Justia California Court of Appeals Opinion Summaries

Four consolidated appeals presented a question of whether medical providers who provided services under California’s Medi-Cal program were entitled to reimbursement for the costs of providing in-house medical services for their own employees through “nonqualifying” self-insurance programs. Even for nonqualifying self-insurance programs, however, the Provider Reimbursement Manual allowed providers to claim reimbursement for reasonable costs on a “claim-paid” basis. Oak Valley Hospital District (Oak Valley) and Ridgecrest Regional Hospital (Ridgecrest) had self-insurance programs providing health benefits to their employees. Claims for in-house medical services to their employees were included in cost reports submitted to the State Department of Health Care Services (DHS). DHS allowed the costs when Oak Valley and Ridgecrest employees received medical services from outside providers but denied costs when the medical services were provided in-house. DHS determined claims paid to Oak Valley and Ridgecrest out of their self-insurance plan for in-house medical services rendered to their employees were not allowable costs. The trial court granted Oak Valley and Ridgecrest's the writ petitions on grounds that costs of in-house medical services were reimbursable so long as they were “ ‘reasonable’ ” as defined by the Provider Reimbursement Manual. DHS appealed in each case. After review, the Court of Appeal concluded Oak Valley’s and Ridgecrest’s self-insurance programs did not meet the requirements of a qualified plan under CMS guidelines and Provider Reimbursement Manual. The Court of Appeal rejected DHS’s contention that Oak Valley and Ridgecrest costs relating to in-house medical services for their employees were inherently unreasonable. To the extent DHS argued the cost reports were not per se unreasonable, but unreasonable under the circumstances of the actual treatments of Oak Valley and Ridgecrest employees, the Court determined the evidence in the record supports the trial court’s findings that expert testimony established Oak Valley and Ridgecrest incurred actual expenses in providing in-house medical services for their employees that were not otherwise reimbursed. Accordingly, the Court affirmed the trial court’s granting of the petitions for writs of administrative mandate. View "Oak Valley Hospital Dist. v. Cal. Dept. of Health Care Services" on Justia Law

Petitioners California Disability Services Association; Horrigan Cole Enterprises, Inc., doing business as Cole Vocational Services; Unlimited Quest, Inc.; Loyd’s Liberty Homes, Inc.; and First Step Independent Living Program, Inc. petitioned for mandamus relief and damages, and sought a declaration against the California Department of Developmental Services (Department) and its director, Nancy Bargmann (collectively respondents). Petitioners challenged the Department’s denial of their requests for a rate adjustment due to the increase of the minimum wage, which, in turn, impacted the salaries of their exempt program directors, who had to be paid twice the minimum wage. The trial court denied petitioners’ petition and complaint for declaratory relief finding providers’ classification of the program directors as exempt employees was not mandated by law, thus “there is no ministerial duty imposed on the Department to grant a wage increase request in order to accommodate continued entitlement to the exemption.” Finding no reversible error, the Court of Appeal affirmed. View "California Disability Services Assn. v. Bargmann" on Justia Law

Under California Public Resources Code section 21167.6, documents "shall" be in the record in a CEQA challenge to an environmental impact report (EIR). The County of San Diego (County), as lead agency for the Newland Sierra project, no longer had "all" such correspondence, nor all "internal agency communications" related to the project. If those communications were by e-mail and not flagged as "official records," the County's computers automatically deleted them after 60 days. When project opponents propounded discovery to obtain copies of the destroyed e-mails and related documents to prepare the record of proceedings, the County refused to comply. After referring the discovery disputes to a referee, the superior court adopted the referee's recommendations to deny the motions to compel. The referee concluded that although section 21167.6 specified the contents of the record of proceedings, that statute did not require that such writings be retained. In effect, the referee interpreted section 21167.6 to provide that e-mails encompassed within that statute were mandated parts of the record - unless the County destroyed them first. The Court of Appeal disagreed with that interpretation, "[a] thorough record is fundamental to meaningful judicial review." The Court held the County should not have destroyed such e-mails, even under its own policies. The referee's erroneous interpretation of section 21167.6 was central to the appeals before the Court of Appeal. The Court issued a writ of mandate to direct the superior court to vacate its orders denying the motions to compel, and after receiving input from the parties, reconsider those motions. View "Golden Door Properties, LLC v. Super. Ct." on Justia Law

