J. Ramirez v. DHS


IN THE COMMONWEALTH COURT OF PENNSYLVANIA Jose Ramirez, : Petitioner : : v. : No. 60 C.D. 2020 : ARGUED: December 9, 2020 Department of Human Services, : Respondent : BEFORE: HONORABLE MARY HANNAH LEAVITT, President Judge1 HONORABLE RENÉE COHN JUBELIRER, Judge HONORABLE P. KEVIN BROBSON, Judge HONORABLE PATRICIA A. McCULLOUGH, Judge HONORABLE ANNE E. COVEY, Judge HONORABLE CHRISTINE FIZZANO CANNON, Judge HONORABLE ELLEN CEISLER, Judge OPINION NOT REPORTED MEMORANDUM OPINION BY JUDGE CEISLER FILED: January 22, 2021 Petitioner Jose Ramirez petitions for review of Respondent Department of Human Services’ December 26, 2019 ruling, which affirmed the Department’s denial of Ramirez’s application for coverage of his long-term medical care via Pennsylvania’s General Assistance (GA) program, due to the fact that he is an undocumented immigrant. Though we conclude that the Department’s ruling was legally erroneous, we affirm on alternate grounds. I. Facts and Procedural History On February 18, 2019, Ramirez, an undocumented immigrant in his late 40s, was admitted to the Garden Spring Nursing Home in Willow Grove, Pennsylvania. Certified Record (C.R.) at 29. At that point, Ramirez was suffering from the 1 This case was assigned to the opinion writer before Judge Brobson succeeded Judge Leavitt as President Judge. following conditions: anoxic brain damage; quadriplegia; persistent vegetative state; and contracture of extremities. Id. It is not clear from the record when exactly Ramirez arrived in the United States, how he came to reside at Garden Spring, or how he was injured. Id. On February 22, 2019, Ramirez, through Garden Spring,2 filed an application with the Department, via which Ramirez sought coverage for his long-term medical care under Pennsylvania’s Medical Assistance (MA) Program. Id. at 9, 12.3 On August 12, 2019, the Department’s Montgomery County Assistance Office denied this application, on the basis that Ramirez’s condition did not qualify for emergency medical assistance, because the information that [the Department] received [did] not show that [Ramirez had] a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing [Ramirez’s] health in serious jeopardy, serious 2 Ramirez was, and is, in a vegetative state and, thus, cannot play an active role in this matter, despite the fact that he is obviously its subject. 3 The . . . MA[] Program is authorized by Sections 441.1-453 of the [Human Services] Code, Act of June 13, 1967, P.L. 31, [as amended,] added by Act of July 31, 1968, P.L. 904, . . . 62 P.S. §§ 441.1-453. Those who are categorically needy or medically needy under the standards of financial eligibility established by [the Department] are eligible for MA. See [Sections 441.1 and 442.1 of the Human Services Code,] 62 P.S. §§ 441.1, 442.1[,] and 55 Pa. Code §§ 141.81, 171.81. The MA program is funded jointly by the state and the federal government. Federal funding is contingent upon adherence to the requirements of the federal Medicaid statute, Title XIX of the Social Security Act, ...

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