Opinion
C. A. PC-2021-03640
08-05-2022
HUSAIN KARIM v. R.I. EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES
For Appellant: Nora Salomon, Esq. For Appellee: Amy Vignali Coleman, Esq.
For Appellant: Nora Salomon, Esq.
For Appellee: Amy Vignali Coleman, Esq.
DECISION
CRUISE, J.
In this administrative appeal, Appellant Husain Abdullah Karim (Karim) seeks judicial review of a final decision of the Rhode Island Executive Office of Health and Human Services (OHHS). The decision found Karim ineligible to receive benefits under the state's Medicare Premium Payment Program (MPPP). This Court exercises jurisdiction pursuant to the Administrative Procedures Act (APA), G.L. 1956 chapter 35 of title 42.
I
Facts and Travel
The relevant factual background of Karim's appeal is undisputed. As of December 2, 2019, Karim received Social Security disability benefits of $1478 per month. (Certified Record of Karim Hearing (Record) Ex. 10 (Letter from Social Security Administration), at 1.) Karim lives with his minor daughter, who receives a monthly child's Social Security benefit of $739 due to Karim's disability. Id. at 3. Karim is enrolled in Medicare. (Compl. ¶ 4.) On December 30, 2019, Karim submitted his application for MPPP benefits to OHHS, which, if approved, would provide financial assistance for Karim and his daughter's payment of Medicare Part A and B premiums, Medicare deductibles, and coinsurance. (Record Ex. 9 (MPPP Application), at 5); 210 RICR 40-05-1.1. On January 9, 2020, Karim's application for MPPP benefits was denied by OHHS. (Record Ex. 7 (OHHS Benefits Decision Notice), at 1.) The OHHS decision stated "[Karim] do[es] not qualify for the Medicare Premium Payment Program category QI-1 because [Karim] [is] eligible for Medicaid." Id. at 3. On February 12, 2020, Karim timely appealed this OHHS decision to deny MPPP eligibility. (Record Ex. 6 (Appeal Form), at 1-4.)
On February 25, 2021, OHHS conducted an appeal hearing with Karim's counsel present. (Admin. Hr'g Tr. 1-11, Feb. 25, 2021.) During the administrative appeal, OHHS representative Sherry Silva (Silva), Senior Eligibility Technician for the Pawtucket Department of Human Services, testified that Karim qualified for MPP as a QI-1, meaning "[h]e's only eligible for either Medicaid or MPP[P], [but] not both." Id. at 3. Specifically, Silva testified that because Karim was eligible for Modified Adjusted Gross Income (MAGI) Medicaid with his child, he was ineligible for MPPP. Id. Silva went on to testify that Beneficiary Status of QI-1 is determined by the number of adults in the household, so in Karim's case, he is a household of one, and only his income is countable, and therefore he is ineligible for MPPP based on only his income. Id. at 4.
Karim agreed that for MPPP purposes, if Karim is a family of one counting only his income, then he has QI-1 status and he cannot have both MPPP and Medicaid, but Karim argued that OHHS's interpretation of family size, namely that he was a family of one for MPPP purposes, was incorrect. Id. at 4-5. Karim argued that the term "family" should be defined by the dictionary definition because it is not defined in the State's Medicaid regulations. Id. at 5-6. Accordingly, Karim argued that because he lives with his minor daughter, the dictionary definition of "family" should apply, and OHHS should consider Karim a family of two when determining MPPP eligibility. Id. at 7. Karim's contention was that "as a family of two with only [Karim's] income counted which is what the SSI methodology would point to, he would be eligible for SLMB and would be eligible for Medicaid [and MPPP]. Id. at 9.
On April 30, 2021, OHHS filed an Administrative Hearing Decision denying Karim's appeal of OHHS's initial denial of Karim's MPPP eligibility. (Record Ex. 15 (OHHS Decision), at 1.) Specifically, OHHS found that "[i]n review of the case [law] cited . . . the family size pertains to a husband and wife not father and child." Id. at 7. The OHHS Decision found that "[Karim's] minor child in this case is not eligible for Medicare, therefore her income should not be counted, and she should not be counted in the family size." Id. Further, the OHHS decision stated, "[t]he Appellant is eligible for MAGI-Medicaid with his minor child therefore, ineligible for MPPP as category QI-l, counting a family size of one and only counting his income as required." Id. In closing, the OHHS stated:
"After careful and considerate review of the Agency's Rules and Regulations, as well as the evidence and testimony presented, this Appeals Officer concludes that the Agency properly applied the federal and state regulations to deny the Appellant MPPP. The Appellant is eligible for either MPPP or Medicaid, not both as a MPPP, category QI-l." Id. at 7-8.
