SEGAL, J.—
AIDS Healthcare Foundation and AHF Healthcare Centers (collectively AHF) appeal from the judgment of dismissal entered after the trial court sustained without leave to amend the demurrer by the State Department of Health Care Services and its director Toby Douglas (collectively the Department) to AHF's petition for a writ of administrative mandamus. AHF sought a writ directing the Department (1) to withdraw its order rejecting and remanding an administrative law judge's proposed decision on AHF's administrative claims against the Department, and (2) to adopt as the "Final Decision" certain portions of the administrative law judge's proposed decision and to reject other portions. The trial court concluded that AHF was not entitled to judicial review because it had failed to exhaust its administrative remedies and that there was no applicable exception to the exhaustion requirement. We conclude that the exhaustion requirement bars AHF's petition because AHF's administrative claim is not final and that the Department's administrative processes and procedures were legally adequate and did not violate the law. Therefore, we affirm.
AHF had a contract with the Department to provide health care services in Los Angeles County to beneficiaries of California Medical Assistance Program (Medi-Cal) suffering from acquired immune deficiency syndrome. The contract stated that AHF would provide certain services to the Medi-Cal beneficiaries and receive payment based on the amount that Medi-Cal would have expended had it provided health care for a similar population through a fee-for-service delivery system.
In 2009 a dispute arose between the parties over the Department's rates of payment to AHF for 2009 and 2010 and the Savings Share incentive payments owed to AHF for 2007 and 2008. The Department rejected AHF's claims. AHF appealed and asked the Department to conduct an administrative review hearing under Health and Safety Code section 100171.
The Department selected Administrative Law Judge (ALJ) Dwight V. Nelsen, an ALJ on the staff of the Department's administrative hearings and appeals office, to hear the appeal. ALJ Nelsen, acting as the sole hearing officer, conducted the hearing at the Department's hearing offices.
In December 2012 ALJ Nelsen issued a proposed decision, which ruled in favor of AHF in part and in favor of the Department in part. ALJ Nelsen recommended that the Department adopt his proposed decision as the Department's final decision.
Douglas, the Director of the Department, delegated the agency's authority to act on ALJ Nelsen's proposed decision to the Department's Chief ALJ Sharon Stevenson. In a February 15, 2013 letter to the Department and AHF, Chief ALJ Stevenson stated she was considering rejecting ALJ Nelsen's proposed decision and "either alternating it or remanding this matter for further hearing and a revised decision." On March 1, 2013, Chief ALJ Stevenson issued an order entitled, "Rejection of Proposed Decision and Remand to Take Additional Evidence," citing Government Code section 11517, subdivision (c)(2)(D).
On April 2, 2013, AHF wrote to Chief ALJ Stevenson objecting to her order. AHF pointed out that the Department's ALJ Nelsen had originally
On April 2, 2013, the same day AHF objected to Chief ALJ Stevenson's order, AHF filed a petition for a writ of administrative mandamus in the superior court. AHF sought an order directing the Department to withdraw Chief ALJ Stevenson's order and to adopt certain portions of ALJ Nelsen's proposed decision and to reject other portions. AHF argued that the Department had exceeded its jurisdiction and violated the Administrative Procedure Act (Gov. Code, § 11340 et seq.; APA) by using Department ALJ's to conduct proceedings and decide the matter. AHF further contended that, to the extent that the Department had jurisdiction, the proposed order was an abuse of discretion. AHF also argued that it was entitled to seek judicial review of the Department's proceedings because it had pursued unsuccessfully all available administrative remedies, and it was "not required to exhaust any remaining administrative remedy because the administrative process itself is the cause of the harm that AHF alleges . . . ."
The Department filed a demurrer to the petition, arguing that AHF had "failed to exhaust their administrative remedies and obtain a final decision by the Department and the Director before seeking judicial relief." The Department argued that, because the matter was still pending before ALJ Freeman, AHF's petition for judicial relief was premature. The Department also defended its practice of using Department ALJ's to conduct administrative proceedings, arguing that the Department acted within its statutory authority under both the Health and Safety Code and the APA.
