Cheryl King v. Department of Health and Social Services, Division of Medicaid and Medical Assistance

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

CHERYL KING, )
)
Appellant, )
)
DEPARTMENT OF HEALTH ) C.A. No. K24A-04-001 RLG
AND SOCIAL SERVICES, )
DIVISION OF MEDICAID AND )
MEDICAL ASSISTANCE, )
)
Appellees. )

Submitted: August 1, 2024
Decided: October 23, 2024

MEMORANDUM OPINION AND ORDER

Upon Appeal from a Decision of the Delaware Department of Health
and Social Services, Division of Medicaid and Medical Assistance
AFFIRMED

Cheryl King, Pro Se Appellant.

Gabriela Kejner, Esquire, Department of Justice, Wilmington, Delaware. Attorney
for Appellee Unemployment Insurance Appeal Board.

GREEN-STREETT, J.
1
I. Introduction

Cheryl King appeals the decision of a Hearing Officer to uphold a

determination by the Delaware Department of Health and Social Services – Division

of Medicaid and Medical Assistance (“DMMA”) to close Ms. King’s food benefits

case.1 DMMA closed Ms. King’s benefits for “refusal to cooperate” with a quality

control inspection into Ms. King’s case.2 Ms. King contends she could not cooperate

because of her disabilities.3 As the Hearing Officer based his decision on substantial

evidence and committed no legal error, his decision is AFFIRMED.

II. Factual and Procedural Background

The Quality Control Unit (“QC”) of DMMA conducts randomized reviews of

clients receiving food benefits, randomly reviewing “80 to 90 cases each month as

part of a federal requirement.”4 On December 20, 2023, QC sent a letter to Ms. King

advising her that her account would be subject to review.5 The letter informed Ms.

King of the review process, notified her of a scheduled phone interview, and included

1
Notice of Administrative Agency Appeal, D.I. 1 (Apr. 2, 2024).
2
Answering Br. at 2.
3
Opening Br. at 2.
4
Tr. of Hearing before Hearing Officer (“Tr.”) at 15.
5
Id.

2
a list of forms Ms. King needed to complete and return to QC.6 Ms. King returned

several of the completed forms to QC before the deadline, but failed to complete the

Non-Household Member Form (the “Form”).7 The Form must be completed by a

third party who can verify the composition of Ms. King’s household.8 Ms. King

advised QC she did not have anyone who could fill out the Form on her behalf.9

During Ms. King’s scheduled phone interview, a QC reviewer inquired about

the Form.10 The QC reviewer asked if Ms. King’s adult son could fill out the Form.11

Ms. King stated her son could not fill out the form, but declined to provide further

explanation.12 At that time, Ms. King requested a Fair Hearing as provided by

federal regulations.13 A QC manager later followed up with Ms. King regarding the

Form, and Ms. King reiterated her son could not complete the Form.14 The QC

6
Id.; see Ex. 2.
7
Id. at 16.
8
Id.
9
Id.
10
Id.
11
Id. at 16-17.
12
Id. at 17.
13
Id.; see 16 Del. Admin. C. 5100-5000 (defining “Fair Hearing” as “an administrative hearing
held in accordance with the principles of due process.”).
14
Id.

3
manager advised Ms. King of several alternative people who could complete the

Form, including Ms. King’s neighbors or postal workers. Ms. King declined those

options.15 Ms. King also renewed her request for a hearing on the matter.16

On January 5, 2024, QC formally requested to sanction Ms. King’s benefits

for failure to cooperate with QC’s review.17 DMMA applied the requested sanction

and discontinued Ms. King’s benefits on January 8th.18 DMMA lifted the sanction

and reinstated Ms. King’s benefits on January 16th, pending the outcome of her

hearing.