On May 27, 2021, Karim filed the instant Complaint for judicial review of the OHHS Decision and requests that this Court reverse the agency's decision and provide Karim MPPP benefits. (Compl. 2.) On June 24, 2021, OHHS answered Karim's Complaint, requesting that this Court dismiss Karim's Complaint with prejudice. (Answer 2.) On August 12, 2021, Karim submitted a Brief in Support of Reversal of the final decision of OHHS. (Pl.'s Brief in Supp. of Reversal (Pl.'s Brief.) On October 22, 2021, OHHS submitted its brief in opposition to reversal of the OHHS Decision. (Def.'s Brief in Opp'n to Reversal of Decision (Def.'s Opp'n Brief).) On October 28, 2021, Karim submitted his Reply Brief. (Pl.'s Reply Brief.)
II
Standard of Review
When reviewing the decision of an administrative agency, the Superior Court "sits as an appellate court with a limited scope of review." Mine Safety Appliances Co. v. Berry, 620 A.2d 1255, 1259 (R.I. 1993). The Court's review is governed by the Rhode Island Administrative Procedures Act (APA), G.L. 1956 chapter 35 of title 42. See Iselin v. Retirement Board of Employees' Retirement System of R.I., 943 A.2d 1045, 1048 (R.I. 2008) (citing Rossi v. Employees' Retirement System of R.I., 895 A.2d 106, 109 (R.I. 2006)). Section 42-35-15(g) provides, in pertinent part:
"The court shall not substitute its judgment for that of the agency as to the weight of the evidence on questions of fact. The court may affirm the decision of the agency or remand the case for further proceedings, or it may reverse or modify the decision if substantial rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions, or decisions are:
"(1) In violation of constitutional or statutory provisions;
"(2) In excess of the statutory authority of the agency;
"(3) Made upon unlawful procedure;
"(4) Affected by other error of law;
"(5) Clearly erroneous in view of the reliable, probative, and substantial evidence on the whole record; or
"(6) Arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion." Sec. 42-35-15(g).
"In essence, if 'competent evidence exists in the record, the Superior Court is required to uphold the agency's conclusions.'" Auto Body Association of Rhode Island v. State of Rhode Island Department of Business Regulation, 996 A.2d 91, 95 (R.I. 2010) (quoting Rhode Island Public Telecommunications Authority v. Rhode Island State Labor Relations Board, 650 A.2d 479, 484 (R.I. 1994)). When reviewing a decision under the APA, the Court may not substitute its judgment for that of the agency on questions of fact. See Johnston Ambulatory Surgical Associates, Ltd. v. Nolan, 755 A.2d 799, 805 (R.I. 2000). The Court defers to the administrative agency's factual determinations, provided that they are supported by legally competent evidence. Arnold v. Rhode Island Department of Labor and Training Board of Review, 822 A.2d 164, 167 (R.I. 2003). The Court cannot "weigh the evidence [or] pass upon the credibility of witnesses [or] substitute its findings of fact for those made at the administrative level." E. Grossman &Sons, Inc. v. Rocha, 118 R.I. 276, 285, 373 A.2d 496, 501 (1977).
Accordingly, the Court will '"reverse factual conclusions of administrative agencies only when they are totally devoid of competent evidentiary support in the record."' Baker v. Department of Employment and Training Board of Review, 637 A.2d 360, 363 (R.I. 1994) (quoting Milardo v. Coastal Resources Management Council, 434 A.2d 266, 272 (R.I. 1981)).
The Court is free to conduct a de novo review of determinations of law made by an agency. See Arnold, 822 A.2d at 167 (citing Johnston Ambulatory Surgical Associates, 755 A.2d at 805). Great "weight and deference" should be given to an administrative agency's interpretations of the statute it is empowered to enforce, as long as "that construction is not clearly erroneous or unauthorized." Labor Ready Northeast, Inc. v. McConaghy, 849 A.2d 340, 344 (R.I. 2004). This is true "even when other reasonable constructions of the statute are possible." Id. at 345. The Court is limited to the certified record in its determination as to whether legally competent evidence exists to support the agency's decision. Barrington School Committee v. Rhode Island State Labor Relations Board, 608 A.2d 1126, 1138 (R.I. 1992). Legally competent or substantial evidence is "relevant evidence that a reasonable mind might accept as adequate to support a conclusion, and means [an] amount more than a scintilla but less than a preponderance." Caswell v. George Sherman Sand &Gravel Co., Inc., 424 A.2d 646, 647 (R.I. 1981).
