ortiz and the language of the reason codes at issue here. Neither "explain what the claimant was required by the regulation to do and how his or her actions failed to meet this standard." Id. Instead, each provides the applicant only with the predicate conclusions necessitating a denial of benefits. Due process requires that the notice provide the individualized reasons underlying this predicate conclusion.
The State responds that the reason codes provided in the adverse action notices are only half of the picture. They argue that the notice to applicants should
The State primarily relies on Rosen v. Goetz, 410 F.3d 919 (6th Cir.2005), to support its argument that Form 2032 and the formal denial notices, when taken together, satisfy due process. In Rosen, the State of Tennessee implemented a program aimed at reducing the fiscal impact of its supplemental Medicaid program, TennCare, which extended Medicaid benefits beyond the federally mandated minimum levels. 410 F.3d at 922. To achieve the reduction, Tennessee decided to eliminate three of the seventeen TennCare eligibility categories, resulting in the disenrollment of 323,000 existing program beneficiaries. Id. At issue in the case was whether Tennessee's proposed disenrollment process complied with federal Medicaid regulations and the Due Process Clause of the Fourteenth Amendment. Id. at 923. The plaintiffs in that case challenged, among other things, the notices issued by Tennessee as violative of due process. Id. at 931. Like the plaintiffs in this case, the Rosen plaintiffs argued that the notices failed to provide sufficient explanation of the reasons for the termination. Id. When disenrolling existing beneficiaries under the reduction program, Tennessee first sent beneficiaries a "Termination Notice" and later sent a second letter that referenced the first notice and provided more information concerning the reason for the discontinuation. Id. at 931. The court rejected the plaintiffs' claim, holding instead that due process is satisfied where notice is made in two letters, not just one, at least where the first notice "references and brings to the attention of recipients" the second. Id.
Rosen contemplates only a situation where both notices were provided after an adverse determination is made by the agency. See id. Rosen does not provide any guidance as to the permissibility of providing full notice in multiple correspondences where, like the State argues here, one portion of the notice precedes the making of the adverse determination. Such amalgamated notice was rejected by the Alaska Supreme Court in Baker v. State, Department of Health and Social Services, where the Alaska Department of Health and Human Services argued that adequate notice, for purposes of due process,
We therefore hold, as a matter of law, that the notices used by the FSSA to inform individuals that their applications for Medicaid, Food Stamp, or TANF benefits have been denied do not satisfy the requirements of due process. Accordingly, the Class A and Sub-class A plaintiffs were entitled to summary judgment on this issue, and the State's motion for summary judgment should have been denied.
On cross-appeal, the State appeals the trial court's order enjoining the FSSA from "terminating, denying, or discontinuing the Food Stamp applications or benefits of the members of Class C based on an alleged `failure to cooperate' with the agency."
Federal law states that "no household shall be eligible to participate in the [Food Stamp] program if it refuses to cooperate in providing information to the State agency that is necessary for making a determination of eligibility or for completing any subsequent review of its eligibility."
The Food Stamp program's implementing regulations contemplate both refusal and failure to cooperate as a basis of denial.
Our understanding of Section 273.2(d)(1) is guided by Section 273.2(h) which addresses delays in eligibility determinations caused by the state or the household.
For these reasons, we hold that federal law permits the FSSA to deny benefits to applicant's who fail to cooperate in the eligibility determination process. We therefore reverse the trial court's grant of summary judgment to the plaintiffs on this issue.
The State also challenges the trial court's determination that the FSSA violated Sheila Perdue's rights under the ADA and the RA. In seeking summary judgment, Perdue challenged the FSSA's administrative policy decision not to assign specific case-workers to applicants to help them navigate the application and recertification processes. Perdue alleges that this policy disproportionately impacts disabled individuals and constitutes a failure to accommodate her disability in violation of Title II of the ADA (42 U.S.C. §§ 12131-12165) and Section 794 of the RA. The State contends, however, that Perdue has failed to designate sufficient evidence to support summary judgment. Specifically, the State makes three arguments: (1) Perdue failed to provide evidence establishing that she is "deaf or that her disability was known to the agency"; (2) Perdue failed to designate evidence establishing that "but for her disability, she would have received the benefit being sought"; and (3) Perdue "did not designate any evidence that established that the [FSSA] intentionally discriminated against Perdue, or refused to provide a reasonable modification to Perdue, or that the rule in question had a disproportionate impact on Perdue as a disabled person." Appellees' Cross-Appeal Br. at 36, 38 (emphasis omitted). We agree with Perdue that the FSSA was required to reasonably accommodate her disability under the ADA and RA.
Perdue alleges the following facts in her verified complaint, which she designated as evidence in her summary judgment motion: Perdue had been receiving Food Stamp and Medicaid for the Disabled benefits for three or four years. In December 2007, the FSSA notified her that she must be recertified for these programs in order to continue receiving benefits. As part of the recertification process, she was required to participate in a telephonic interview. Perdue timely appeared for the interview. Because she was having difficulty hearing the interviewer over the telephone, she asked the interviewer if she could schedule an in-person interview. The interviewer told her that she could not. Perdue then gathered her paperwork and traveled to a nearby FSSA Help Center where she requested assistance completing her recertification forms. None was provided. Perdue then completed the forms herself to the best of her ability and submitted them. The State has offered no competing facts.
