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11/19/87 Christopher Hession, v. the Department of Public

November 19, 1987

CHRISTOPHER HESSION, PLAINTIFF-APPELLANT

v.

THE DEPARTMENT OF PUBLIC AID ET AL., DEFENDANTS-APPELLEES



APPELLATE COURT OF ILLINOIS, FIRST DISTRICT, FOURTH DIVISION

516 N.E.2d 820, 163 Ill. App. 3d 553, 114 Ill. Dec. 665 1987.IL.1714

Appeal from the Circuit Court of Cook County; the Hon. Arthur L. Dunne, Judge, presiding.

APPELLATE Judges:

PRESIDING JUSTICE McMORROW delivered the opinion of the court. LINN and JOHNSON, JJ., concur.

DECISION OF THE COURT DELIVERED BY THE HONORABLE JUDGE MCMORROW

Plaintiff Christopher Hession (Hession) requested that the Illinois Department of Public Aid (the IDPA) provide him medical assistance for certain medical bills he incurred during a three-month stay at a Chicago hospital in 1982. The IDPA denied his application following evidentiary hearings, and Hession filed an action for administrative review in the circuit court of Cook County. The trial court affirmed the IDPA's decision to deny medical assistance to Hession for his medical bills with respect to the first month of his hospital stay, but reversed the IDPA's decision denying assistance with regard to the second and third

On review, the question presented is whether the IDPA should have granted Hession's application for medical assistance relating to his first month's medical bills. The IDPA denied this request on the ground that Hession had approximately $400 in savings above the appropriate eligibility limit. Hession's medical bills for the first month amounted to about $16,000. He argues that the IDPA should have offset his $16,000 medical bills by $400, the amount of his excess savings, and that the IDPA should have provided him medical assistance for the remaining $15,600 in bills. This offset, which Hession and the IDPA refer to herein as a "resource spend down" is, according to Hession, required by pertinent Federal and State statutes and regulations, and equal protection of the law under the United States and Illinois Constitutions.

We find that the IDPA should have applied resource spend down to determine Hessions' eligibility for medical assistance for his first month's medical bills. In view of this Conclusion, we reverse the order of the trial court and the decision of the IDPA, and remand the matter to the IDPA for further consideration consistent with the views expressed herein.

Background

Hession was hospitalized in Chicago from October 7, 1982, to December 5, 1982. He applied for medical assistance with the IDPA on November 8, 1982. At the time of his application, Hession's only asset was his savings account, which contained $1,953.05. His total medical bills, for which he requested assistance, amounted to over $38,000.

The IDPA denied Hession's request for medical assistance on the ground that "the value of [his] assets [exceeded] the amount allowable by agency standards." Thereafter Hession filed an action for administrative review of the IDPA's denial of his application for medical assistance. Based upon Brengola-Sorrentino v. Department of Public Aid (1984), 129 Ill. App. 3d 566, 472 N.E.2d 877, the trial court remanded the matter to the IDPA. The court ordered further determination of whether the IDPA informed Hession, before it denied his application, that he could reduce his assets below the maximum allowed by agency standards in order to be eligible for benefits.

Following an evidentiary hearing, the IDPA reaffirmed its denial of Hession's medical assistance application. Upon administrative review of the matter before the circuit court, the trial court affirmed in part the IDPA's decision, on the ground that Hession was not eligible for assistance in October 1982. The trial court determined that the IDPA was not required to use resource spend down, according to the provisions of pertinent Federal and State statutes and regulations, or equal protection of the law.

The trial court also reversed the IDPA's decision in part, on the basis that Hession was eligible for medical assistance in November and December 1982 because the IDPA failed to advise Hession when he applied for assistance, in November, that he could reduce his assets in order to become eligible for assistance. The IDPA does not appeal from the trial court's partial reversal of its decision. Hession appeals from the portion of the ...


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