III
Analysis
A Applicable Law
States are not required to participate in the federal-state program known as Medicaid, but those states that participate are required to comply with federal Medicaid law. Wilder v. Virginia Hospital Association, 496 U.S. 498, 501 (1990). General Laws 1956 § 42-7.2-6.1 and 210 RICR 10-05-2.2 authorizes and designates OHHS as the entity responsible for appeals and hearings related to Medicaid. Section 42-7.2-6.1(a)(2); 210 RICR 10-05-2. Federal law requires state Medicaid agencies to provide MPPP benefits to certain categories of people entitled to Medicare Part A. 42 U.S.C. § 1396a(a)(10)(A). The MPPP helps low-income elders and adults with disabilities pay all or some of the costs of Medicare Part A and Part B premiums, deductibles, and co-payments. 210 RICR 40-05-1.6.1(A).
Medicare Part A covers hospital insurance coverage and Medicare Part B covers physician services, durable medical equipment, and outpatient services. 210 RICR 40-05-1.6.1(A)(2).
The pathways to MPPP eligibility include Qualified Medicare Beneficiaries (QMBs), Specified Low Income Medicare Beneficiaries (SLIMBs), and Qualified Individuals (QI-1s). 210 RICR 40-05-1.6.2. MPPP eligibility is based on the applicant's countable income and resources calculated by using the Supplemental Security Income Eligibility (SSI) methodology. 42 U.S.C. § 1396a(p)(1)(B). In Rhode Island, OHHS determines an MPPP applicant's countable income by applying the SSI methodology for the applicable beneficiary status. 42 U.S.C. § 1396d(p)(1); 210 RICR 40-05-1.6.2. Therefore, a person's income and resources, calculated using the SSI methodology, determine whether a person is MPPP eligible. 210 RICR 40-05-1.6.1(A)(1). The SSI methodology for QI-1 requires that some or all the income of a spouse who is ineligible for MPPP but lives with the applicant must be deemed to the applicant. 20 C.F.R. §§ 416.1160, 1163; 210 RICR 40-05-1.11.5(B). However, the deeming of income from child to parent is prohibited. 210 RICR 40-05-1.11.5(D). Therefore, when determining a person's initial eligibility and countable income for MPPP purposes, income is not deemed from a child to a parent. 210 RICR 40-05-1.11.5(D)(1).
Deemed income is income attributed to another person whether or not the income is actually available to the person to whom it is deemed. 210 RICR 40-05-1.4.
The applicant's countable income is then compared to the Federal Poverty Line (FPL) applicable to the "family of the size involved." 42 U.S.C. § 1396a(a)(10)(E)(i),(iii); 210 RICR 40-05-1.6.2(A). QMBs must have countable income of no greater than 100 percent of the FPL applicable to the "family of the size involved"; SLIMBs must have countable income over 100 percent of the FPL but under 120 percent of the FPL applicable to the "family of the size involved"; and QI-1s must have countable income of 120 percent to 135 percent of the FPL applicable to the "family of the size involved." 42 U.S.C. § 1396a(a)(10)(E)(iii). While QMBs and SLIMBs can have both MPPP and Medicaid, QI-1s cannot have both MPPP and Medicaid. 42 U.S.C. §.1396a(a)(10)(E)(iv).
B
Arguments 1. Appellant's Arguments
Karim argues that this Court should "[r]everse the decision [of OHHS] and find that an individual living together with his minor child [is] a family of two for purposes of MPP[P] and order [OHHS] to promptly provide [Karim] with MPP[P] benefits wrongfully denied[.]" (Compl. 2.) In support of this requested relief, Karim argues that the decision of OHHS is "clearly erroneous and contrary to the plain language of the federal Medicaid Act, which requires EOHHS to determine MPP[P] eligibility by comparing his countable income to the Federal Poverty Line (FPL) applicable to a 'family of the size involved.'" (Pl.'s Brief 1.)