"In reviewing an order sustaining a demurrer, we independently evaluate whether the operative complaint states facts sufficient to state a cause of action." (Alborzian v. JPMorgan Chase Bank, N.A. (2015) 235 Cal.App.4th 29, 34 [185 Cal.Rptr.3d 84]; see Zelig v. County of Los Angeles (2002) 27 Cal.4th 1112, 1126 [119 Cal.Rptr.2d 709, 45 P.3d 1171]; Brown v. County of Los Angeles (2014) 229 Cal.App.4th 320, 322 [177 Cal.Rptr.3d 268].) Where, as here, the trial court sustained the demurrer without leave to amend, we determine whether there is a reasonable possibility that the plaintiff can cure the defect by amendment. (Loeffler v. Target Corp. (2014) 58 Cal.4th 1081, 1100 [171 Cal.Rptr.3d 189, 324 P.3d 50].)
This appeal involves the interpretation of statutes in the Government Code and the Health and Safety Code. "Statutory interpretation is a question of law that we review de novo." (Bruns v. E-Commerce Exchange, Inc. (2011) 51 Cal.4th 717, 724 [122 Cal.Rptr.3d 331, 248 P.3d 1185].) "In doing so, `it is well settled that we must look first to the words of the statute, "because they generally provide the most reliable indicator of legislative intent." [Citation.] If the statutory language is clear and unambiguous our inquiry ends. "If there is no ambiguity in the language, we presume the Legislature meant what it said and the plain meaning of the statute governs." [Citations.] In reading statutes, we are mindful that words are to be given their plain and commonsense meaning. [Citation.] . . . Only when the statute's language is ambiguous or susceptible of more than one reasonable interpretation, may the court turn to extrinsic aids to assist in interpretation. [Citation.]' [Citation.]" (Kirby v. Immoos Fire Protection, Inc. (2012) 53 Cal.4th 1244, 1250 [140 Cal.Rptr.3d 173, 274 P.3d 1160].) These extrinsic or "secondary rules of construction" include "maxims of construction, which express familiar insights about conventional language usage; the legislative history; and the wider historical circumstances of a statute's enactment." (Joannou v. City of Rancho Palos Verdes (2013) 219 Cal.App.4th 746, 752 [162 Cal.Rptr.3d 158].)
The trial court sustained the Department's demurrer without leave to amend, ruling that AHF had failed to exhaust its administrative remedies because the decision of the Department was not final and that AHF had not demonstrated any applicable exception to the rule requiring exhaustion. The trial court was right on both counts.
A party must exhaust its administrative remedies before it seeks judicial review. An administrative remedy is exhausted only upon termination of all available administrative review procedures. (See City of San Jose v. Operating Engineers Local Union No. 3 (2010) 49 Cal.4th 597, 609 [110 Cal.Rptr.3d 718, 232 P.3d 701] [exhaustion requires "`a full presentation to the administrative agency upon all issues of the case and at all prescribed stages of the administrative proceedings'"]; accord, Coachella Valley Mosquito & Vector Control Dist. v. California Public Employment Relations Bd. (2005) 35 Cal.4th 1072, 1080 [29 Cal.Rptr.3d 234, 112 P.3d 623] (Coachella Valley).) "`The exhaustion doctrine is principally grounded on concerns favoring administrative autonomy (i.e., courts should not interfere with an agency determination until the agency has reached a final decision) and judicial efficiency (i.e., overworked courts should decline to intervene in an administrative dispute unless absolutely necessary).'" (Coachella Valley, supra, 35 Cal.4th at p. 1080, quoting Farmers Ins. Exchange v. Superior Court (1992) 2 Cal.4th 377, 391 [6 Cal.Rptr.2d 487, 826 P.2d 730].)
The doctrine of finality "`is . . . closely related . . . to'" the requirement of exhaustion of administrative remedies. (O.W.L. Foundation v. City of Rohnert Park (2008) 168 Cal.App.4th 568, 582 [86 Cal.Rptr.3d 1].) "`A decision attains the requisite administrative finality when the agency has exhausted its jurisdiction and possesses "no further power to reconsider or
AHF argues that the doctrine of exhaustion of administrative remedies does not bar its petition because the decision of the Department was final at the time AHF sought judicial review.
