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Child Care Assistance Program Policy Manual Issued 07/2023 Appeal requests 15.9 Requesting a fair hearing or appealing an administrative disqualification A provider’s request for a fair hearing must: • Be in writing. • List each item from the adverse action notice the provider disagrees with, the reason(s) why the provider disagrees, and if applicable, the dollar value of each item the provider disagrees with. • State the dollar amount the provider believes to be correct, if applicable. • State the statute and/or rule references the provider believes supports their position. • Include a name, address, and telephone number of a person at the provider’s business that can be contacted regarding the appeal. The provider may request an appeal by completing the Child Care Assistance Program (CCAP) Provider Appeal to State Agency (DHS-8075) form or by writing a letter requesting an appeal that includes the required components. The provider must send the appeal request directly to the DHS Appeals Division at: Minnesota Department of Human Services Appeals Division P.O. Box 64941 St. Paul, MN 55164-0941 Fax: 651-431-7523

The provider’s appeal must be received by the Minnesota Department of Human Services, Appeals Division, within 30 days of the date the adverse action notice was mailed. All provider appeal requests must be received within the 30-day time frame in order to be considered timely. Good cause delays are not allowed for provider appeals. If the provider submits their appeal to the CCAP agency, immediately forward the appeal directly to the DHS Appeals Division. In some situations, the provider may have the option to continue receiving benefits during the fair hearing process. See Chapter 15.15 (Continuation of Benefits). Follow the appeal process regardless of the possibility of fraud. Requesting a contested case hearing A provider’s request for a contested case hearing must: • Be in writing • Be received by DHS within 30 days of the date the notice was mailed to the provider • Include: o Each item the provider disagrees with and the reason(s) the provider disagrees o The statute and/or rule references the provider believes supports their position o The name and address of a contact for the provider’s appeal o Any other specific information required by DHS.