First, Karim argues that "[t]he hearing officer's finding that a person must be eligible for Medicare in order to be included in [the] MPP[P] family size has no basis in state or federal law." Id. at 5. Second, Karim argues that "[t]he hearing officer erroneously found that the SSI methodology for determining amount of countable income also determines family size." Id. Third, Karim argues that the Agency's interpretation of family size is inconsistent with the plain language of the federal statute. Id. at 7-8.
2. Appellee's Arguments
In response, OHHS requests that the Court deny the relief requested by Karim because, in its view, the Appeals Officer correctly upheld the agency decision "comparing [Karim's] countable income to the official Federal Poverty Line (FPL) applicable to a family of one." (Def.'s Opp'n Brief) 1.) OHHS asserts that the Appeals Officer's ruling that a person must be eligible for MPPP in order to be included in family size when determining eligibility was not clearly erroneous. Id. at 5-6. OHHS also argues that the "authorities cited by Plaintiff are not dispositive of this issue because key facts are different." Id. at 4. Lastly, OHHS contends that the term "family of the size involved," within the context of an applicant with a child, is vague and confers interpretive deference to OHHS that should not be disturbed by this Court. Id. at 6-8.
C
Analysis
OHHS interpreted the Federal and Rhode Island Statutes and made the following conclusions of law: "[Karim's] minor child . . . is not eligible for Medicare, therefore her income should not be counted, and she should not be counted in the family size . . . [Karim] is eligible for MAGI-Medicaid with his minor child therefore, ineligible for MPPP as category QI-1, counting a family size of one and only counting [Karim's] income as required." (Record Ex. 15 (Admin. Hr'g Decision), at 7.) Karim applied for MPPP as a QI-1 but was subsequently denied MPPP because he was eligible for MAGI-Medicaid with his child. (Record Ex. 7 (OHHS Benefits Decision Notice), at 3.) Karim's central argument concerns whether OHHS should be including his minor child in the family size for MPPP determination purposes. (Pl.'s Brief 1.) This Court now conducts a de novo review of these determinations of law made by OHHS, limited to the certified record in its determination as to whether legally competent evidence exists to support the agency's decision. Arnold, 822 A.2d at 167; Barrington School Committee 608 A.2d at 1138.
Karim urges the Court to count his family size as two, but count only his income using the SSI methodology, which would make Karim eligible for the MPPP under category SLIMB, allowing him to have both MPPP and Medicaid benefits. (Pl.'s Brief 1.) First, Karim argues that "[t]he hearing officer's finding that a person must be eligible for Medicare in order to be included in the MPP[P] family size has no basis in state or federal law." Id. at 5. Second, Karim argues that "[t]he hearing officer erroneously found that the SSI methodology for determining amount of countable income also determines family size." Id. Third, Karim argues that the Agency's interpretation of "family size" is inconsistent with the "plain language" of the federal statute. Id. at 7-8. Each argument is considered in turn. For the following reasons, this Court declines to grant Karim's requested relief.
i
The Hearing Officer's Ruling that a Person Must be Eligible for Medicare in Order to Be Included in the MPPP Family Size
The OHHS Decision stated "[Karim's] minor child in this case is not eligible for Medicare, therefore her income should not be counted, and she should not be counted in the family size." (OHHS Decision 7.) Karim argues that "[t]he hearing officer's finding that a person must be eligible for Medicare in order to be included in MPP[P] family size has no basis in state or federal law." (Pl.'s Brief 5.) In response, OHHS states "Plaintiff is attempting to have it both ways . . . get[ting] the benefit of not having his child's income counted in his income, but he also wants the child to be counted in the family size calculation to have a higher income threshold." (Def.'s Opp'n Brief 6.) Accordingly, OHHS states that "[t]he Appeals Officer's finding that a child should be excluded from family size because . . . she is not eligible for MPPP is not clearly erroneous." Id.
The MPPP eligibility pathways include income and resource limits for "Individual/Couple." 210 RICR 40-05-1.6.5. This regulation outlines that "[t]he Medicare Premium Payment Program (MPPP) helps low-income elders sixty-five (65) and older and adults with disabilities pay all or some of the costs of Medicare Part A and Part B premiums, deductibles and co-payments." 210 RICR 40-05-1.6.1(A) (emphasis added). Absent from that regulation is any provision affording MPPP to children. See id. In addition, a child's income can never be deemed to a parent. 210 RICR 40-5-1.11(D)(1). In view of both these regulations, the OHHS Decision determined that "[i]ncluding the child in the family size for a program [that] there is no potential eligibility for is not feasible." (OHHS Decision 7.) These considerations are "relevant evidence that a reasonable mind might accept as adequate to support a conclusion" that Karim's minor child in this case is not eligible for MPPP, and therefore, her income should not be counted, and she should not be counted in the family size. Caswell, 424 A.2d at 647; see also Baker, 637 A.2d at 363. Accordingly, this Court rules that the OHHS determination was not clearly erroneous in this respect.
