Bills v. Hardy

Summary

The West Virginia Supreme Court of Appeals reviewed the termination of Michael Bills's eligibility for the Medicaid Mentally Retarded/Developmentally Delayed Home and Community-Based Waiver Program. The court held that the circuit court improperly applied the Administrative Procedures Act's deferential standard of review instead of independently reviewing the facts and law in the certiorari proceeding. The court reversed and remanded, allowing consideration of additional evidence concerning the assessment of self-direction and the Department's lack of specific standards for that determination.

Holdings

1. The Administrative Procedures Act does not apply to contested cases involving the receipt of public assistance, including this Medicaid Waiver Program eligibility dispute.
2. A circuit court reviewing a covered state-agency decision by writ of certiorari must independently review both the law and the facts and render judgment as law and justice require.
3. In reviewing the DHHR decision by writ of certiorari, the circuit court has authority to receive and consider evidence independent of the administrative record.
4. The circuit court's application of the APA's deferential standard was not harmless because the disputed issue—whether Bills had substantially limited functioning in self-direction—was pivotal to his eligibility.

Questions Presented

1. Whether the circuit court applied the correct standard of review to the DHHR's decision terminating Bills's Medicaid Waiver Program benefits.
2. Whether the circuit court was required to independently review the law and facts in a writ-of-certiorari proceeding involving a public-assistance decision outside the scope of the Administrative Procedures Act.
3. Whether the circuit court could consider additional evidence relevant to Bills's eligibility and the DHHR's assessment of self-direction on remand.
4. Whether the DHHR's lack of a specific policy or standard for evaluating substantial limitation in self-direction required reversal of the circuit court's judgment.

Disposition

reversed_and_remanded