The APA is a detailed and comprehensive collection of statutes governing administrative procedures in California, divided into several categories, including statutes that govern the Office of Administrative Hearings (OAH) (Gov. Code, § 11370 et seq.) and statutes that govern the adjudication of administrative claims involving state agencies. The provisions of the Government Code governing administrative adjudications are contained in chapter 4.5 (Gov. Code, § 14000 et seq.), which provides the general provisions for the adjudication of administrative claims,
In general, the APA governs evidentiary hearings conducted by all state agencies. (See Gov. Code, § 11410.20.) The APA applies "to a decision by an agency if, under the federal or state Constition or a federal or state
Certain agencies, however, conduct administrative hearings pursuant to enabling statutes or implementing regulations for those agencies that prescribe the relevant procedures and do not incorporate the APA. (See Cal. Law Revision Com. com., 32D West's Ann. Gov. Code (2005 ed.) foll. § 11410.20, p. 271;
Thus, whether the APA applies to a particular agency and its administrative proceedings in whole or in part depends on the relevant agency's particular statutory and regulatory scheme. (See Gov. Code, § 11501, subd. (a) [Gov. Code, § 11500 et seq. apply "to any agency as determined by the statutes relating to that agency"]; see also Gov. Code, § 11415.10, subd. (a) ["[t]he governing procedure by which an agency conducts an adjudicative proceeding is determined by the statutes and regulations applicable to that proceeding," and "[i]f no other governing procedure is provided by statute or regulation, an agency may conduct an adjudicative proceeding under the administrative adjudication provisions of the Administrative Procedure Act"].) Moreover, where statutes prescribe hearing provisions "for various individual agency proceedings, those provisions prevail over the more general provisions of the APA" (Usher v. County of Monterey (1998) 65 Cal.App.4th 210, 217 [76 Cal.Rptr.2d 274]; see Department of Alcoholic Beverage Control v. Alcoholic Beverage Control Appeals Bd. (2002) 99 Cal.App.4th 880, 884 [121 Cal.Rptr.2d 729]), and a statute applicable to a particular agency controls over a conflicting or inconsistent provision of the APA. (See Gov. Code,
Contested administrative hearings under the APA are conducted pursuant to procedures outlined in Government Code section 11517. Subdivision (a) provides that "[a] contested case may be originally heard by the agency itself . . . . Alternatively, at the discretion of the agency, an administrative law judge may originally hear the case alone . . . ." (Gov. Code, § 11517, subd. (a), italics added.) The agency's choice in subdivision (a) of whether to hear the case "itself" or have an ALJ "originally" hear it has significant procedural implications; specifically, the procedures of subdivision (b) apply when the agency hears the case "itself," and the procedures of subdivision (c) apply when an ALJ originally hears the case. Whether subdivision (b) or (c) applies is one of the main issues in this appeal.
The term "agency itself" as used in Government Code section 11517 means the "head of the agency" or its "governing body." (Usher v. County of Monterey, supra, 65 Cal.App.4th at p. 218; accord, Langan v. City of El Monte (2000) 79 Cal.App.4th 608, 617-618 [94 Cal.Rptr.2d 254].) Pursuant to Government Code section 11500, subdivision (a), the term "agency" includes state boards, commissions, and officers. Where the statute refers to the "`agency itself,'" "the power to act shall not be delegated unless the statutes relating to the particular agency authorize the delegation of the agency's power to hear and decide." (Gov. Code, § 11500, subd. (a).) Thus, if an "agency itself" must hear and decide the matter the agency may not delegate the hearing and decisionmaking authority to a subordinate agency hearing officer (i.e., an employee who is neither the agency head nor a member of its governing body), unless the agency's enabling statutes allow the delegation. (Usher v. County of Monterey, supra, 65 Cal.App.4th at p. 218; see, e.g., Greer v. Board of Education (1975) 47 Cal.App.3d 98, 112-113 [121 Cal.Rptr. 542] [school board, rather than district hearing officer, was required to determine certain issues reserved for the board].)
