Opinion
No. WD 65425
March 14, 2006
Appeal from the Circuit Court of Cole County, The Honorable Richard G. Callahan, Judge.
Susan Hyde and her minor daughter, Hilary Mason, appeal the circuit court's judgment upholding the Department of Mental Health's order denying their request for attorney fees under Section 536.087.1, RSMo 2000. Although an appeal from the circuit court's judgment, we review the department's order rather than the circuit court's judgment. Maples v. Department of Social Services, 11 S.W.3d 869, 870 (Mo.App. 2000). Because the underlying proceeding was an "agency proceeding" as defined by Section 536.085(1), we reverse the department's order.
Mason suffers several developmental disabilities, including autism and obsessive-compulsive disorder. She is frequently violent toward her sister and others, including family and health care workers. Hyde applied for Medicaid benefits for Mason at the St. Louis Regional Center for Developmental Disabilities — North, a facility operated by the department's Division of Mental Retardation and Developmental Disabilities. Hyde requested in-home services to assist Mason in the morning and evenings under a Medicaid waiver program in which minors receive services funded by the federal Medicaid program normally available only at an institution. Missouri has a limited number of waivers available, so the division provides waivers according to applicants' needs. Some individuals, including those in emergency situations, receive waivers immediately; the division places others on a waiting list. Individuals on the waiting list receive services according to the priority of their needs rather than according to the date that the division placed them on the list of eligible recipients.
In July 2002, Kathleen Hopkins, assistant director of St. Louis Regional Center — North, informed Hyde that, although Mason was eligible to participate in the Medicaid waiver program, the facility was placing Mason on the waiting list because she did not meet emergency-need criteria. Two months later, Mason began receiving in-home respite services from personnel at Judevine Center for Autism, funded by Missouri's general revenue.
Unhappy with Mason's being placed on the waiting list, Hyde appealed to the Department of Mental Health. She argued that Mason met emergency-need criteria, so she should receive a Medicaid waiver immediately.
The department's appeals referee convened a hearing on March 25, 2003. Acting on behalf of the department, the referee declared that St. Louis Regional Center — North "did not present substantial and competent evidence to supports its position that Hilary Mason does not meet emergency need criteria or that the in-home support services [Hyde] has requested cannot be funded through the Medicaid Waiver program." The referee ordered St. Louis Regional Center — North to "continue the services currently provided . . . and pay for them with funds available under the Medicaid Waiver program."
Pursuant to Section 536.087, Hyde filed an application for award of attorney fees. A lawyer employed by a non-profit legal service organization had represented her during the proceedings, although she did not allege that she actually paid for the services. The department denied the request on the ground that, although St. Louis Regional Center — North erred, it was "substantially justified in determining that Mason did not qualify for immediate, emergency placement and in determining that the services should not be funded by the Medicaid Waiver program."
Hyde appealed the denial of attorney fees to the circuit court, which upheld the department's decision. The circuit court ruled that, although it disagreed with the department's decision, it lacked jurisdiction to award attorney fees because the underlying proceeding was not an "agency proceeding" as defined by Section 536.085(1), rendering Hyde ineligible for attorney fees. Hyde appeals.
Section 536.087.7 authorizes the courts to:
[M]odify, reverse or reverse and remand the determination of fees and other expenses if the court[s] find that the award or failure to make an award of fees and other expenses . . . was arbitrary and capricious, was unreasonable, was unsupported by competent and substantial evidence, or was made contrary to the law or in excess of the court's or agency's jurisdiction.
When the agency's decision involves interpretation and application of law to undisputed facts, we form our own conclusions and are not bound by the agency's interpretation. Maples, 11 S.W.3d at 870-71. We defer, however, to the department's findings of fact and consider all evidence in the light most favorable to the department's decision. Hohensee v. Division of Medical Services, 135 S.W.3d 512, 517 (Mo.App. 2004).
