No. 98-2879DCommonwealth of Massachusetts Superior Court CIVIL ACTION MIDDLESEX, SS.
March 3, 1999
MEMORANDUM OF DECISION AND ORDER ON PLAINTIFF’S MOTION FOR JUDGMENT ON THE PLEADINGS
BRASSARD, JUSTICE.
Plaintiff, Susan Abod (“Ms. Abod”) is appealing the decision of defendant, Department of Transitional Assistance (“Department”), denying certain bottled water, organic foods, detergents and cleaners, and organic clothing in calculating countable income for food stamp purposes. For the reasons set forth below, Ms. Abod’s motion is DENIED in part and ALLOWED in part and the Department’s decision is VACATED as to the bottled de-ionized water.
BACKGROUND
Ms. Abod is a 47 year old woman with a diagnosis of multiple chemical sensitivities (“MCS”), chronic fatigue syndrome, and fibromyalgia. As a result of these illnesses, Ms. Abod has been on disability since 1985. To decrease the chances of Ms. Abod having an MCS attack, her physician, Dr. Edward Chapman prescribed the following items: certified organic foods, de-ionized water, baking soda to use as laundry detergent, certified organic clothing which is manufactured without sizing or chemical dyes, and chemically neutral household products. She was also prescribed certain prescription medications and formulated vitamin and mineral supplements which are processed without dyes or chemicals. Ms. Abod’s physicians maintain that these items are a necessary part of Ms. Abod’s medical care and treatment.
On February 2, 1998, the Department sent Ms. Abod a notice stating that her food stamp benefits would be $63.00. On February 17, 1998, Ms. Abod filed a timely appeal, challenging the amount of the assistance. On April 1, 1998, the Department held an administrative hearing, at which time Ms. Abod argued that the Department should except these aforementioned expenses as deductible medical expenses. Because Ms. Abod did not have an updated letter from her doctor listing the expenses that she believed qualified as allowable medical expenses, the hearing officer agreed to hold the administrative record open for two weeks so that Ms. Abod could submit such a letter.
Within this two week window, Ms. Abod submitted two letters which listed the following twelve items: de-ionized bottled spring water, certified organic foods, Alka Seltzer Gold, certified organic clothing, baking soda, “simple” cleaner, special laundry detergent, enzyme potential desensitization injections, B-12 injections and syringes, Tofrinil, Florinefl, and specially formulated vitamin and mineral supplements.
On May 8, 1998, the Hearing Officer issued a decision in which he concluded that Alka Seltzer, injections, Tofrinil, Florinefl, and the vitamin and mineral supplements qualify as deductible medical expenses pursuant to 7 C.F.R. 273.9(d)(3) and 106 CMR 364.400(C)(3). The Hearing Officer further concluded that the extra expenses for organic foods, bottled water, organic clothing, household cleaning produces and detergents are not deductible medical expenses for food stamp purposes. Ms. Abod now brings an appeal requesting that this court conclude that the Department must take into account the difference between the cost of the special diet, clothing, and cleaning items and normal diet, clothing, and cleaning items.
DISCUSSION
The focus of this review is whether the Department of Transitional Assistance’s decision to deny certain bottled water, organic foods, detergents and cleaners, and organic clothing in calculating countable income for food stamp purposes was unsupported by substantial evidence or based on an error of law. G.L.c. 30A, § 14(7)(e); Tenneco, Inc. v. Commissioner of Revenue, 410 Mass. 380, 383 (1987). Pursuant to G.L.c. 30A, § 1(6), “substantial evidence” is defined as “such evidence as a reasonable mind might accept as adequate to support a conclusion.” Edward E. v. Department of Social Services, 42 Mass. App. Ct. 478, 479-480 (1997). The determination of whether an agency decision is supported by substantial evidence must be based on the entire administrative record, taking into account whatever in the record fairly detracts from the weight of the evidence. Arnone v. Commissioner of the Department Social Sevices, 42 Mass. App. Ct. 33, 34 (1997).
In deciding whether to uphold the agency’s conclusion, the court gives due weight to the experience and expertise of the agency, as well as to the discretionary authority conferred upon it. G.L.c. 30A, § 14(7); Dohoney v. Director of Division of Employment Security, 377 Mass. 333, 337 n. 3 (1979). The reviewing court may not substitute its judgment for that of the agency. Southern Worcester County Vocational Sch. Dist. V. Labor Relations Committee, 386 Mass. 414, 420-421 (1982) citing Olde Towne Liquor Store, Inc. v. Alcoholic Beverages Control Comm’n, 372 Mass. 152, 154 (1977). Thus, as long as the facts in the record as a whole would support the agency decision, it must be upheld. Wolf v. Department of Public Utilities, 407 Mass. 363, 370 (1990); Dohoney, supra. A court should therefore only interfere with an agency’s exercise of discretion in the most extraordinary circumstances. Levy v. Board of Registration and Discipline in Medicine, 378 Mass. 519, 529 (1979).