As noted, if an "agency itself" hears the matter, then Government Code section 11517, subdivision (b), governs the proceedings. Subdivision (b) provides: "(1) An administrative law judge shall be present during the consideration of the case and, if requested, shall assist and advise the agency in the conduct of the hearing. [¶] (2) No member of the agency who did not hear the evidence shall vote on the decision. [¶] (3) The agency shall issue its
Government Code section 11517, subdivision (c)(2), lists the actions the agency may take with respect to the ALJ's proposed decision. The agency may:
ALJ's can come from the OAH or from within an agency. In general, an ALJ on the staff of the OAH and appointed by the director of the OAH must conduct all hearings under the APA. Government Code section 11502 provides: "(a) All hearings of state agencies required to be conducted under this chapter shall be conducted by administrative law judges on the staff of the Office of Administrative Hearings. This subdivision applies to a hearing required to be conducted under this chapter that is conducted under the informal hearing or emergency decision procedure provided in Chapter 4.5 (commencing with Section 11400). [¶] (b) The Director of the Office of Administrative Hearings has power to appoint a staff of administrative law judges for the office as provided in Section 11370.3." Only the Director of the OAH can appoint ALJ's from the staff of the OAH. Government Code section 11370.3 provides: "The director shall appoint and maintain a staff of full-time, and may appoint pro tempore part-time, administrative law judges qualified under Section 11502 which is sufficient to fill the needs of the various state agencies. The director shall also appoint any other technical and clerical personnel as may be required to perform the duties of the office. The director shall assign an administrative law judge for any proceeding arising under Chapter 5 (commencing with Section 11500) and, upon request from any agency, may assign an administrative law judge to conduct other administrative proceedings not arising under that chapter and shall assign hearing reporters as required. Any administrative law judge or other employee so assigned shall be deemed an employee of the office and not of the agency to which he or she is assigned."
Nevertheless, certain California agencies maintain their own administrative hearing offices and employ and appoint "in-house" ALJ's to conduct administrative adjudications rather than using ALJ's from the OAH. (See, e.g., Gov. Code, § 18671 [civil service hearings]; Veh. Code, § 14100 et seq. [hearings to suspend or revoke driver's licenses]; Welf. & Inst. Code, § 10953 [social service entitlement claims conducted by ALJ's on the staff of the State Department of Social Services]; Bus. & Prof. Code, former § 24210, subd. (a) [claims involving applications for and revocations of alcohol licenses].) And, where a statute authorizes an agency to select one of its in-house ALJ's to conduct administrative proceedings, that statute controls over the APA statutes that require an ALJ on the staff of the OAH to conduct the proceedings.
To hear AHF's claims, the Department, pursuant to Health and Safety Code section 100171, selected an in-house ALJ from the Department staff, ALJ Nelsen, who, acting pursuant to Government Code section 11517, subdivision (c), heard the matter alone and rendered a proposed decision.
The Department asserts that the administrative proceedings concerning AHF's claims complied with Health and Safety Code section 100171 and Government Code section 11517. Therefore, according to the Department, its adjudication of AHF's claims was not final when AHF sought judicial review, and the trial court properly concluded that AHF had failed to exhaust its administrative remedies.
AHF argues that the Department's adjudicative process violated the APA in various respects and, as a result, ALJ Nelsen's proposed decision effectively became the "final decision" of the Department. To that end, AHF contends that, pursuant to Health and Safety Code section 100171, the Department had the option of selecting an ALJ from the OAH or an ALJ from the Department. AHF contends that where, as here, the Department selects an in-house ALJ from its own staff, rather than one appointed by the Director of the OAH from the OAH's staff of ALJ's, then the proceedings were or should be deemed conducted by the "agency itself." Therefore, AHF argues, because the "agency itself" heard the matter, the Department was required to proceed according to Government Code section 11517, subdivision (b), which provides that only members of the agency who heard the evidence can "vote" on the decision. As a result, according to AHF, the Department was not allowed to designate the Department's Chief ALJ Stevenson to review and reject ALJ Nelsen's proposed decision. AHF also contends that Chief ALJ Stevenson lacked authority to remand the matter to a new ALJ—ALJ Freeman—to conduct additional proceedings.
