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38-CV-20-208

Filed in District Court


State of Minnesota
7/28/2020 4:31 PM

STATE OF MINNESOTA DISTRICT COURT

COUNTY OF LAKE SIXTH JUDICIAL DISTRICT

Sandra J. Oliver, File No. 38-CV-20-208


Appellant,
MEMORANDUM
vs
Lake County Health
and Human Services,
Respondent.

Appellant has failed to comply with the statutory requirements of filing an appeal to District
Court of an Order of the Commissioner of Human Services.

On May 14 , 2020, the Commissioner ofthe Department of Human Services issued an Order

affirming the decision of the Administrative Law Judge, denying Appellant’s appeal of Lake County
Human Services Decision to Appellant. (Exhibit 1) The Order was sent by mail to Appellant. She
had 30 days to le and serve an appeal on interested parties. On June 12, 2020, Appellant served a
Notice of Appeal on Lake County Human Services, which was purported to be filed in Ramsey County
ofthe Second Judicial District. (Exhibit 2) lt is not clear if the Notice of Appeal was ever filed with a
court. On June 26, 2020, 14 days later, 43 days after the Commissioner’s Decision, Appellant mailed
this new notice of appeal, to the Commissioner of Human Services and Lake County Human
Services. On June 30, 2020, Appellant filed an “Amended Notice of Appeal” in Lake County District
Court ofthe Sixth Judicial District, which initiated this case. (Exhibit 3)

Appeals of commissioner of human services orders must be filed with the district court in the

county responsible for furnishing assistance. Minn. Stat. § 256.045, subd. 7. The appellant has 30
days to serve a notice of appeal on the Commissioner of Human Services and any adverse party and
file the original notice and proof of service. Id. Three days are added to the 30—day time limit ifthe
Commissioner’s Decision was mailed to Appellant. Reynolds v. Minn. Dep’t of Human Servs., 737
N.W.2d 367( Minn. App 2007). Appellant had until June 16, 2020 to serve and file the appeal. She
served a notice of appeal on the parties for a Ramsey County appeal within the timeframe. However,
it does not appear it was ever filed in the district court of the county responsible for furnishing
assistance. She drafted a new notice of appeal, served and filed that outside of the 33—day window to
file an appeal. She did not comply with the requirements ofthe statute. When a party fails to appeal
an agency decision within the statutorily prescribed time limit, the appeal is dismissed for lack of
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38-CV-20-208
Filed in District Court
State of Minnesota
7/28/2020 4:31 PM

jurisdiction. The Court does not have subject matterjurisdiction and this appeal should be dismissed.
Davis v. Minn. Dept. of Human Rights, 352 N.W.2d 852, 854 (Minn. App 1984). While some leeway is
given to pro se appeiiants, the rules of procedure apply to all litigants. State v. Seifelt, 423 N.W.2d
368, 372 (Minn. 1988). ln addition, Appellant’s husband is an attorney, licensed for many years, and
appeared with her in the initial hearing on this matter. Appellant should not be given any deference
for violating the procedural requirements of the statute.

Dated: July 28, 2020 /s/Russe/I H. Conrow


Russell H. Conrow, #281955
Lake County Attorney‘s Office
Lake County Courthouse
601 Third Avenue
Two Harbors, MN 55616
(21 8) 834—8350
[email protected]
38-CV-20-208
Filed in District Court
State of Minnesota
7/28/2020 4:31 PM

RECENED
DEPARTMENT 0F Mmszom
HUMAN SERVICES Lakecm
Survices
Health and Human

Appellant: Sandra Oliver


DENIAL OF REQUEST FOR
For: Medical Assistance Overpayment RECONSlDERATlON

Agency: Lake County

Docket: 232888

1. On April 7, 2020, the Commissioner of Human Services made a decision that


affirmed the Agency's assessment that it overpaid Appellant’s Medical Assistance benefits. We
found that Appellant’s failure to report income changes caused the overpayment. Specifically,
we found that Appellant’s household income increased and thatthe household did not timely
report the change to the Agency. ‘

2. On May 7, 2020, the Appeals Division received Appellant's request to reconsider


our earlier decision. Minn. Stat. § 256.0451, subd. 24, says that a party seeking reconsideration
must do so within 30 days of the original decision, and Appellant submitted the request within
this time limit. Also, that party must show why the decision should be reconsidered, meaning
they must have a persuasive claim that the earlier decision is not correct.