After the Department discharged plaintiff based on her failure to report another deputy's use of force against an inmate and her failure to seek medical assistance for the inmate, the Commission affirmed the discharge. However, the trial court granted plaintiff's petition for writ of mandate and directed the Commission to set aside the discharge, award her back pay, and reconsider a lesser penalty.The Court of Appeal reversed and held that the Department did not abuse its discretion in discharging plaintiff where plaintiff's conduct furthered the code of silence at the Men's Central Jail, requiring the Department to take action. In this case, plaintiff's conduct in following the code of silence undermined the Department's trust and confidence in plaintiff as a deputy sheriff and negatively impacted the operation of the jail. Furthermore, at the Commission hearing, plaintiff minimized her responsibility to report the use of force. Therefore, given the Department's reasoned explanation that the discharge was necessary, the court concluded that this is not the exceptional case where reasonable minds cannot differ on the appropriate penalty. The court remanded for the trial court to enter a new judgment denying the petition for writ of mandate. View "Pasos v. Los Angeles County Civil Service Commission" on Justia Law

The California State Teachers’ Retirement System (CalSTRS) determined that Ernest Moreno’s retirement benefits had been incorrectly calculated and initiated proceedings to adjust Moreno’s retirement benefits and collect the overpayment. The trial court denied Moreno’s petition for writ of administrative mandamus challenging the CalSTRS actions. Moreno appealed, contending: (1) CalSTRS’s adjustment of his retirement benefits and collection of the overpayment were barred by the statute of limitations found in Education Code section 22008 (c) because CalSTRS was on inquiry notice of the problem as early as 2008; and (2) CalSTRS should have been equitably estopped from adjusting his retirement benefits and collecting the overpayments. After review, the Court of Appeal concluded: (1) CalSTRS was not on inquiry notice of the reporting error that led to overpayment until December 2014 when it began an audit of Moreno’s retirement benefits, and, therefore, CalSTRS’s adjustments to Moreno’s retirement benefits and collection of overpayments were not barred by the statute of limitations; and (2) CalSTRS was not equitably estopped because CalSTRS was not apprised of (or on notice about) the overpayments until December 2014. View "Moreno v. Cal. State Teachers' Retirement System" on Justia Law

The San Mateo County Assessment Appeals Board invalidated escape assessments imposed by the County Assessor based on the value of machinery and equipment (M&E) at Genentech’s San Mateo County facility. The fair market value of the M&E on which property tax is imposed is determined with reference to either the cost of equipment purchased in a finished state or, if the equipment is not purchased in a finished state, costs incurred to bring the equipment to a finished state. The Board determined that Genentech purchased all of the M&E in a finished state and that the assembly of the equipment into a production line did not render the equipment “self-constructed property” justifying the inclusion of the additional costs in determining fair market value. The trial court determined that none of the equipment was in a finished state until put to use in a functioning production line and that the additional costs capitalized for accounting purposes add to the value of the property for purposes of the property tax.The court of appeal reversed. The trial court adopted a standard for determining when equipment is in a finished state for which there is no justification, and erroneously rejected Board findings that are supported by substantial evidence. Fair market value and net book value are separate concepts with separate purposes; the assessor may not rely on Genentech’s capitalization of expenses for accounting purposes to establish that those expenses increase the value of the equipment and are subject to assessment. View "Church v. San Mateo County Assessment Appeals Board" on Justia Law

The Imperial Irrigation District (District) supplied water from the Colorado River system to California's Imperial Valley, holding its water rights in trust for the benefit of its users, and was empowered by California law to manage the water supply for irrigation and other beneficial uses. In 2013, the District implemented an equitable distribution plan with an annual water apportionment for each category of users (2013 EDP). Michael Abatti presently owns and farms land in the Imperial Valley. Abatti, as trustee of the Michael and Kerri Abatti Family Trust, and Mike Abatti Farms, LLC (collectively, Abatti) filed a petition for writ of mandate to invalidate the 2013 EDP on the grounds that, among other things, the farmers possess water rights that entitle them to receive water sufficient to meet their reasonable irrigation needs—and the plan unlawfully and inequitably takes away these rights. Abatti's position, fairly construed, is that farmers are entitled to receive the amounts of water that they have historically used to irrigate their crops. The District contended the farmers possessed a right to water service, but not to specific amounts; the District was required to distribute water equitably to all users, not just to farmers; and that the 2013 DEP allowed the District to do so, while fulfilling its other obligations, such as conservation. The superior court granted the petition, entering a declaratory judgment that prohibited the District from distributing water in the manner set forth in the 2013 EDP, and required the District to use a historical method for any apportionment of water to farmers. The District appealed, and Abatti cross-appealed an earlier order sustaining the District's demurrer to his claims that the District's adoption of the 2013 EDP constitutes a breach of its fiduciary duty to farmers and a taking. The Court of Appeal concluded the farmers within the District possessed an equitable and beneficial interest in the District's water rights, which was appurtenant to their lands. "Although the superior court acknowledged certain of these principles, its rulings reflect that it took an unduly narrow view of the District's purposes, thus failing to account for the District's broader obligations, and took an overly expansive view of the rights of farmers." The superior court was directed to enter a new judgment: (1) granting the petition on ground that the District's failure to provide for equitable apportionment among categories of water users constituted an abuse of discretion; and (2) denying the petition on all other grounds, including as to declaratory relief. View "Abatti v. Imperial Irrigation Dist." on Justia Law