It is clear that Health and Safety Code section 100171, subdivision (b), mandates that an ALJ conduct the proceedings and that the Department select the ALJ. Health and Safety Code section 100171, subdivision (b), states that "[n]otwithstanding Section 11502" the hearing "shall be conducted before an administrative law judge selected by the department" and assigned to a Department hearing office. (Health & Saf. Code, § 100171, subd. (b), italics added.) Consistent with the requirement that the Department select the ALJ, subdivision (b) exempts the Department from the requirement of Government Code section 11502, subdivision (b), that the Director of the OAH select the ALJ. In addition, because Health and Safety Code section 100171, subdivision (b), does not authorize the Department director, any Departmental body, or any non-ALJ Department representative to conduct the hearings, the "agency itself" cannot hear the matter.
It is not entirely clear, however, whether this exemption in subdivision (b) also excuses the Department from the requirement of Government Code section 11502, subdivision (a), that the ALJ must be selected from the OAH ALJ staff. The more reasonable interpretation of this ambiguity in the statute, however, is that it does. The reference in Health and Safety Code section 100171, subdivision (b), to Government Code section 11502 is the broad and all-inclusive "[n]otwithstanding section 11502," which suggests that hearings under Health and Safety Code section 100171 proceed in spite of the procedures set forth in all of Government Code section 11502. (See Davis v. Fresno Unified School Dist. (2015) 237 Cal.App.4th 261, 282 [187 Cal.Rptr.3d 798] ["the ordinary meaning of the word `notwithstanding' is `in spite of'"]; accord, In re G.Y. (2015) 234 Cal.App.4th 1196, 1201 [184 Cal.Rptr.3d 461].) In addition, there is no other language in Health and Safety Code section 100171 that implies the Department may select an ALJ from the OAH staff. In fact, the APA does not authorize anyone other than the director of the OAH to select and appoint ALJ's on OAH staff to hear administrative matters that, like this one, are conducted (at least in part) under chapter 5 of the APA. (See Gov. Code, § 11370.3.) As reflected in Health and Safety Code section 100171, the Department is among the state agencies, such as the State Department of Social Services, the Alcoholic Beverage Control Appeals Board, and the Department of Motor Vehicles, that maintain a staff of ALJ's and hearing offices.
In any event, even assuming the Department was authorized to select an ALJ from the OAH staff, its failure to do so in this case does not mean, as AHF argues, that the "agency itself" conducted the hearing under Government Code section 11517, subdivisions (a) and (b). Rather, the failure to select an appropriate ALJ simply means that the wrong hearing officer conducted the proceedings. Nor does the fact that ALJ Nelsen worked for the Department (rather than the OAH) lead to the conclusion that the "agency itself" conducted the hearing. ALJ Nelsen was not qualified to act as the "agency itself" because, as noted, in this context the phrase "agency itself" means "governing body" or agency head. (Usher v. County of Monterey, supra, 65 Cal.App.4th at p. 218, accord, Langan v. City of El Monte, supra, 79 Cal.App.4th at pp. 617-618.) ALJ Nelsen held neither of these positions in the Department.
Moreover, nothing authorizes the Department to delegate its power to ALJ Nelsen to hear and decide the matter. (See Gov. Code, 11500, subd. (a) ["wherever the words `agency itself' are used the power to act shall not be delegated unless the statutes relating to the particular agency authorize the delegation of the agency's power to hear and decide"].) Although Health and Safety Code section 100171 requires an ALJ to conduct the hearings, the power to "decide" is reserved for the Director of the Department. (See (Health & Saf. Code, § 100171 [describing administrative proceedings "leading to a final decision of the director"].) Thus, in view of the definition of "agency itself," and the limitations placed on ALJ Nelsen's authority under Health and Safety Code section 100171, the Department's selection of ALJ Nelsen to hear the matter cannot mean that the "agency itself" conducted the proceedings under Government Code section 11517, subdivisions (a) and (b).