A Hearing Officer conducted a Fair Hearing on Ms. King’s alleged failure to

cooperate on February 21, 2024.19 During the hearing, the Hearing Officer heard

testimony from the QC manager and Ms. King.20 Ms. King submitted several

exhibits, including (1) a video of her son; (2) a letter stating her son suffers from a

disability caused by a blow to the head; and (3) a video of her neighbors.21

15
Id.
16
Id.
17
Id. at 18.
18
Id.
19
Id. at 1.
20
Id.
21
Id. at 26-27.
4
Ms. King proffered a number of reasons why she could not complete the Form.

She explained her son’s disability prevented him from completing the Form; she

could not ask her neighbor to complete the Form because her neighbors are racist;

and she could not ask the postal worker to complete the Form – as suggested by QC

staff – because she “did not want to disclose [her] disability to others, or the fact that

[she is] receiving food benefits.”22 Ms. King testified she could not get the Form

completed because of her own disability.23 Ms. King did not disclose what disability

she suffers from, or why it affected her ability to find someone to complete the Form

on her behalf.

The Hearing Officer issued his written decision on March 20, 2024, upholding

DMMA’s decision to close Ms. King’s food benefits.24 He found QC offered Ms.

King “several opportunities to cooperate with having an individual not residing in

the home who knows of the household composition, to complete the Non-Household

Member Form [sic].”25 The Hearing Officer concluded Ms. King’s stated reasons

for failing to complete the Form were unpersuasive.26 Accordingly, he upheld

22
Id. at 25-26.
23
Id. at 25.
24
R. at 8.
25
R. at 16.
26
Id.

5
DMMA’s closure of Ms. King’s benefits based on Ms. King’s failure to complete the

Form.27

Ms. King appealed the Hearing Officer’s decision to this Court on April 2,

2024,28 and the Court issued a brief schedule on May 14, 2024.29 Ms. King filed her

Opening Brief on May 28, 2024.30 DMMA filed its Answering Brief on June 14,

2024.31 The brief schedule established the deadline for Ms. King to file any reply

brief as July 8, 2024.32 Ms. King did not file a reply by that deadline, and did not

request any allowance from the Court to file a reply out of time. The Court took Ms.

King’s appeal under advisement on the papers on August 1, 2024.

III. Standard of Review

Any recipient of public assistance benefits “against whom an administrative

hearing decision has been decided may appeal such decision to the Superior Court

if the decision would result in financial harm to the appellant.” 33 The appeal “shall

27
Id.
28
D.I. 1.
29
D.I. 13.
30
D.I. 14.
31
D.I. 16.
32
D.I. 13.
33
31 Del. C. § 520.

6
be on the record without a trial de novo.”34 This Court reviews the Hearing Officer’s

decision to ensure it is “supported by substantial evidence and free from legal

error.”35 “The Court is not to replace the trier of fact in an appeal of an administrative

board decision.”36 If the Hearing Officer’s decision is supported by substantial

evidence and free from legal error, it must be affirmed.37

IV. Analysis

A. Ms. King’s potential ADA-related claim is unsupported by the
Record

On appeal, Ms. King contends she did not refuse to cooperate, but rather could

not cooperate because of her disability.38 She posits the American Disabilities Act

(the “ADA”) entitles her to accommodation, and DMMA’s failure to provide that

accommodation during the review process amounts to discrimination.39 Ms. King

does not dispute the evidence relied upon by the Hearing Officer. Ms. King also

34
Id.

35
Ringgold v. Delaware Dep’t of Health & Soc. Servs., 2018 WL 7021956, at *1 (Del. Super. Dec.
21, 2018).
36
Id.
37
Id.
38
Opening Br. at 3.
39
Id. at 2-3.

7
does not point to any incorrect application of law made by either DMMA or the

Hearing Officer, save for her contention regarding discrimination.

“The ADA prohibits discrimination against individuals with disabilities in all

areas of public life.”40 “The ADA provides that an individual is disabled if … she

has a physical or mental impairment that substantially limits one or more of [ ] her

major life activities.”41 To advance a claim under the ADA, Ms. King must show:

(1) “she is a qualified individual with a disability;” (2) she is being “denied the

benefits of some service, program[,] or activity by reason of [ ] her disability;” and

(3) “the entity which provides the … program [ ] is a public entity.”42

The record lacks any evidence, provided by Ms. King or otherwise, of Ms.

