Golf v. N.Y. State Dept. of Social Services

Floyd Golf was institutionalized from July 11, 1993, until his death on August 8, 1993. On September 15, 1993, an application for Medicaid benefits was filed with the Monroe County Department of Social Services. The application was denied because Mr. Golf's resources had exceeded by $13,100 the maximum amount allowable for receipt of Medicaid benefits. At the same time, the monthly income of Eileen Golf, Mr. Golf's wife, was below the minimum monthly maintenance needs allowance (MMMNA) for the community spouses of institutionalized Medicaid recipients. At a fair hearing, Mrs. Golf argued that the Department should raise her community spouse resource allowance (CSRA) by attributing Mr. Golf's excess resources to her, which would have pushed her income closer to the MMMNA and rendered him eligible for Medicaid. Only after Mr. Golf's excess resources had been shifted, she argued, could she be allocated a sufficient amount of Mr. Golf's income to allow her to achieve the MMMNA. The Department refused to establish a higher resource allowance for Mrs. Golf. Instead, it allocated a portion of Mr. Golf's income to her and then denied his Medicaid application because of excess resources. Mrs. Golf appealed the determination.

The court finds that in refusing to allocate Mr. Golf's excess resources to Mrs. Golf before looking to his income, the Department was putting "the proverbial 'cart' before the proverbial 'horse'." The pertinent federal and state statutes, the court writes, "very clearly" require that until eligibility is established, the income of the institutionalized spouse is attributable only to him and is not available to his spouse. The court thus orders the Department to increase Mrs. Golf's CSRA "by the amount of the excess resources attributed to petitioner's decedent and to redetermine Medicaid eligibility of petitioner's decedent." In its ruling, the court cites, among other cases, Gruber v. Ohio Dept. of Human Servs., 98 Ohio App 3d 72, 647 N.E.2d 861, lv. denied 71 Ohio St 3d 1493, 646 N.E.2d 468; and Kimnach v. Ohio Dept. of Human Servs., 96 Ohio App 3d 640, 645 N.E.2d 825, lv. denied 71 Ohio St 3d 1447, 644 N.E.2d 409.