Petitioner Shaun Smith filed, as an indigent defendant representing himself in propria persona (pro. per.) in a pending criminal action, a petition for writ of mandate, prohibition, or other appropriate relief against respondent Sacramento County Superior Court, challenging respondent’s policies and procedures pertaining to pro. per. defendants then in effect. Central to petitioner’s grievance were the duties the court assigned to the pro. per. coordinator -- an individual hired and supervised by, and subject to the control and direction of, Sacramento County (the county). The court revised its policies and procedures pertaining to pro. per. defendants in response to a Court of Appeal order to show cause. The revisions did not quell petitioner’s concerns pertaining to the pro. per. coordinator’s role in the disposition of investigative and ancillary defense services requests and the review of subpoenas. Considering the nature of those duties delegated to the pro. per. coordinator, as provided in respondent’s revised policies and procedures, the Court of Appeal concluded respondent impermissibly delegated its judicial powers in contravention of the separation of powers clause of the California Constitution. The Court of Appeal thus issued a writ of mandate directing the respondent-trial-court to cease and desist from applying and implementing the pertinent portions of its revised pro. per. policies and procedures, and directed the trial court to revise those policies and procedures in a manner consistent with the Court of Appeal's opinion in this case. View "Smith v. Superior Court" on Justia Law

After plaintiff was injured while performing work in the Adult Offender Work Program (AOWP), he filed suit against the county for its failure to accommodate his preexisting physical disability and failure to engage in the interactive process under the Fair Employment and Housing Act (FEHA).The Court of Appeal affirmed the trial court's grant of summary judgment in favor of the county. The court held that an individual sentenced to perform work activities in lieu of incarceration in the absence of any financial remuneration, is precluded, as a matter of law, from being an "employee" within the meaning of the FEHA. The court explained that, while remuneration alone is not a sufficient condition to establish an individual is an employee under the statute, it is an essential one. Because plaintiff earned no sufficient financial remuneration as a result of participation in the AOWP, he could not be deemed an employee under the FEHA. The court did not reach plaintiff's remaining arguments. View "Talley v. County of Fresno" on Justia Law

In May 2020, the chairs of the California Assembly and Senate committees that consider election-related matters prepared a formal letter to Governor Gavin Newsom indicating they were working on legislation to ensure Californians could vote by mail in light of the emergency occasioned by COVID-19. The Governor issued Executive Order No. N-64-20 on May 8, 2020, which required all voters to be provided vote-by-mail ballots. That order affirmed, however, that the administration continued to work “in partnership with the Secretary of State and the Legislature on requirements for in-person voting opportunities and how other details of the November election will be implemented” and “[n]othing in this Order is intended, or shall be construed, to limit the enactment of legislation on that subject.” The order was signed on June 3, 2020. The issue presented for the Court of Appeal's review concerned an order of the Sutter County Superior Court, entered on June 12, 2020, granting a temporary restraining order against the Executive Order, finding it constituted “an impermissible use of legislative powers in violation of the California Constitution and the laws of the State of California.” The Court of Appeal determined there was no basis for the superior court to grant real parties in interest relief using ex parte procedures prescribed by California law. "The hearing on the ex parte application, conducted only one day after the underlying action was filed in superior court, was held without proper notice to the Governor or his appearance. Apart from these procedural deficiencies, real parties in interest also failed to make the requisite substantive showing for use of an ex parte proceeding. In short, the real parties in interest failed to present competent evidence establishing imminent harm from the Governor’s executive order requiring immediate action." View "Newsome v. Superior Court (Gallagher)" on Justia Law