3. Appellant’s arguments fall into two broad categories. Appellant claims that the
income change was timely reported, and therefore that any overpayment was based on Agency
error. Appellant also argues that her apparent eligibility for MinnesotaCare during the
overpayment period should eliminate any overpayment.

4. Regarding the factual question of whether the income change was reported
timely, Appellant argues that she received several notices confirming eligibility for Medical
Assistance during the overpayment period "and after the Agency was notified of my husband’s
Social Security income...” Appellant did receive such notices, but we found that the Agency had
not been informed of the new RSDl income. Appellant reiterates her claim to the contrary, but
provides no new evidence of having informed the Agency of the change. Appellant does point
to the fact that RSDl income showed up in the prepopulated annual renewal form, and argues
that this form was "prefilled in with the information the Agency already had in my file.” That is
an inaccurate understanding of this form, however, as it automatically draws from federal
databases that hold information about the receipt of federal benefits, including RSDl. In other

P.0. Box 64W} ISL Paul. MN 155164-094! lAn Equal Opporlunirv Employer

Exhibit 1
38-CV-20-208
Filed in District Court
State of Minnesota
7/28/2020 4:31 PM

words, the presence ofthe RSDI income on the renewal form is not evidence that Appeilant
reported this income. Appellant argues that it is an ”uncontroverted fact[}” that her spouse
”testified that he notified the Agency no later than June of his change in income." While
Appellant’s spouse testified to this, whether the change was in fact reported to the Agency is
the essential controverted fact in this case, and we found no other evidence beyond the
testimony that Appellant had done do. Appellant has not provided a convincing reason to
revisit this conclusion, and we therefore decline to do so.

5. Appellant also argues that she was eligible for MinnesotaCare benefits beginning
in June 2019, after her spouse began receiving Retirement, Survivors, and Disability Insurance
("RSDI") income that led to the household being over income for the Medical Assistance
program. Our earlier decision acknowledges that Appellant was eligible for MinnesotaCare in
the sense that her household’s income was within the eligibility constraints of the program.
However, Appellant was not enrolled in MinnesotaCare, consistent with our finding that her
spouse’s new income was not timely reported to the Agency. As Minn. Stat. § 256L.OS, subd.
3(a), says, MinnesotaCare coverage does not take effect until after eligibility is approved and
the first premium is paid. Appellant indicates that the Medical Assistance overpayment should
be offset based on the fact that her household income was within the limits of the
MinnesotaCare program after the increase caused by her spouse’s receipt of RSDl benefits.1
This appears to be based in part on a provision in the Minnesota Health Care Programs
Eligibility Policy Manual, at section 1.3.2.5, which states that an "overpayment amount may be
reduced or eliminated if the enrollee would have been eligible for the same program under a
different basis.” However, MinnesotaCare is not the same program as Medical Assistance. The
programs have different eligibility standards, with MinnesotaCare uniquely requiring premium
payments for eligibility, requiring that enrollees have no access to other minimum essential
coverage, among other differences. See, e.g., Minn. Stat. §§ 256L07 and256L.15. More
fundamentally, the reference in the manual provision to ”different basis” is to the Medical
Assistance bases of eligibility (also referred to as "eligibility categories”), which do not apply to
MinnesotaCare. They are delineated in Minn. Stat. § 2568.055, and confer different income
limits for different bases.

6. insummary, Appellant has not provided a convincing rationale to revisit our


earlier decision, and we therefore decline to reconsider it. We confirm the April 7, 2020,
RECEIVED
MAY 1 8 2020

Lake County
inmgd'm
lAppeliant notes correctly that the Agency misconstrued her household’s projected annual income SGWlGeS
Human Services Judge. However, our earlier decision corrects this error, confirming as noted above that Appellant’s
household income was within the bounds of MinnesotaCare limitations. At Applicable Law 13, we state ”Thus, the
household PAI for 2019 was $28,120 and Sandra was eligible for MinnesotaCare." We conclude, however, that Appellant
did not enroll in MinnesotaCare, based on the finding that her spouse’s new income was not reported to the Agency.
2
38-CV-20-208
Filed in District Court
State of Minnesota
7/28/2020 4:31 PM

decision in ail respects. This order is the final agency action for purposes ofjudicial review, and
that process is described below.

