Appeals Court Concludes New Jersey Does Not Have A Duty to Inform Disabled Beneficiary Of Eligibility For Services

A New Jersey appeals court held that the State did not have a duty to inform a woman with special needs who was residing in an out-of-state residential facility that she was eligible for priority placement for services due to a change in regulations. The court also found that the disabled woman was not entitled to a hearing to challenge the State’s decision. In the Matter of J.S.(N.J. App.Div., No. A-4132-11T1, June 21, 2013).

J.S. is a 47-year-old woman with who is severely impaired due to a brain injury. In 1984, J.S.’s parents placed her in a residential facility in Massachusetts, which was initially paid for by her school district and eventually by her parents. In 1995, the Division of Developmental Disabilities (DDD) placed J.S. on a non-priority waiting list for services due to her out-of-state residence, and because J.S. did not object to the decision or request any additional services at that time, no Individualized Habitation Plan (IHP) was drawn up for her. In 1996, DDD changed its regulations to place children on a Priority Waiting List (PWL) for services when their parents both turn age 55. (J.S.’s parents were both over 55 at the time.) The regulations required DDD to inform beneficiaries of their eligibility for placement on the PWL, but because J.S. did not have an IHP, she was never directly notified of her eligibility.

In 2004, when J.S. learned that she was entitled to placement on the PWL, she applied and was immediately placed on the list. In 2009, J.S. requested retroactive placement on the PWL dating back to the date of the change in regulations in 1996. DDD gave J.S. and several other similarly situated claimants non-contested administrative conferences. Claimants filed a complaint for declaratory and injunctive relief in the Chancery Division, Mercer County, seeking to compel the agency to transmit their administrative appeals to the Office of Administrative Law for contested case hearings. The Chancery Division granted the DDD’s motion to transfer the case to the Appellate Division. The appeals court  then granted the DDD’s motion to remand to the agency to issue final decisions addressing the merits of the appeals. On remand, the agency rejected the claims. J.S. appealed, claiming that DDD had a duty to inform her of the changes in the regulations and that she was entitled to a contested hearing because there were disputed facts and the matter involved a serious private interest.

The Superior Court of New Jersey, Appellate Division, affirmed DDD’s decision to deny retroactive placement on the PWL and to only offer a non-contested hearing. The court found that “[t]he agency, within its expertise and discretion, tied the mechanism for informing the families of the ‘option’ of the priority placement and the exercise of that ‘option’ to the ‘time of the annual IHP’. Accordingly, the express language of [the regulation] did not impose on the DDD an affirmative obligation to advise appellants of the change in regulations.” The court goes on to say that “[t]he pertinent facts of the present case are not in dispute. As the matter solely involves the DDD’s interpretation and implementation of its regulation, a hearing is unnecessary.”

For the full text of this decision, go to: In the Matter of J.S.

(Courtesy of the Academy of Special Needs Planners)