UPM P-1570.10 - Procedures Prior to the Hearing - All Issues Except Emergency Housing

CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Prior to the Hearing - All Issues Except Emergency Housing SNAP ______________________________________________________________________________ P-1570.10 1. If you receive a written request for a Fair Hearing, stamp the date of receipt and forward the hearing request (including the envelope) to the Office of Legal Counsel, Regulations and Administrative Hearings (OLCRAH) in Central Office. You may fax the request or send it by intra or interoffice mail. Keep a copy of the request for the case record. If the requester did not include a name or address or client identification number, note that information on a separate piece of paper and provide that with the documents you send to OLCRAH.

2. If you receive an oral request for a Fair Hearing:

For all programs except SNAP, inform the requester that he or she must file the request in writing to the OLCRAH in Central Office. Requests may be mailed or faxed to:

Department of Social Services Office of Legal Counsel, Regulations and Administrative Hearings 25 Sigourney Street Hartford, CT 06106

FAX 860-424-5729

For issues involving SNAP, inform the assistance unit that he or she may request a hearing by calling the Office of Legal Counsel, Regulations and Administrative Hearings at 1-800-462-0134 or 860-424-5760; he or she may also mail or fax his or her request to the above address or fax number.

3. If the requester asks, assist the requester in submitting the Fair Hearing request to OLCRAH.

4. When you learn that a Fair Hearing has been requested, determine the issue being contested.

5. If the request for a Fair Hearing is received by OLCRAH or the regional office within 10 days from the mailing of a notice of adverse action, as described in policy at HYPERLINK "http://dssweb/dscgi/ds.py/Get/File-1099/1570_20.doc" 1570.20, continue benefits at their present level and do not take the adverse action prior to the Fair Hearing decision unless directed by the Hearing Officer. For Medicaid, if the recipient requests a hearing before the date of the action, the agency may not terminate or reduce benefits. The exception to this rule is for programs where the client was notified ahead of time that there was an expiration date to the benefits, i.e. spenddown cases (S99/F99/G99), and the extended medical benefits program (F03). For the TFA program, refer to Section HYPERLINK "http://dssweb/dscgi/ds.py/Get/File-2415/8525_10.doc" 8525.10B.

CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.10 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Prior to the Hearing - All Issues Except Emergency Housing SNAP ______________________________________________________________________________

P-1570.10 6. Review the case record with your supervisor to determine whether the Department has acted correctly and in a timely manner.

7. If the Department has erred, contact the requester and resolve the dispute in favor of the requester, if appropriate. If the requester agrees that the issue is resolved, ask him or her to send OLCRAH a written withdrawal. Let OLCRAH know that the requester has indicated that the matter has been resolved.

8. Ask the requester if he or she wishes to withdraw his or her request for a Fair Hearing if the issue is resolved in favor of the requester. Inform the requester that the withdrawal must be in writing. Assist with the withdrawal if so requested. If the requester tells you that he or she will not attend the hearing or will withdraw the hearing, let the Hearing Officer know as soon as possible.

9. If you receive a written withdrawal of a Fair Hearing request, make a copy for the case record and fax the withdrawal to the Fair Hearing Unit. If you are unable to fax the withdrawal, please call the Hearing Officer as soon as possible. If you receive an oral withdrawal of a hearing, please call the Hearing Officer as soon as possible.

10. If the request for a Fair Hearing is not withdrawn, prepare a written case summary for the Hearing Officer. The summary should include:

A brief statement of the case situation; All relevant facts pertaining to the issue being contested; The policy citation upon which the Department's decision is based; Your name and telephone number; and Copies of relevant exhibits, e.g. documents, notices from the department, EMS screens.

11. Submit the summary to your supervisor and have it reviewed by the Operations Manager for approval.

12. The requester, his or her legal representative and the Hearing Officer should receive a copy of the hearing summary and exhibits so that it is received at least five working days prior to the scheduled hearing date.

13. Allow the assistance unit and its legal representative to examine the case record at a reasonable time prior to the Fair Hearing date, if so requested, as described in Section 1020.

CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.10 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Prior to the Hearing - All Issues Except Emergency Housing SNAP ______________________________________________________________________________

P-1570.10 14. For Spanish-speaking assistance units, arrange to have a Spanish interpreter available to attend the hearing.