Our conclusion that the Department's in-house ALJ's can hear matters alone under Government Code section 11517, subdivisions (a) and (c), finds further support in another subdivision provision of Health and Safety Code section 100171. (See Outfitter Properties, LLC v. Wildlife Conservation Bd. (2012) 207 Cal.App.4th 237, 244 [143 Cal.Rptr.3d 312] [court construes "words in context, keeping in mind the statutory purpose, and harmonizes statutes or statutory sections relating to the same subject, both internally and with each other, to the extent possible"].) Subdivision (f) of Health and Safety Code section 100171 refers to the Department proceeding pursuant to Government Code section 11517, subdivision (c). (See Health & Saf. Code, § 100171, subd. (f) ["[i]n the case of any adjudicative hearing conducted by the department, `transcript,' as used in subdivision (c) of Section 11517 of the Government Code, shall be deemed to include any alternative form of recordation . . ."].) Although the issues in this case do not involve the use of transcripts or alternative forms of recordation, the fact that Health and Safety Code section 100171, subdivision (f), refers to Government Code section
Finally, even if AHF were correct that the Department failed to use the appropriate ALJ to conduct the proceedings in the case, such a failure would not mean that the decision reached by ALJ Nelsen becomes "final." Instead, it would mean that, because an unauthorized ALJ conducted the proceedings, the matter must be returned to the agency for consideration by an authorized, appropriately appointed ALJ. (See Absmeier v. Simi Valley Unified School Dist. (2011) 196 Cal.App.4th 311, 320 [126 Cal.Rptr.3d 237] ["`[f]ailure to provide an administrative law judge where one is required is a ground for nullifying the agency's action for lack of jurisdiction,'" and "`[i]n such a case the reviewing court should remand the matter to the agency for further consideration'"], citing Usher v. County of Monterey, supra, 65 Cal.App.4th at p. 219.) AHF does not ask for this remedy.
AHF also contends, in the alternative, that exceptions to the exhaustion requirement apply to its petition. Courts recognize several exceptions to the
AHF challenges the Department's administrative process, which AHF asserts is legally inadequate and violates the APA. AHF argues that the Department's administrative adjudication effectively denied it a full and fair determination on the merits. Thus, according to AHF, the Department's procedures "`"are the very source of the asserted injury"'" for which AHF seeks a remedy. (Brown v. City of Los Angeles, supra, 102 Cal.App.4th at p. 168; see Chrysler Corp. v. New Motor Vehicle Bd. (1979) 89 Cal.App.3d 1034, 1038-1039 [153 Cal.Rptr. 135].)
The inadequate remedy exception does not apply. First, as discussed, the Department's adjudicative proceedings did not violate the APA or the Health and Safety Code, and therefore its procedures are not the "source of" AHF "injury." Second, AHF's petition was not limited to an attack on the legal adequacy of the Department's administrative processes. Although AHF's arguments on appeal focus exclusively on the legal adequacy of the Department's adjudicative procedures, AHF's claims before the trial court did not. Instead, AHF's claims in the trial court were also about the underlying merits of its contract dispute with the Department, and AHF sought to obtain a reversal of those portions of the ALJ's order that AHF contended were wrongly decided. The principal sources of the injury alleged in the petition were AHF's claims that ALJ Nelsen had refused to award AHF "not less than $966,881.50" on its 2007 Savings Share claim and had refused to order the Department to recalculate its 2008 Savings Share "using actuarially sound methodologies, principles and practices." Such claims do not render an administrative remedy legally inadequate under the exhaustion doctrine; an administrative remedy is not inadequate simply because it is not the result desired. (See Campbell v. Regents of University of California (2005) 35 Cal.4th 311, 322-323 [25 Cal.Rptr.3d 320, 106 P.3d 976] ["courts have found the [exhaustion requirement] inapplicable only when the agency lacks authority to hear the complaint, not when the administrative procedures arguably limit the remedy the agency may award"].) Therefore, AHF's claims do not
The judgment is affirmed. Respondents are entitled to costs on appeal.
Zelon, Acting P.J., and Beckloff, J.,