ii
The Hearing Officer's Ruling Regarding Definition of Family of the Size Involved
The OHHS Decision determined that the term family is not defined, but a Qualified Medicare Beneficiary means an individual who is entitled to Medicare Part A, has SSDI income, and has resources within defined parameters. (OHHS Decision 7.) Therefore, "[since Karim's] minor child . . . is not eligible for Medicare, . . . she should not be counted in the family size [either]." Id. Karim argues that "[t]he hearing officer erroneously found that the SSI methodology for determining amount of countable income also determines family size." (Pl.'s Brief 5.) Specifically, Karim contends that "[t]he Hearing Officer . . . erred in implicitly finding that the SSI income methodology . . . define[d] 'family' or 'family size.'" Id. Relatedly, Karim contends that "[t]he Agency's interpretation of 'family' and 'family size' is inconsistent with the plain language of the federal statute." Id. at 7-8. In response, OHHS contends that "OHHS's interpretation of the federal statute and regulations at issue, which was upheld by the Appeal's Officer, was reasonable and not clearly erroneous, the Court should defer to the agency on the interpretation of family size in this context." (Def.'s Opp'n 5.)
Karim argues that the holding in Stanley v. R.I. Executive Office of Health and Human Services, Nos. PC-2015-1857, PC-2015-3094, 2016 WL 3453822 (R.I. Super. June 21, 2016), involving two administrative appeals of OHHS decisions, which found applicants ineligible to receive benefits under the MPPP, is similar to the instant case. Stanley, 2016 WL 3453822, at *1. In Stanley, the Court considered whether each appellant's spouse should factor into the determination of household size for purposes of income beneficiary status. Ultimately, in Stanley, the Superior Court concluded that
This Court proceeds mindful that Rhode Island Superior Court cases are not binding precedent upon this Court. See Breggia v. Mortgage Electronic Registration Systems, Inc., 102 A.3d 636, 641 (R.I. 2014).
"the term 'family of the size involved' is not ambiguous as applied to Appellants . . . [t]herefore, finding that the applications of both Appellants should have been considered according to the guidelines for a household size of two, not one, this Court finds that Appellants are therefore eligible for benefits pursuant to the Rhode Island MPP[P] program for the months that they were wrongly deemed to be ineligible." Id. at *5.Stanley held that "family" should be defined according to the dictionary definition because the term is not ambiguous and not defined in the Medicaid statute. Id. Specifically, the Court discussed the potential ambiguity of the term "family," stating "there are instances where the word 'family' might be ambiguous." Id. For example, it is not clear whether family would include '"adult children who live with their parents, or a 17-year-old child who does not, or nieces and nephews who live with their aunts and uncles."' Id. (quoting Wheaton v. McCarthy, 800 F.3d 282, 287 (6th Cir. 2015)). Karim analogizes his benefits appeal to the successful Stanley appeal, urging this Court to adopt its rationale and grant his requested relief. (Pl.'s Brief 5-6; Admin. Hr'g Tr. 7, Feb. 25, 2021.) However, Stanley did not address whether defining a person who was single and living with his minor daughter was an "individual" under the federal statutes governing medical assistance programs such as Medicare and Medicaid. See Stanley, 2016 WL 3453822, at *4. Therefore, Karim's reliance on Stanley, in this instance, is misguided.
Karim also cites Wheaton v. McCarthy, 800 F.3d 282, 288 (6th Cir. 2015), Martin v. North Carolina Health and Human Services, 670 S.E.2d 629, 633 (N.C. 2009), and Winick v. Department of Children and Family Services, 161 So.3d 464, 467 (Fla. Dist. Ct. App. 2014) which all involve cases that interpret "family of the size involved" in relation to spouses but not children. Wheaton, 800 F.3d at 288; Martin, 670 S.E.2d at 633; Winick, 161 So.3d at 467. These decisions ultimately determined that because the term is not defined in the regulation or statute, it should be defined by its common dictionary usage, or the "plain meaning" of the term. Wheaton, 800 F.3d at 288; Martin, 670 S.E.2d at 633; Winick, 161 So.3d at 467. None of these cases are binding upon this Court.
