Justia California Court of Appeals Opinion Summaries

Articles Posted in Public Benefits
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In 2011, the California Legislature adopted legislation which dissolved the redevelopment agencies (RA's) that had been formed by municipalities throughout the state under the provisions of the Community Redevelopment Law (CRL). Before their dissolution, the operations of RA's were funded by way of so-called "tax increment" financing. Shortly before the Legislature dissolved RA's, plaintiffs-appellants Virginia Macy, a low-income resident of the city; Libreria Del Pueblo, Inc.; and California Partnership filed a petition for a writ of mandate against the Fontana Redevelopment Agency alleging the agency failed to provide the low- and moderate-income housing required under the CRL. Plaintiffs asked for relief in the form of the payment of $27 million into the agency's low- and moderate-income housing fund (LMIHF). AB 26 created successor agencies that were given responsibility over certain obligations of each dissolved RA. Importantly, under the dissolution legislation, the liability of successor agencies was limited to the value of the assets those agencies received from their respective predecessor RA's. After enactment of AB 26, plaintiffs amended their petition and added defendant and respondent City of Fontana (the city), initially in its role as the successor agency provided by AB 26, and later also in its separate capacity as a municipal corporation. In its capacity as a municipal corporation, the city filed a demurrer to the petition, arguing that under AB 26 only a successor agency may be held liable for the preexisting obligations of an RA. The trial court sustained the demurrer without leave to amend. Plaintiffs appealed, but the Court of Appeal affirmed: the low- and moderate-income housing were never the liabilities of municipalities and their general funds. "An extension of RA statutory liabilities to municipalities and their general funds would require a very clear expression of the Legislature's intention to depart from the historical treatment of low- and moderate-income housing obligations; no such expression appears in AB 26 or later amendments to the dissolution legislation." View "Macy v. City of Fontana" on Justia Law

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A Welfare and Institutions Code section 602 petition alleging violations of Penal Code section 288, subdivision (a) (lewd or lascivious acts with a child under the age of 14) was sustained against A.A., a juvenile court dependent from 2007-2015. A.A. was committed to a period of confinement with the DJJ. A.A. subsequently turned 18 years old and the juvenile court terminated its dependency jurisdiction over him. In this appeal, the court rejected A.A.'s contention that the juvenile court should have maintained dependency jurisdiction over him and provided him with services under the California Fostering Connections to Success Act, Assembly Bill No. 12. In this case, A.A. is not eligible for A.B. 12 benefits where A.A. is not a nonminor dependent; the juvenile court reasonably concluded that A.A. did not wish to remain subject to dependency jurisdiction; and the juvenile court did not err in concluding that A.A. was not participating in a transition to living independently case plan where he was committed to a juvenile detention facility. Further, DCFS has complied with the requirements of section 391, subdivision (b), and the juvenile court's order did not violate section 303, subdivision (b). Accordingly, the court affirmed the judgment. View "LA Cnty. DCFS v. A.A." on Justia Law

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Legislation, effective in 2004 requires that injured workers’ requests for medical treatment be evaluated through a process called utilization review (UR). Under the UR process, a request for treatment cannot be denied by a claims adjustor and must be approved unless a clinician determines that the treatment is medically unnecessary. Workers can challenge decisions denying requested treatment, but employers cannot challenge decisions approving it. The 2004 legislation called for administrative adoption of uniform standards for physicians to use in evaluating treatment. In 2013, additional reforms went into effect, establishing a new procedure, independent medical review (IMR), to resolve workers’ challenges to UR decisions. Stevens challenged the constitutionality of the IMR process, arguing that it violated the state Constitution’s separation of powers clause, its requirements that workers’ compensation decisions be subject to review and the system “accomplish substantial justice,” and principles of due process. The court of appeal rejected those claims, but remanded Stevens’s request for a home health aid. The Legislature has plenary powers over the workers’ compensation system under article XIV, section 4 of the state Constitution. California’s scheme for evaluating workers’ treatment requests is fundamentally fair and affords workers sufficient opportunities to present evidence and be heard. View "Stevens v. Workers' Comp. Appeals Bd," on Justia Law