King’s disability. Beyond her testimony that her disability prevents her from finding

someone to complete the Form, Ms. King provided no description of her disability.

Further, Ms. King provided no evidence that she requested any accommodation from

DMMA – aside from her implicit request that her failure to return the completed

Form be ignored. Thus, the Court cannot ascertain whether Ms. King possesses a

40
In re Murphy, 283 A.3d 1167, 1176 (Del. 2022).

41
Petition of Rubenstein, 637 A.2d 1131, 1136 (Del. 1994); see also 42 U.S.C.A. § 12102(2).

42
Genesis Healthcare v. Delaware Dep’t of Health & Soc. Servs., 2018 WL 3096640, at *9 (Del.
Super. June 22, 2018) (quoting Lincoln Cercpac v. Health & Hosp. Corp., 920 F.Supp. 497
(S.D.N.Y. 1996)).

8
disability as recognized by the ADA, or what accommodation DMMA could have

provided.

Ms. King suggests her request that a DMMA staff member complete the Form

on her behalf should have been treated as a request for a reasonable

accommodation.43 Without any information about Ms. King’s disability or how it

affects her, the Court cannot determine if Ms. King needed such an accommodation.

DMMA informed Ms. King that its staff could not complete the Form for her, as

DMMA could not verify Ms. King’s “household composition.”44 Additionally, QC

provided Ms. King with several alternative solutions to facilitate completion of the

Form. Those suggestions included asking Ms. King’s son to complete the Form;

having Ms. King’s neighbors complete the Form on her behalf; or having a postal

worker complete the Form.45

Ms. King rejected all of those suggestions.46 Of particular note, Ms. King

declined QC’s suggestion of a postal worker because she “did not want to disclose

[her] disability to others, or the fact that [she is] receiving food benefits.”47 A review

43
Opening Br. at 1.
44
Tr. at 16.
45
Id. at 16-17.
46
Id.
47
Id. at 26.

9
of the Form reveals it contains no mention of any disability or indication that Ms.

King receives food benefits.48 The Form only requires verification of Ms. King’s

address; the names of anyone else residing with Ms. King; the relationship between

Ms. King and the person completing the Form; and the address of the person

completing the Form. Even if the Form contained a reference to food benefits, or

Ms. King’s disability, Ms. King’s disability does not prevent her from having a postal

worker complete the Form. Rather, Ms. King’s desire for privacy dissuaded her from

asking a postal worker for assistance as QC suggested. The ADA seeks to prevent

discrimination based on disabilities – not based on a desire for privacy.

Ms. King has failed to demonstrate that her undocumented disability prevents

her from utilizing the suggestions provided by QC to have the Form completed. The

Record shows QC requested a sanction on Ms. King’s benefits because of her failure

to complete the Form. As QC and DMMA did not discriminate against Ms. King

based on any disability, and as Ms. King failed to show any additional

accommodation was necessary, Ms. King’s argument based on the ADA must fail.

B. The Hearing Officer’s decision was based on substantial evidence
and free from legal error

Ms. King does not contend the Hearing Officer lacked substantial evidence to

support his decision. Upon review of the Record, the Court finds the Hearing Officer

48
See Ex. 5.
10
based his decision on substantial evidence. Ms. King’s benefits were closed because

she failed to cooperate with a QC review. Ms. King failed to cooperate because she

did not complete the Form. Her failure to complete the Form remains undisputed,

and serves as sufficient grounds for the closing of her benefits. The Court also finds

the Hearing Officer’s decision free from legal error.

V. Conclusion

The Hearing Officer’s decision is based on substantial evidence and free from

legal error. Ms. King has failed to raise an appealable issue. Her argument based

on the ADA fails because (1) Ms. King provided no documentation or description of

her disability; and (2) QC attempted to work with Ms. King on finding a way for her

to have the Form completed. Accordingly, the decision of the Hearing Officer is

AFFIRMED.

IT IS SO ORDERED.

11