FOR THE OF HUMAN SERVICES:


COMMISSIONER
V.\
/

5/14/2020

John Freeman Date


Director, Appeals Division

FURTHER APPEAL RIGHTS

This decision is nal, unless you take further action.


Appeiiants who disagree with this decision shouid consider seeking iegai counsel to identify
further legal action.

if you disagree with this decision, you may start an appeal in the district court. This is a
separate legal proceeding that you must start within 30 days of the date of this decision. You
start this proceeding by serving a written copy of a notice of appeal upon the Commissioner
and any other adverse party of record and filing the original notice and proof of service with
the court administrator of the county district court The law that describes this process is
Minnesota Statutes § 256. O45 subdivision 7. i

cc: Sandra Oliver, Appellant


Lake County

RECEIVED
MAY 1 8 2020

Lake County
Hoaith and Human Services
38-CV-20-208
Filed in District Court

Scahnned‘ 6/12/2020 9:47:01 AM


State of Minnesota
7/28/2020 4:31 PM

RECEIVED
m DEPARTMENT OF
HUMAN SERVICES JUN122020
Lake County

Appellant: Sandra Oliver


DENIAL OF REQUEST FOR
For: Medica! Assistance Overpayment RECONSIDERATION

Agency: Lake County

Docket: _
232888

1. On April 7, 2020, the Commissioner of Human Services made a decision that


affirmed the Agency’s assessment that it overpaid Appellant's Medical Assistance benefits. We
found that Appellant’s failure to report income changes caused the overpayment. Specifically,
we found that Appellant's household income increased and that the household did not timely
report the change to the Agency.

2. On May 7, 2020, the-Appeals Division received Appellant's request to reconsider


our earlier decision. Minn. Stat. § 256.0451, subd. 24, says that a party seeking reconsideration
must do so within 30 days of the original decision, and Appellant submitted the request within
this time limit. Also, that party must show why the decision should be reconsidered, meaning
they must have a persuasive claim that the earlier decision is not correct.

3. Appellant’s arguments fall into two broad categories. Appellant claims that the
income change was timely reported, and therefore that any overpayment was based on Agency
error. Appellant also argues that her apparent eligibility for MinnesotaCare during the
overpayment period should eliminate any overpayment.

4. Regarding the factual question of whether the income change was reported
timely, Appellant argues that she received several notices confirming eligibility for Medical
Assistance during the overpayment period "and after the Agency was notified of my husband’s
Social Security income..." Appellant did receive such notices, but we found that the Agency had
not been informed of. the new RSDl income. Appellant reiterates her claim to the contrary, but
provides no new evidence of having informed the Agency of the change. Appellant does point
to the fact that RSDl income showed up in the prepopulated annual renewal form, and argues
that this form was "prefilled in with the information the Agency already had in my file.” That is
an inaccurate understanding of this form, however, as it automatically draws from federal
databases that hold information about the receipt of federal benefits, including RSDl. in other

P.0. Bax 64941 lSi. Paul, MN '55l64-094/ lAn Equal Opporluniry Employer
38-CV-20-208
Filed in District Court
30a_nned 6/12/2020 9:47:02 AM State of Minnesota
7/28/2020 4:31 PM
h RECEIVED
JUN 1 2 2020

Lake County
words, the presence of the RSDI income on the renewal form Is not evidenmdbbeamwlces
reported this income. Appellant argues that it ls an "uncontroverted fact[]” that her spouse
"testified that he notified the Agency no later than June of hls change ln income.” While
Appellant’s spouse testified to this, whether the change was in fact reported to the Agency is
the essential controverted fact ln this case, and we found no other evidence
beyond the
testimony that Appellant had done do. Appellant has not provided a convincing reason to
revisit this conclusion, and we therefore decline to do so.