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A single mother of five children subject to dependency proceedings sought to reverse a court order denying her further reunification services with respect to her three oldest children and to stay a hearing under Welfare and Institutions Code 366.26 that had been set for September 16, 2015. She claims the court erred in denying her further reunification services because she has made and continues to make reasonable efforts to address the problems that led to the removal of her children, so denial of additional services is not in the children’s best interests. The court of appeal stayed the hearing, but ultimately denied the petition and lifted the stay. Mother has received extensive child welfare services and has taken advantage of them only sporadically. The children have been involved with the dependency system for 11 years, and have spent six years in out-of-home placement with multiple caregivers, not always in healthful circumstances. Mother’s drug abuse, mental instability, and abusive relationships with men, have exposed the children to a continuing risk of harm, delayed their educational development, and left them without a stable home. The court’s factual findings in determining to withhold further services were supported by substantial evidence. View "D.T. v. Superior Court" on Justia Law

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The Juvenile Court found R.G., a nonminor dependent within the transition jurisdiction of the juvenile court (Welf. & Inst. Code, 450), ineligible for extended foster care support payments between January 13 and March 13, 2015, because he was neither employed at least 20 hours per week nor participating in a program or activity that promoted or removed barriers to employment, as is required to receive financial support pursuant to section subdivisions (b)(4) and (b)(3) of section 11403 of the California Fostering Connections to Success Act, under which certain youth in foster care may continue receiving financial assistance after turning 18. The court of appeal agreed and reversed. The undisputed evidence indicated that R.G.’s activities, which were primarily self-directed, included formulating a specific job search plan; applying online and in person to numerous jobs; following up with prospective employers; receiving feedback from an independent living skills program specialist on how to improve his resume and job applications; and maintaining contact with the social worker on his progress. This evidence showed that he was working toward his goals during the period in question as contemplated by the statute. View "In re R.G." on Justia Law

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Pursuant to federal law, California’s Medi-Cal program requires beneficiaries to use other health coverage (OHC) they may have before accessing Medi-Cal benefits. The state Department of Health Care Services (DHCS) maintains a database with codes that indicate whether a Medi-Cal beneficiary has OHC and, to some extent, the scope of that coverage. The codes are available to providers when a beneficiary seeks services. Medi-Cal beneficiaries filed suit. Because DHCS allegedly permits Medi-Cal providers to refuse nonemergency services to beneficiaries with OHC, and because the codes are not always correct and the information is limited, beneficiaries may be improperly denied service and referred to other providers even when there is no OHC available for the requested service; beneficiaries may experience delays in receiving nonemergency care and may be subject to a higher copayment than permitted under Medi-Cal. Plaintiffs argued that the assignment of an OHC code should trigger notice and a hearing. The trial and appeals courts rejected their arguments. Neither Welfare and Institutions Code 10950 nor regulation 50951 nor the California Constitution requires DHCS to provide a hearing or notice when it assigns an OHC code. Plaintiffs did not establish any violation of a ministerial duty subject to enforcement by a writ of mandate. View "Marquez v. Dept. of Health Care Servs." on Justia Law

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Plaintiff-appellant Christopher J. Warner served as a municipal and then superior court judge from July 1996 until his retirement in October 2010. In November 2010, he applied for a disability retirement benefit under the Judges' Retirement System II Law (JRS II). Defendant-respondent California Public Employees' Retirement System (CalPERS) granted his application, and he was awarded a monthly retirement allowance, paying him an amount equal to 65 percent of his retirement-level salary. In May 2011, Judge Warner applied to CalPERS to receive a distribution of his monetary credits in the JRS II system, which totaled $572,407. CalPERS staff denied the request. Judge Warner appealed that decision to the CalPERS Board of Administration. After a hearing, the administrative law judge (ALJ) issued a proposed decision recommending the staff decision be affirmed. The Board adopted the ALJ's recommendation. In January 2013, Judge Warner filed a petition for writ of mandate in San Bernardino County Superior Court challenging the Board's decision. The Judicial Council assigned the case to Los Angeles County Superior Court, which later an order denying the petition. This appeal presented a matter of first impression for the Court of Appeal: a question of statutory interpretation regarding the JRS II. Judge Warner contended that under JRS II, he was entitled to receive both a disability retirement allowance and payment of the monetary credits he accrued during his service. CalPERS ruled JRS II entitles Judge Warner only to the disability retirement allowance. The trial court denied Judge Warner's petition for writ of mandate, which sought to reverse the agency's ruling. Finding no reversible error in the Superior Court's judgment, the Court of Appeal affirmed. View "Warner v. CalPERS" on Justia Law

