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Black v. District of Columbia Department of Human Services

Court of Appeals of The District of Columbia

July 19, 2018

Donna Black, Petitioner,
v.
District of Columbia Department of Human Services, Respondent.

          Argued April 26, 2018

          On Petition for Review of a Final Order of the District of Columbia Office of Administrative Hearings (DHS-371-15) (Hon. Sharon E. Goodie, Administrative Law Judge)

          Jennifer Mezey, with whom Jonathan H. Levy and David Carpman, Legal Aid Society of the District of Columbia, were on the brief, for the petitioner.

          Lucy E. Pittman, with whom Karl A. Racine, Attorney General for the District of Columbia, and Todd S. Kim and Loren L. AliKhan, Solicitor General and Deputy Solicitor General at the time the brief was filed, were on the brief, for the respondent.

          Before Blackburne-Rigsby, Chief Judge, Easterly, Associate Judge, and K ravitz, Associate Judge, Superior Court of the District of Columbia [*]

          KRAVITZ, ASSOCIATE JUDGE

         Donna Black seeks review of a decision of an administrative law judge at the Office of Administrative Hearings denying her request for retroactive benefits under the Program on Work, Empowerment, and Responsibility. The program, known as POWER, provides cash assistance to residents of the District of Columbia who have minor children and meet the financial eligibility standards of the Temporary Assistance for Needy Families program (TANF) but are unable to comply with TANF's work requirements because of a physical or mental incapacity or a need to care for an incapacitated household member. Ms. Black has received POWER benefits since October 2015 and was a TANF recipient for many years before then. She contends that the Department of Human Services (DHS) was required to screen her for POWER eligibility when she recertified for TANF in February 2014 and that she was eligible for POWER as a matter of law at that time because of her daughter's receipt of Supplemental Security Income (SSI) disability benefits.

         Ms. Black's claim of automatic POWER eligibility due to her daughter's SSI disability designation is foreclosed by the plain language of the POWER statute. We nonetheless reverse the decision of the Office of Administrative Hearings, concluding that the administrative law judge applied an erroneous legal standard in determining that Ms. Black presented insufficient evidence of her daughter's incapacity to establish eligibility for POWER benefits. Because it also appears that DHS failed to comply with a clear statutory mandate to screen for POWER eligibility when Ms. Black recertified for TANF in February 2014, we remand to DHS with instructions to screen Ms. Black for the POWER program retroactive to that time.

         I. Relevant Public Benefits Programs

         A brief overview of the relevant public assistance programs is essential to a proper understanding of our analysis to follow.

         A. Temporary Assistance for Needy Families

         TANF is a federally-funded program that provides cash assistance to families with minor children and little or no income. See 42 U.S.C. §§ 601-619 (2012). Congress funds the program through block grants to the states (including the District of Columbia), id. § 603, with a 60-month limit on the total time an adult may receive TANF benefits funded by federal grants, id. § 608 (a)(7)(A). To promote self-sufficiency and reduce dependence, federal law mandates that states impose work requirements on benefits recipients. Id. §§ 602 (a)(1)(A)(ii)-(iii), 607. District of Columbia residents who receive TANF benefits thus must work or participate in job search or job readiness activities to avoid cuts in benefits or other sanctions. D.C. Code §§ 4-205.19b to 4-205.19f (2012 Repl).

         The amount of money a District of Columbia family receives under TANF is calculated by deducting the family's income (if any) from a payment level set by statute for the family's size. D.C. Code § 4-205.52 (a) (2017 Supp.). A family's size is generally determined by counting the dependent children under the age of 18 and their parents living in the household, id. § 4-205.15 (a), while excluding children over 18 and household members who receive SSI benefits, id. § 4-205.15 (e)(1). As examples, a family with four eligible recipients and no income receives $463.00 in monthly TANF benefits under current law; a family with ten eligible recipients and no income receives $950.00. Id. § 4-205.52 (c).

         Federal law permits states to use their own funds to provide TANF benefits beyond the 60-month limit on the use of federal funds, 42 U.S.C. § 608 (a)(7)(F), and the District of Columbia has long exercised this authority, see D.C. Code § 4-205.11b (2012 Repl). Beginning in 2011, however, District of Columbia law reduced the amount of TANF benefits provided to families beyond the 60-month limit, with payments to those long-term recipients subjected to successive cuts in 2011, 2013, and 2014 and projected to be reduced to zero in 2017 and beyond. Id. §§ 4-205.11b; 4-205.52 (c-2)-(c-3) (2017 Supp.).[1]

         B. Program on Work, Empowerment, and Responsibility

         POWER is a locally-funded program in the District of Columbia that provides cash assistance to residents who have minor children and meet the financial eligibility criteria for TANF but are unable to satisfy TANF's work requirements due to a physical or mental incapacity. Initially, an "assistance unit" (household) was eligible for POWER only if the head of the assistance unit was physically or mentally incapacitated. D.C. Code § 4-205.72 (b)(2) (2012 Repl.). Effective October 1, 2013, however, the program was expanded to include additional categories of eligible households, including, as relevant here, families in which the head of the household is "needed in the home, due to medical necessity, to care for a household member who is physically or mentally incapacitated." Id. § 4-205.72a (a)(1)(B) (2017 Supp.).