5. Appellant also argues that she was eligible for MinnesotaCare benefits beginning
in June 2019, after her spouse began receiving Retirement, Survivors, and
Disability insurance
("RSDl") income that led to the household being over income for the Medical Assistance
_ .
program Qur earlier decision acknowledges that Appellant was eligible, for,MinnesotaQare in
the sense that her household’s income was within the eligibility constraints of the
program.
However, Appellant was not enrolled in MinnesotaCare, consistent with our finding that her
spouse’s new income was not timely reported to the Agency. As Minn. Stat. § 256L.05, subd.
3(a), says, MinnesotaCare coverage does not take effect until after eligibility is approved and
the first premium is paid. Appellant indicates that the Medical Assistance
overpayment should
be offset based on the fact that her household income was within the limits of the
MinnesotaCare program after the increase caused by her spouse’s receipt of RSDl benefits}
This appears to be based in part on a provision in the Minnesota Health Care Programs
Eligibility Policy Manual, at section 1.3.2.5, which states that an “overpayment amount may be
reduced or eliminated if the enrollee would have been eligible for the same program under a
different basis." However, MinnesotaCare is not the same program as Medical Assistance. The
programs have different eligibility standards, with MinnesotaCare uniquely requiring premium
payments for eligibility, requiring that enrollees have no access to other minimum essential
coverage, among other differences. See, e.g., Minn. Stat. §§ 256L.07 and 256L.15. More
fundamentally, the reference in the manual provision to ”different basis” is to the Medical
Assistance bases of eligibility (also referred to as "eligibility categories”), which do not
apply to
MinnesotaCare. They are delineated in Minn. Stat. § 2568.055, and confer different income
limits'for different bases.
'

6. in summary,
Appellant has not provided a convincing rationale to revisit our
earlier decision, and we therefore decline to reconsider it. We confirm the April 7, 2020,

‘Appeilant notes correctly that the Agency misconstrued her household's projected annual income in its response to the
Human Services Judge. However. our earlier decision corrects this error,
confirming as noted above that Appellant’s
household income was within the bounds of MinnesotaCare limitations. At Applicable taw 13, we state ”rhus, the
household PAI for 2019 was $28,120 and Sandra was eligible for MinnesotaCare." We conclude,
however, that Appellant
did not enroll in MinnesotaCare, based on the finding that her spouse’s new income was not
reported to the Agency.
2
38-CV-20-208
Filed in District Court

Scanned 6/12/2020 9:47:04 AM


State of Minnesota
7/28/2020 4:31 PM
A‘ . \

decision in all respects. This order is the final agency action for
purposes of judicial review, and
that process is described below.

FOR THE COM ISSIONER OF HUMAN SERVICES:

f
at;Wm" 5/14/2020
Jol‘r’ reeman Date
Dir ctor, Appeals Division
... _-- . .. .. . __...

FURTHER APPEAL RIGHTS

This decision is nal, unless you take further action.


'

Appellants who disagree with this decision should consider seeking legal counsel to identify
further legal action.

if you disagree with this decision, you may start an appeal in the district court. This is a
separate legal proceeding that you must start within 30 days of the date of this decision. You
start this proceeding by sewing a written copy of a notice of appeal upon the Commissioner
and any other adverse party of record, and filing the original notice and proof of service with
the court administrator of the county district court. The law that describes this
'
process is
Minnesota Statutes § 256.045, subdivision 7.

cc: Sandra Oliver, Appellant


Lake County
38-CV-20-208
Filed in District Court
Scanned 6/12/2020 9:46:58 AM State of Minnesota
7/28/2020 4:31 PM

June 9, 2020

Sandra J. Oliver
1562 Burlington Rd.
Two Harbors, MN 55616 RECElVED
Ms. Jodi Harpstead
JUN I 2 2020

Commissioner of Human Services Lake County


H ”Rh and Human
P.0. Box 64941 Services
St. Paul, MN 55164-0941

Mr. Jonathan Plese


Lake County Health and Human Services
616 Third Avenue
Two Harbors, MN 55616

RE: Notice of Appeal

Dear Ms. Harpstead and Mr. Plese:

Enclosed and served upon you, please nd Notice of Appeal of the Denial of Request for
Reconsideration, Docket No. 232888.

Sincerely,

iwm
Sandra Oliver
Enc.