Section 536.087.1 authorizes the awarding of attorney fees to parties "who prevail in an agency proceeding or civil action arising therefrom . . . unless the court or agency finds that the position of the state was substantially justified or that special circumstances make an award unjust." But it applies only when the party has prevailed in an "agency proceeding." Section 536.085(1) defines an agency proceeding as "an adversary proceeding in a contested case . . . in which the state is represented by counsel, but does not include proceedings for determining the eligibility or entitlement of an individual to a monetary benefit or its equivalent[.]"
This is a case of first impression. We find no cases — nor do the parties cite to any — in which a court has determined whether or not an application for Medicaid waiver is a proceeding to determine "eligibility or entitlement . . . to a monetary benefit or its equivalent."
In construing statutes, our single goal is to ascertain the legislature's intent. We endeavor to achieve this goal by giving effect to the plain and ordinary meaning of the statute's language. State ex. rel Golden v. Crawford, 165 S.W.3d 147, 148 (Mo. banc 2005). We also construe statutes according to the legislature's obvious purposes. Person v. Scullin Steel Company, 523 S.W.2d 801, 803 (Mo. banc 1975). We previously declared that the purpose of Section 536.087's provision for attorney fees is "to require agencies to carefully scrutinize agency and court proceedings and to increase accountability of the administrative agencies . . . [and] to encourage relatively impecunious private parties to challenge abusive or unreasonable government behavior by relieving [them] of the fear of incurring large litigation expenses." State ex rel. Division of Transportation v. Sure-Way Transportation, Inc., 948 S.W.2d 651, 657 (Mo.App. 1997) (quotation and citation omitted). We have also declared that Section 536.087 "has a broad public policy purpose [of ensuring] the legitimacy and fairness of government and the law so that contests between private citizens and the government are decided on the merits of the matter and not on the costs." Wadley v. Department of Social Services, 895 S.W.2d 176, 179 (Mo.App. 1995).
The dictionary is the prime source for finding the plain and ordinary meanings of pertinent statutory terms. E.g., Tendai v. Missouri State Board of Registration for the Healing Arts, 161 S.W.3d 358, 366 (Mo. banc 2005). Relying on the dictionary, the Supreme Court declared, in State v. Barnes, 942 S.W.2d 362, 366 (Mo. banc 1997), that the plain and ordinary meaning of "benefit" is "a `payment' or `gift' or `a natural advantage.'" The General Assembly restricted the scope of "benefit" in Section 536.087 to benefits of money ("monetary benefits") — that is, payments or gifts of money — or its equivalent. The dictionary defines "equivalent" as "like in signification or import . . .: SYNONYMOUS[;] equal in value: COMPENSATIVE, CONVERTIBLE . . . [;] corresponding or virtually identical esp[ecially] in effect or function . . .: TANTAMOUNT[.]" WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY OF THE ENGLISH LANGUAGE UNABRIDGED 769 (1993).
Hyde was not seeking a payment or gift of money or its equivalent for her daughter. She was seeking status. The division had already agreed to give Hyde the equivalent of a monetary benefit: in-home services for her daughter. In addition, she wanted the division to declare her daughter's case to meet emergency-need criteria so that her daughter would, in effect, go to the head of the line in obtaining the approved benefits — that delivery of benefits to her daughter would not rest on availability of funds distributed according to priorities. Although she succeeded in obtaining a change in status of her daughter's case, she did not receive any more benefits for her daughter than she was receiving before.
Hence, we conclude that Hyde was not seeking a monetary benefit or its equivalent. This means that her case fit within the definition of an "agency proceeding" in Section 536.085(1). She was, therefore, eligible for attorney fees. We reverse the department's order to deny attorney fees and remand to the circuit court for it to determine the proper amount of attorney fees to be awarded in this case. Because the department did not cross-appeal the circuit court's conclusion that the department was not substantially justified in placing Mason on a waiting list, we need not address that issue.
Joseph M. Ellis, Presiding Judge, and Thomas H. Newton, Judge, concur.