The food stamp program was established in order to promote the general welfare, and to safeguard the health and well-being of the Nation’s population by raising the level of nutrition among low income households. 7 U.S.C. § 2011. To alleviate hunger and malnutrition, the food stamp program permits low-income households to obtain a more nutritious diet by increasing the food purchasing power for all eligible households who apply for participation. Id. Participation in the program is limited to those households whose incomes and other financial resources are determined to be a substantial limiting factor in permitting them to obtain a more nutritious diet. 7 U.S.C. § 2014(a). In order to participate in the food stamp program, states must meet guidelines established by the United States Department of Agriculture. 7 U.S.C. § 2014(b).
In accordance with national uniform guidelines, Massachusetts has promulgated regulations to administer the food stamp program within the state. 106 CMR 360.020. For purposes of assessing eligibility for food stamps, both federal and state food stamp regulations contain specific provisions which aid in determining which expenses are considered deductible medical expenses. 7 C.F.R. 273.9(d)(3); 106 CMR 364.400(C). Additionally, both the federal and state regulations explicitly state that special diets are not allowable medical expenses. Id.
In light of the plain meaning of both the federal and state statutes which describe the parameters of allowable medical expenses, the hearing officer’s decision denying compensation for the costs of organic foods, detergents and cleaners, and organic clothing is based on substantial evidence and is not an error of law. Again, 106 CMR 364.400(C) specifically states that special diets are not considered deductible medical expenses. Moreover, the regulations do not provide for a deduction for any sort of cleaning products or organic clothing, although such products may be required for certain medical conditions. See 106 CMR 364.400(C). The absence of these items from the clear delineation of allowable medical deductions set out in 106 CMR 364.400(C) is clear evidence that this regulation does not apply to these requested items.
However, in light of the Department’s interpretation of its own regulations in Eden v. McIntire, C.A. No. 97-6719, its decision not to allow Ms. Abod’s bottled de-ionized water to be included as a deductible medical expense is arbitrary and capricious. The Department contends that it allowed bottled water to be included as a deductible medical expense in Eden because the plaintiff’s physician submitted a letter that explicitly tied the plaintiff’s use of bottled water to her medical treatment (Letter from Daniel P. LePage dated 2/12/99). Because the plaintiff’s physician explained that the bottled water was actually used to prepare medications that the plaintiff needed to treat her condition, the Department considered the de-ionized water part of the medication itself. Id. Therefore, the Department allowed the special water as an allowable medical deduction. Id.
Although Ms. Abod’s physicians never explicitly specified that bottled water is necessary for Ms. Abod to ingest her medication, this Court nonetheless finds that Ms. Abod’s need for bottled water is indistinguishable from that of the plaintiff in Eden. In a letter to the Department, Ms. Abod’s physician, Edward H. Chapman, M.D. stated that due to her medical condition, Ms. Abod can only drink de-ionized bottled spring water (Letter from Edward H. Chapman M.D. to Mr. Connor dated 4/9/98). Moreover, Ms. Abod takes a variety of prescription medications, vitamins, and mineral supplements, some of which are presumably in pill form and thus must be ingested with water (Letter from Jeanne T. Hubbuch, M.D. to Mr. Connor). To help neutralize chemical reactions, Ms. Abod also uses over the counter Alka Seltzer Gold, a medication which is dissolved in water prior to ingestion (Letter from Edward H. Chapman, M.D. to Mr. Connor dated 4/9/98).
Ms. Abod clearly needs water to ingest many of her medications. Despite the fact that this requirement is not specifically stated in the administrative record, the Department should nevertheless follow the reasoning of Eden. Like the plaintiff in Eden, because the bottled water is actually necessary to prepare medications that Ms. Abod requires to treat her condition, the Department should consider the bottled de-ionized water part of the medication itself. Accordingly, in light of the reasoning articulated in Eden, the Department’s failure to consider bottled de-ionized water a deductible medical expense is arbitrary and capricious.
ORDER
It is hereby ORDERED that the Department’s decision denying bottled de-ionized water as a deductible medical expense be VACATED. Plaintiff’s motion for judgment on the pleadings is otherwise DENIED, and the decision of the Department is AFFIRMED.
_______________________________ Raymond J. Brassard Justice of the Superior Court
Dated: March 3, 1999