Title II of the ADA prohibits discrimination against the disabled by "public services." 42 U.S.C. §§ 12131-12165. Section 12132 of the ADA mandates that "no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any such entity." Id. § 12132. ADA regulations require a public entity to "make reasonable modifications in policies, practices, or procedures when the modifications are necessary to avoid discrimination on the basis of disability." 28 C.F.R. § 35.130(b)(7). Such modifications are required "unless the public entity can demonstrate that making the modifications would fundamentally alter the nature of the service, program, or activity." Id. Similarly, Section 794 of the RA provides: "No otherwise qualified individual with a disability . . . shall, solely by reason of her or his disability, be excluded from the participation in, be denied the
As outlined in the preceding paragraph, to sustain a claim under either the ADA or the RA, Perdue must demonstrate that (1) she is a "qualified individual with a disability" (2) who was excluded from or denied the benefits of the services, programs, or activities of, or otherwise subjected to discrimination (3) by a public entity (4) by reason of her disability. 42 U.S.C. § 12132; 29 U.S.C. § 794(a).
As an initial matter, based on the facts presented, there is no issue of material fact that would support the State's argument that Perdue was denied benefits "by reason of" her disability. While there doesn't appear to be any evidence of intentional discrimination, the FSSA clearly did not provide any accommodations to Perdue to assist her in applying for benefits, and this failure to accommodate disproportionately impacted this plaintiff as a disabled person. The fact that she was unable to participate in the telephone interview alone places a heavier burden on the disabled.
Lastly, there is no issue of material fact as to whether Perdue is a "qualified individual with a disability." Under the ADA, a "qualified individual with a disability" is "an individual with a disability who, with or without reasonable modifications to rules, policies, or practices, . . . meets the essential eligibility requirements for the receipt of services or the participation in programs or activities provided by a public entity." Id. § 12131(2). This determination is inextricably linked with the determination of whether the denial, exclusion, or discrimination was "by reason of such disability." Alexander v. Choate, 469 U.S. 287, 300 n. 19, 105 S.Ct. 712, 719 n. 19, 83 L.Ed.2d 661, 671 n. 19 (1985) (discussing the identical requirements of the RA: "However, the question of who is `otherwise qualified' and what actions constitute `discrimination' under the section would seem to be two sides of a single coin; the ultimate question is the extent to which a [public entity] is required to make reasonable modifications in its programs for the needs of the handicapped."). Both the ADA and the RA seek to "assure evenhanded treatment and the opportunity for handicapped individuals to participate in and benefit from [covered] programs." Id. at 304, 105 S.Ct. at 721, 83 L.Ed.2d at 674. Accordingly, a public entity is not "required to make `fundamental' or `substantial' modifications to accommodate the handicapped, [but] it may be required to make `reasonable' ones," which includes providing otherwise qualified disabled individuals with "meaningful access" to its benefits. Id. at 300, 105 S.Ct. at 720, 83 L.Ed.2d at 671.
The parties disagree about the precise benefit for which Perdue must be "otherwise qualified." On the one hand, a plaintiff "must show that, `but for' [her] disability, [she] would have received the ultimate benefit being sought" in order to maintain a claim under the ADA or RA. Wis. Comm. Servs., Inc. v. City of Milwaukee, 465 F.3d 737, 755 (7th Cir.2006). Thus, the State contends, Perdue must demonstrate her eligibility to receive the Food Stamp and Medicaid benefits for which she was applying at the time of the alleged violation. On the other hand, Perdue argues that any entitlement to benefits she might have is meaningless unless she is able to meaningfully participate in the application process. As such, Perdue contends that she must only demonstrate her eligibility to apply for Food Stamp and Medicaid benefits to satisfy the "otherwise qualified" requirement. We are persuaded that Perdue is correct and do not believe that the accommodation requirements of the ADA and RA were intended to operate so rigidly as the State would have us conclude.
In Choate, the Supreme Court admonishes us that we should not define the benefit—for which a disabled individual must show they are "otherwise qualified"—in a manner that "effectively denies otherwise qualified handicapped individuals the meaningful access to which they are entitled. . . ." 469 U.S. at 301, 105 S.Ct. at 720, 83 L.Ed.2d at 672. Were we to
Having concluded that the FSSA violated Perdue's rights under the ADA and RA, the trial court ordered the FSSA to provide her with a "caseworker or case management services." Findings of Fact, Conclusions of Law, and Summary Judgment, Appellants' App'x at 38. The trial court's order was premised on the Second Circuit's conclusion in Henrietta D. v. Bloomberg, that the case management system utilized by New York City in that case represented a reasonable accommodation. Id. at 36 (citing 331 F.3d 261, 280 (2d Cir.2003)). Henrietta D., however, does not stand for the proposition that a case management system is the only reasonable accommodation sufficient to accommodate disabled applicants for social services. It stands only for the proposition that such a system is a sufficient reasonable accommodation. 331 F.3d at 280. The ADA and RA only require that the FSSA provide meaningful access to the disabled unless such "reasonable accommodation . . . would impose an undue hardship on the operation of its program." See id., 331 F.3d at 281-82 (citing 28 C.F.R. § 41.53). Thus, the FSSA is not required to adopt any specific form of accommodation such as a caseworker or case management services. Rather, the FSSA is only required to make reasonable accommodations sufficient to accommodate the disabled.
Summary judgments in favor of the State as to Class A and Sub-class A and in favor of the plaintiffs as to Class C are reversed, and summary judgment in favor of Sheila Perdue is affirmed in part. With respect to Class A and Sub-class A, we grant the plaintiffs' motion for summary judgment and hold that the notices used by the FSSA to inform applicants that
SHEPARD, C.J., and SULLIVAN, RUCKER, and DAVID, JJ., concur.
Id.