NC Register Volume 21 Issue 09 - Office of Administrative Hearings

CONTESTED CASE DECISIONS
35. Petitioner’s mother brings a variety of strengths: she wants the best for her son; she demonstrates patience and understanding;
and she can “read” Petitioner correctly and respond appropriately. Mr. Piper testified, “So looking at this from the standpoint of one
of my employees—she has the characteristics that I readily search for and seek out in an individual. She’s a joy to supervise because
she follows—at least she follows my directives very well, and I’ve been advising for ten years, and she’s done that very well.” (Piper
Deposition, pp. 18-19, 34)
Supported Employment Service
36. The parties stipulated that Petitioner can receive Supported Employment services. (Joint Pre-Trial Order, filed July 5, 2005)
No evidence was presented that Petitioner’s mother was unqualified to furnish the service in question, Supported Employment.
37. Petitioner was motivated to obtain a job upon his own initiative. He possesses the ability to hold a job and is motivated by
money. (Piper Deposition, p. 25)
38. Presently Petitioner works at a grocery store several hours each week cleaning restrooms, accompanied by his mother.
(Respondent’s Ex. 3, pp. 1-2) This paid work is unsupervised and unsupported by Petitioner’s CAP-MR/DD Plan of Care. No goals
have been established for the activity and there is no supervised interaction with the store management. Petitioner’s employment is
presently aided exclusively by natural supports. (T pp. 65-66, 93)
39. Petitioner’s paid activities present an opportunity for Petitioner to learn skills useful in enhancing his independence. If
conducted in the context of Supported Employment, the paid activities would occur subject to the supervision of a qualified
developmental disabilities professional and pursuant to the goals developed for the Plan of Care. (Piper Deposition, p. 24)
40. The testimony of the witnesses Levi, Piper and McCrary is each found to be credible, based on the demeanor of the
witnesses, the supporting records, the detail and consistency of their testimony, and other observations of the fact finder. Their
testimony is given due weight based upon their relevant experience with and training in working with individuals with developmental
disabilities, their knowledge of and history with Petitioner, and their visits and interactions with Petitioner and his family at
Petitioner’s home and in the community.
41. The testimony of Mr. Piper is accorded significant weight due to his extensive experience in the field of developmental
disabilities services and his extensive, direct professional history with Petitioner and Petitioner’s family.
42. The testimony of witnesses Leon and Smathers, while credible, is accorded less weight due to their lack of direct knowledge
of Petitioner, his impairments, his history of services, and his environment.
Based upon the foregoing Findings of Fact and upon the preponderance or greater weight of the evidence of the whole record,
the undersigned Administrative Law Judge makes the following:
CONCLUSIONS OF LAW
1. The Office of Administrative Hearings has jurisdiction over the parties and the subject matter pursuant to Chapter 150B of
the N.C. General Statutes.
2. All parties have been correctly designated and there is no question as to misjoinder or nonjoinder.
3. The N.C. Office of Administrative Hearings has jurisdiction over the parties and subject mater of this contested case pursuant
to Chapters 150B and 108A of the N.C. General Statutes and applicable federal law.
4. The Medicaid program is jointly financed with federal and state funds “and is basically administered by each state within
certain broad requirements and guidelines.” House Subcomm. On Health and the Environment, Data on the Medicaid Program:
Eligibility, Services, Expenditures Fiscal Years 1967-77, H.R. Rep. No. 10, 95 th Cong., 1 st Sess. 1. The state determines the scope of
the services offered and generally determines the eligibility level for the programs. Id. The Act implements a federal-state joint
venture in which participating states administer a Medicaid program developed by the state within the parameters established by
federal law and regulations. Generally, the Medicaid Act consists of numerous sections and subsections that together form a
cooperative mosaic through which the federal government reimburses a portion of the payments made by participating states to
providers furnishing care to eligible persons. Pennhurst State School and Hospital v. Halderman, 451 U.S. 1, 101 S.Ct. 1531 (1981).
5. The Medicaid program provides a federal subsidy to states that choose to reimburse qualified individuals for certain medical
expenses. See 42 U.S.C. § 1396 et seq. Although participation in the program is voluntary, states which choose to participate in the
Medicaid program must comply with federal Medicaid law. 42 U.S.C. § 1396a(a).
6. The Community Alternatives Program-Mental Retarded/Developmentally Disabled (CAP-MR/DD) is a Medicaid waiver
program permitted under 42 U.S.C. § 1396n(c) which provides for home or community-based services to eligible individuals beyond
what would normally be provided by Medicaid. This specific waiver allows North Carolina to pay for home and community-based
services for an individual who would otherwise need institutionalization in an Intermediate Care Facility for the Mentally Retarded
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