Exhibit 2
38-CV-20-208
Filed in District Court
Scanned 6/12/2020 9:46:59 AM State of Minnesota
7/28/2020 4:31 PM

STATE 0F MINNESOTA
DISTRICT COURT
COUNTY OF RAMSEY
SECOND IUDICIAL DISTRICT

Court File No.:


Case Type: Civil omer/Misc.
'

SANDRA OLIVER,

Plaintiff,

vs.
N TICE OF. PEAL
JODI HARPSTEAD,
COMMISSIONER
OF HUMAN SERVICES,
RECEIVED
Defendant.
JUN 1 2 2020

Lake County
Health and Human Services

Pursuant to Minn. Stat. §256.045, subdivision 7, Sandra Oliver


hereby appeals the
Commissioner of Human Services’ Denial of Request for
Reconsideration, dated May 14, 2020,
as the nal agency acn'on in the above-referenced matter, a copy ofwhich is attached hereto.

<
Dated: June 9, 2020.
Sandra Oliver, Pro Se
1562 Burlington Rd.
Two Harbors, MN 55616
(612) 701-7038
38-CV-20-208
Filed in District Court
State
StateofofMinnesota
Minnesc
7/28/2020 14:31
6/30/2020 1 :50PM
A

STATE OF MINNESOTA DISTRICT COURT

COUNTY OF LAKE SIXTH JUDICIAL DISTRICT

Coun File No.:


Case Type: Civil Other/Misc.

SANDRA OLIVER,

Plaintiff,

vs. AIVIENDED NOTICE OF APPEAL

IODI HARPSTEAD,
COMMISSIONER
OF HUMAN SERVICES,

Defendant.

Pursuant to Minn. Stat. §256.045, subdivision 7, Sandra Oliver hereby appeals the

Commissioner of Human Services’ Denial of Request for Reconsideration, dated May l4, 2020,

as the final agency action in the above-referenced matter, a copy of which is attached hereto.

WQW
.
I)

Dated: June 26, 2020.


Sandra Oliverq, Pro Se
1562 Burlington Rd.
Two Harbors, MN 55616
(612) 701—7038

Exhibit 3
38-CV-20-208
Filed in District Court
I

"gateofofMinnesota
State Minnesc
7/28/2020 14:31
6/30/2020 1 :50PM
A

DEPARTMENT 0F
HUMAN SERVICES

Appellant: Sandra OIiver


DENIAL OF REQUEST FOR
For: Medical Assistance
Overpayment RECONSIDERATION

Agency: Lake County

pocket; w ‘ “2321838“ _ _

1. On April 7, 2020, the Commissioner of Human Services made


a decision that
affirmed the Agency’s assessment that it
overpaid Appellant's Medical Assistance benefits. We
found that Appellant’s failure to report income
changes caused the overpayment. Specifically,
we found that Appellant’s household income increased
and that the household did not timely
‘repo'rtthe change to the Agency. y

'2. On May7, 2020, the‘Appeals DiVi‘sion ’


received Appellant's request to reconsider
our earlier decision. Minn. Stat. § 256.0451, subd.
_

24, says that a party seeking reconsideration


must do so within 30 days of the original decision, and Appellant submitted the '
request within
this time limit. Also, that party must show
why the decision should. be reconsidered, meaning
they must have a persuasive claim that the earlier decision is not r‘ correct. .

3. Appellant’s arguments fall into two broad categories. Appellant claims that the
income change was timely reported, and therefore that
any overpayment was based on Agency
error. Appellant also argues that her

apparent eligibility for MinnesotaCare during the
overpayment periOd‘should‘eliminate any overpayment; ’ “ ‘

4. Regarding the factual question of whether the income change Was


reported
timely, Appellant argues that she received several notices
confirming eligibility for Medical
Assistance during the overpayment period ”and after the
Agency was notified of my husband’s
Social Security income...” Appellant did receive such
notices, but we found that the Agencyhad
not been informed of the new RSDI income. Appellant reiterates her claim to the
contrary, but
provides no new evidence of having informed the
Agency of the change. Appellant does point
to the‘fact that
RSDI income showed up in the prepopulated annual renewal form, and
that this form was'”prefilled in with the information the argues
Agency already had in my file.” That is
an inaccurate understanding of this
form, however, as it automatically draws from federal
databases that hold information about the receipt of
federal‘benefits, including RSDI. In other

P.O. Box 64941 ISL Paul. MN l55164~094l 'An Equal Opportunity Employer
38-CV-20-208
Filed in District Court
n.

