Spouse of Applicant for Public Aid Benefits Lacks Standing to Challenge Decision to Impose a Spend-down and Penalty on Medical Benefits or Results of Subsequent Appeal

An Illinois Appellate Court in the Fourth District affirms a trial court’s order dismissing a spouse’s complaint seeking judicial review of an administrative decision and the results of a subsequent appeal. The spouse lacked standing as she was neither applicant, recipient of public benefits, nor a participant in any administrative proceedings. In Campbell v. Hou, (Ill. App. 4th, No. 21-0536, August 10, 2022).

In March 2017, Burnie Campbell entered a nursing home and applied for public benefits. He passed away in 2019. The Illinois Department of Human Services (DHS) approved his application in 2020, subject to a $310,081 spend-down and $385,543 penalty. These assessments were imposed because DHS found Mr. Campbell had transferred assets for less than fair market value in the five years preceding his application.

As a result of this decision, his spouse became liable for his nursing home bills under the Illinois Family Expense Act.

In February 2020, an authorized representative of Mr. Campbell, who was not his wife, filed an administrative appeal of the DHS decision on his behalf. The representative appeared at a hearing before an administrative law judge (ALJ). Mrs. Campbell did not. After considering the evidence, the ALJ upheld DHS’ decision.

Subsequently, Mrs. Campbell filed a complaint seeking judicial review of the ALJ’s and DHS decisions. DHS filed a motion to dismiss Mrs. Campbell’s complaint, arguing she did not have standing. DHS also pointed out that Mrs. Campbell could have obtained standing, had she opened an estate for Mr. Campbell and become its administrator, but failed to do so.

The trial court granted DHS’ motion to dismiss because it found Mrs. Campbell was not a party to the administrative case, nor an applicant or recipient of public benefits. As such, under applicable statutes, she did not have the standing to seek a judicial review of the ALJ’s decision or the underlying DHS decision. Mrs. Campbell appealed the dismissal.

The request to be considered for public medical benefits is governed by the Illinois Public Aid Code (PAC). Section 11-8.7 of the PAC limits judicial review to “applicants” or “recipients” of public aid. The PAC also adopts provisions of the Administrative Review Law (ARL). Section 3-102 of the ARL provides that judicial review of agency decisions is limited to parties of record before an administrative agency and only when the decision adversely affects their rights, duties, or privileges.

Mrs. Campbell was not a recipient or applicant of public benefits. She was also not authorized to pursue Mr. Campbell’s administrative remedies, such as an appeal of DHS’ decision. She was not a party of record before HHS. However, she argued she was adversely affected by DHS’ decision, which should allow her to benefit from judicial review. Under this argument, the dismissal of her complaint was improper.

The court declines to adopt any standard that conflicts with either statute. Because the PAC, as written, requires that the person challenging DHS’ decision be either an applicant for or a recipient of public aid, the court cannot ignore the statute or use a different standard to conform to Ms. Campbell’s circumstances. Parties seeking review of an agency’s decision must meet the requirements outlined in the statute. Even if the court could set aside the PAC’s requirement of who can challenge an agency decision, Mrs. Campbell still cannot get around the ARL’s requirement that she be a party of record to an administrative proceeding to seek judicial review of a decision of an administrative agency.

The trial court’s order dismissing Mrs. Campbell’s case is consistent with the requirements of PAC and ARL of the estate and is affirmed.

Read the full text of this decision.