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Robles worked collecting food grease from restaurants until his 2010 termination. Robles’s supervisor cited Robles’s attempt to buy shoes at the Red Wing store, where employees can use an annual $150 shoe allowance. Robles asked the clerk to measure his friend’s foot because he “intended to give it to my friend.” Robles reasoned that he had shoes and his friend needed them. The clerk told Robles “that was not possible.” Robles believes there was a misunderstanding of policy but no misconduct. Robles sought unemployment benefits. The Employment Development Department’s record contained no employer information about the incident. The EDD’notice stated that Robles’s claim was denied because he “broke a reasonable employer rule.” Robles appealed, stating his employer did not cite any specific rule, that he was not aware of any such rule, and that he did not obtain an improper benefit or cause his employer any harm. Despite being twice ordered to do by the trial court, EED continued to refuse to award benefits. The court of appeal affirmed the court’s most recent response to Robles’s motion to enforce writ of administrative mandate,ordering EDD “to pay withheld federal extension benefits, costs and interest in the amount of $45,560.39, within 30 days.” View "Robles v. Emp't Dev. Dept." on Justia Law

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Since 1996, retired employees of the City and County of San Francisco) have been eligible for a supplemental cost of living allowance (COLA) as part of their pension benefits when the retirement fund’s earnings from the previous year exceeded projected earnings. In 2011, voters passed Proposition C, an initiative measure that conditioned payment of the supplemental COLA on the retirement fund being “fully funded” based on the market value of the assets for the previous year. POB, a political action committee representing the interests of retired city employees, challenged the amendment as an impairment of a vested contractual pension right under the contract clauses of the federal and state Constitutions. The court of appeal held that, with respect to current employees and employees who retired after the supplemental COLA went into effect, the full funding requirement cannot stand. Employees who retired before November 6, 1996 had no vested contractual right in the supplemental COLA; the 2011 amendment may be applied to their pensions. The court rejected POB’s claim that the full funding requirement must be set aside because the Board of Supervisors failed to obtain an adequate actuarial report before placing Proposition C on the ballot. View "Protect Our Benefits v. City & Co. of San Francisco" on Justia Law

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Pomianowski was 19 years old when she was in an automobile accident which left her a ventilator-dependent quadriplegic. She required total care in all aspects of daily living. A lawsuit filed against the County of Santa Cruz and Ford Motor Company, resulted in a settlement for $3,175,000.00. The court directed that the funds be deposited in a special needs trust (Probate Code sections 3600-3605). At age 23, Pomianowski died, with $1,294,453.23 left in the trust, which was ordered to reimburse the Department of Health Care Services for medical expenses paid on her behalf before her death. The trustee argued that the assets were exempt from reimbursement rights because the beneficiary was under 55 years of age when the services were provided. The court of appeal affirmed, holding that the Department was entitled to reimbursement under both the Medicaid statute, 42 U.S.C. 1396a, and the statutes and regulations implementing Medicaid through California’s Medi-Cal program. The statutes and regulations do not exempt beneficiaries under age 55, nor is there a public policy reason to shield the trust assets from recovery so that $417, 812.43 spent by the public can pass to the beneficiary’s parents along with the rest of the trust assets. View "Herting v. Cal. Dep;t of Health Care Servs." on Justia Law