State of
State ofMinnesota
Minnesc

7/28/2020
6/30/202 4:31
0 11: 50PM
A

words, the presence of the RSDI income on the renewal formIs not evidence
that Appellant
reported this'Income. Appellant argues that it is an ”uncontroverted
fact’ that her spouse
“testified that he notified the Agency no later than June of his
changem income.” While
Appellant’s spouse testified to this, whether the change was in fact
reported to the Agency is
the essential controverted fact in this case, and we found no other
V
evidence beyond the
testimony that Appellant had done do. Appellant has not provid a
ed convincing reason to
revisit thisconclusion, and we thereforedecline to do so.

5. Appellant also argues that she was eligible for MinnesotaCare benefits
in June 2019, beginning
after
her spOuse began receiving Retirement, Surviv
ors, and Disability insurance
(”RSDl”) incOm e that led to the house hold being over income for the Medical Assistance
_ prxogramk Qungarw_.decisip .a_ckno_\~|,e,dge_s_:hat Aapellantwgs, eligibLaio LMinn
gaétaQare in
the sense that her household’s income was within the
_.

eligibility constraints of the program


However, Appellant was not enrolled'in MinnesotaCare, consistent with our
finding that her
spouse’ s new inco‘m’e was not timely reported to the Agency. As Minn. Stat. 256L.
§
3(a), says, MinnesotaCare coverage does not take effect until after eligibilityIs appro and
05, subd.
ved
the first premium is paid.
Appellant indicates that the Medical Assistance overpayment should
be offset based on the fact that her household income was
within the limits of the
MinnesotaCare program after the
Increase caused by her spouse’ s receipt of RSDi benef
This appears to be basedIn part on a its}
provision in the Minnesota Health Care Progra
ms
Eligibility Policy Manual, at section 1. 3. 2. 5, which states that an
”overpayment amount may be:
reduced or eliminated if the enrollee would have been
eligible far the same program under a
different basis’ However, MinnesotaCare is not the same progra as Medical
m Assistance The
programs have different eligibility standards, with MinnesotaCare
uniquely requiring premium
payments for eligibility, requiring that enrollees have no access to other minim '

um essential
coverage, among other differences. See, e.g., Minn. Stat. §§ 256L.07 and 256L15.
More
fundamentally, the reference in the manual provision to ”different basis” is to the Medic
al
Assistance bases of eligibility (also referred to as
”eligibility categories”), which do not apply to
MinnesotaCare— They are Minn S.tat § 2568. 055 and confer dlerent mcome
limitsfar differentbases delineatedIn — .
. _,

'

6. in summary, Appellant has not


o

provided a convin‘cingvrationale to-revisit our


earlier decision, and we therefore decline-to reconsider it. We
confirm the April 7, 2020,

'1
Appellant notes correctly that the Agencymisconstrued her household’s
projected annual income in its response to the
Human Services Judge. However, our’earlier decision corrects this
error, confirming as noted above that Appella
household income ‘was within the bounds of nt's
MinnesotaCare limitations. At Applicable‘Law 13', we state f’Thus, the ‘

household PAi for 2019 was


,

$28,120 and Sandra was eligible far MinnesotaCare,” We conclude, hoWev‘e‘ that

did hot enroll in MinnesotaCare, based on the r, Appellant
finding that her spouse’s new income was not reported to the
Agency.
2
38-CV-20-208
Filed in District Court
State of
Iggat'e. 3fMinnesota
Minnesc
7/28/2020 11:50
6/30/2020 4:31 PM
A

decision in all respects. This order is the finai agency action for
that process described below. purposes ofjudiciai revi‘ew,.and.
is

HUMAN SERVICES:
FoR.THEnc0Miissi0NER‘0F
A! . ‘

:/

i
.

hexWm”
. ~


5/14/2020
Joh’, Freeman i

Date
Dir, ctor, Appeals Division

FURTHER APPEAL RIGHTS

This decision is nal, unless you’ take


‘ further action. A

Appellants who disagree with this decision should consider


seeking legal counsel to identify
further legal, action. '

lfyou disagree with this decision, you may start an appeal in the district ’
coart. This is a
separate legal proceeding that you must start within 30
days of the date of'this decision. You
startthis proceeding'by serving a written
copy of a notice of appeal upon the Commissioner
and any other of
adverse party record, and filing the original notice and proof
v

the c0urt administrator of the county district Court. The law that describes of'service with '

Minnesota Statutes § 256.045, subdivision 7. ' this process is

cc: Sandra Oliver, Appellant


Lake County

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