         POWER holds significant advantages over TANF for eligible participants. Recipients of POWER benefits do not have to work or take part in job search or job readiness activities. See D.C. Code § 4-205.76 (2012 Repl.) (requiring only classes and training opportunities). Cash assistance payments under POWER are in the same amounts as full TANF benefits, id. §§ 4-205.52, 4-205.78, and are provided (and always have been) without time limits or reductions after 60 months, id. § 4-205.72 (e). And a month in which a person receives POWER benefits does not count toward the person's 60-month TANF limit, see id. § 4-205.11a, thereby preserving the person's ability to receive TANF benefits at the full amount in the event the person loses his or her eligibility for POWER and wishes to return to the TANF program.

         In light of these advantages, DHS, which administers both programs, is required by law to screen for POWER eligibility every time a person applies or recertifies for the TANF program and whenever a TANF applicant or recipient raises an issue of incapacity or disability. See 29 DCMR § 5829.1 ("The Director or his or her designee shall screen TANF applicants and recipients at the point of application, recertification, or when incapacity or disability is raised by the applicant or recipient for the Program on Work, Employment and Responsibility (POWER) to determine if the head of the assistance unit has a physical or mental incapacity."); D.C. Code § 4-205.19a (b) (2017 Supp.) ("As part of the redetermination of eligibility, a TANF recipient shall be provided information about the POWER program and screened for POWER eligibility.").

         If, through a screening or otherwise, it appears that a TANF applicant or recipient may be eligible for POWER benefits under D.C. Code § 4-205.72 due to the person's own physical or mental incapacity, then DHS is required to conduct a "medical review" to determine whether the person is in fact incapacitated. Id. § 4-205.74 (a). If it appears that a TANF applicant or recipient may be eligible for POWER benefits under D.C. Code § 4-205.72a due to the need to care for a physically or mentally incapacitated member of the person's household, then DHS must conduct a "review" to determine whether the household member is in fact incapacitated and, if so, whether the head of household is needed in the home. Id. § 4-205.74 (a-1).

         Statutory provisions defining "physical or mental incapacity" and setting forth the permissible means of proof of incapacity under TANF and POWER are discussed in detail in Section III.C of this opinion.

         C. Supplemental Security Income

         SSI is a federal assistance program that provides cash benefits to low-income persons who are older than 65 or blind or disabled. See 42 U.S.C. §§ 1381-1385 (2012). A child under the age of 18 is "disabled" for the purpose of establishing SSI eligibility if the child "has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Id. § 1382c (a)(3)(C)(i).

         II. Factual and Procedural Background

         Ms. Black resides in the District of Columbia with her husband, her nine children, and one grandchild. Seven of Ms. Black's children were under the age of 18 at the time of the administrative hearing, in October 2015. One of the seven minor children, a 13-year-old girl, had been receiving SSI benefits for many years due to learning and speech disabilities that left her functioning academically at a kindergarten level despite her enrollment in the eighth grade. Two of the other minor children suffered from disabilities as well - one with asthma, the other with effects of lead poisoning - but their conditions were not sufficiently severe to make them eligible for SSI.

         Ms. Black was a long-time participant in the TANF program, having received benefits for more than 200 months by the time of the administrative hearing. DHS thus began reducing the amount of Ms. Black's monthly TANF payments in 2011, as by then Ms. Black was well past the 60-month limit. The first cut, on April 1, 2011, reduced Ms. Black's payment to $718.00 from $897.00, the full amount at the time for a family with eight eligible recipients. (Ms. Black, her husband, and the six minor children not receiving SSI were deemed eligible recipients.) Additional cuts on October 1, 2013 and October 1, 2014 reduced Ms. Black's monthly payments to $539.00 and then to $319.00.

         Proceeding pro se, Ms. Black made a timely request for a hearing before the Office of Administrative Hearings (OAH) to challenge both the October 2014 reduction in her TANF benefits and a further adjustment made in June 2015 due to confusion over the death of one child, the aging-out of another, and the birth of a baby. At a pre-hearing administrative review at DHS on July 15, 2015, Ms. Black and DHS resolved their differences over the June 2015 adjustment, with ...


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