Unlike the cases cited by Karim involving spouses factored into family size, the instant case involves a parent with a minor child applying for MPPP. (OHHS Decision 1). Here, the phrase "family of the size involved" is ambiguous because children are not accounted for in the MPPP framework, whereas spouses are accounted for in the MPPP framework. See 210 RICR 40-051.6.1, 1.6.5. Karim is correct that Medicaid statutes do not define "family of the size involved." See 42 U.S.C. § 1396d. Centers for Medicare and Medicaid Services allow states to define "family size" for MPPP purposes, but Rhode Island has not defined "family size." (Record Ex. 11 (Letter from Secretary of OHHS Roberts), at 3.)
A letter from former Secretary of OHHS Elizabeth Roberts states, "[a]lthough the State [MPPP] rules do not include a specific definition of 'family of the size involved,' the State has chosen to define family size for the MPP[P] Program by using the [SSI] methodology, which also includes the deeming rules and defines family size in terms of an individual or a couple." Id. According to SSI income deeming rules when determining eligibility for SSI, when an ineligible spouse has no income to deem, the SSI applicant's countable income is compared to the standard for an individual to determine eligibility. 20 C.F.R. § 416.1163(d)(1). During the appeal hearing of the OHHS denial, OHHS representative Silva testified:
"defining the family size for an MPP[P] case it's only an individual or a couple. The children are never taken into account because the children would never be eligible for MPP[P]. So, it doesn't make plain sense that you would be including the child in the family size just to increase that unit number but then you're not including that . . . child's income. Which based on those decisions that you cited . . . it clearly explains that if a couple or individual, and if the couple is deemed an ineligible, the spouse is neither counted for the household size nor is their income counted." (Record Ex. 16 (Admin. Hr'g Tr., Feb. 25, 2021) at 7-8.)
Within 210 RICR 40-05-1.6, "Medicare Premium Payment Program," the State outlines that "[a] person's income and resources, as calculated using the SSI methodology, determine which type of Medicare premium assistance is available." 210 RICR 40-05-1.6(A)(1). If a person is eligible for MPPP, the State pays Medicare premiums after determining which pathway to follow. 210 RICR 40-05-1.6.5. That regulation describes the two potential MPPP pathways for coverage groups of "Individuals/Couple" but not for children or family. 210 RICR 40-05-1.6.5. Considering that (1) children are not accounted for in the MPPP statute, that (2) SSI Methodology compares spouses with one non-deeming partner to the FPL standard for an individual, and that (3) income may not be deemed from child to parent for income in the SSI methodology, this reasoning collectively constitutes legally competent evidence to support OHHS's conclusion that "family of the size involved" for a single parent with a child within the MPPP context is a family size of one. 210 RICR 40-05-1.6.5; 210 RICR 40-05-01.11(D)(1).
Based on this analysis, "a reasonable mind might accept as adequate to support a conclusion" that Karim was properly considered a QI-1 with a family size of one. See Caswell, 424 A.2d at 647. Great weight and deference should be given to OHHS's interpretation "as long as that construction is not clearly erroneous or unauthorized." Labor Ready Northeast, Inc., 849 A.2d at 344 (internal quotation omitted). The weight and deference afforded to OHHS remains "even when other reasonable constructions of the statute are possible." Id. at 345. The fact that OHHS adopted a ruling that may contradict Karim's preferred dictionary definition of "family" does not overcome the great "weight and deference" afforded to OHHS interpretation. Id. at 344. OHHS was entitled to interpret "family of the size involved" by using SSI methodology, and this definition should be given deference by this Court. Id. Accordingly, the Court defers to the OHHS interpretation of "family size involved" in this context and concludes that Karim should be considered a family size of one for MPPP purposes. 210 RICR 40-05-1.6.5.
IV
Conclusion
Concluding that Karim's MPPP application was correctly considered according to the guidelines for a household size of one, this Court determines that Karim is not eligible for benefits pursuant to the Rhode Island MPPP program. For the reasons stated above, this Court affirms the OHHS Decision denying MPPP benefits to Karim because his income exceeds the income limits for an individual applicant. The Court determines that the interpretation of the OHHS is entitled to deference because, in view of the surrounding statutes and legislation, the OHHS interpretation is neither clearly erroneous nor unauthorized by law.