12 Fair Hearings,2605(b)(13) - Assurance 13

12.1 How many fair hearings did the Grant recipient have in the prior federal Fiscal Year? 0 12.2 How many of those fair hearings resulted in the initial decision being reversed? 0 12.3 Describe any policy and/or procedural changes made in the last federal Fiscal Year as a result of fair hearings? The State of Montana did not have any LIHEAP programmatic changes due to Fair Hearings during FFY2024 12.4 Describe your fair hearing procedures for households whose applications are denied and/or not acted upon in a timely manner. Notification letters regarding denials are sent to each household. The notification letters will be generated from the Low Income Home Ener Program (LIHEAP) Chimes computer system. The notification letters contain the language explaining the household's right to a fair hearing. At the action affecting the recipient's benefits, the subgrantee notifies the applicant of their fair hearing rights. The subgrantee shall notify every household: of the eligibility determination of the Low Income Home Energy Assistance Program (LIHEAP) application, and 1. of the right to a Notice of Fair Hearing. 2. DEFINITION OF REQUEST - A request for a hearing is any clear expression, oral or written, by the claimant or authorized representative t or her case to a higher authority. The claimant who orally requests a Fair Hearing will be asked to fill out the form on the Low Income Home Energ Program (LIHEAP) notification letter. The sub-grantee shall assist the household in preparing the written request, if necessary. TIME ALLOWED TO FILE - The claimant shall have reasonable time, not to exceed ninety (90) days, in which to request a hearing. REQUESTING A FAIR HEARING Prior to the steps below, the eligibility worker has sent a notification of fair hearing from the CHIMES system Claimant completes the "Energy Assistance Request for Fair Hearing" form. 1. Mails the request form to the Office of Administrative Hearings, Box 202922, Helena, MT 59620. 2. SCHEDULING AN ADMINISTRATIVE REVIEW The hearings officer will notify the subgrantee that an administrative review has been ordered. 1. Upon receipt of form DPHHS-LS-007, a time and place for the Administrative Review is set and the claimant is notified. 2. Notification includes: A statement indicating the purpose and scope of the Administrative Review, the effect the review has on the claimant's righ Hearing, and the claimant's right to representation. 3. Fair hearing: If the claimant is still dissatisfied after the administrative review, the hearings officer sets the time and place for the fair hearing the claimant. The decision written by the administrative law judge is technically a proposed decision rather than a final decision. The proposed decision b decision when neither party appeals it to the Board of Public Assistance. A proposed decision must be appealed within 15 days. This means a written request to appeal must be received by the Office of Fair hearing days after the proposed decision is mailed to the parties. The certification of service at the end of the decision shows the date it was mailed. The LIHEAP application contains language that notifies the applicant of the right to be informed of the fair hearing process. In taking a LIHEAP application a subgrantee must: Review and act on a submitted application within (45) days. Action includes approval, denial or sending a letter of missing information. 1. Request any additional information or documentation needed to determine the eligibility or benefit amount, or both. If an applicant fails information or documentation necessary for a determination of eligibility within 45 days of the date of the most recent request for additio information, the application must be denied, but the household may reapply for assistance. 2. Determine eligibility within forty-five (45) days of receipt of the completed application. 3. Notify applicants of determination of eligibility within forty-five (45) days of receipt of the completed application. Written notice of the d 4. is sent to applicants and recipients when assistance has been authorized, denied or terminated, using the Chimes LIHEAP system. The no letter of authorization states the action taken and the amount authorized. The notification letter of denial or termination states the specif denial or termination and the individual's right to request a fair hearing. Notification letters regarding approvals, denials and missing information are to be sent to each household. The notification letters w generated from the LIHEAP Chimes computer system. The notification letters contain language explaining the household's right to a fair h the time of any action affecting the recipient's benefits, the subgrantee notifies the applicant of their fair hearing rights. The subgrantee shall notify every household: of the eligibility determination of the LIHEAP application and 1. of the right to a fair hearing. 2. The Administrative Rules of Montana (ARM) address the fair hearing requirement. The following is an excerpt from the ARM. 37.70.311 PROCEDURES FOLLOWED IN PROCESSING APPLICATIONS (1) (A): An application is filed by the applicant togeth verification for determining financial eligibility and benefit award. After an application is filed, the local contractor may request an additio information or documentation needed to determine the eligibility or benefit amount, or both. If an applicant fails to provide information or documentation necessary for a determination of eligibility within 45 days of the date of the most recent request for additional information, application will be denied, but the household may reapply for assistance. TIME ALLOWED TO FILE - The claimant shall have a reasonable time, not to exceed ninety (90) days, in which to request a heari 12.5 When and how are applicants informed of these rights? An applicant or recipient is informed of the right to a fair hearing when there is an adverse action as defined in Administrative Rules of Montana 37.5.304 (1)(a)-(c). "Adverse action" means: a failure of the department to provide a claimant an opportunity to make application or reapplication for benefits; • a failure of the department to act with reasonable promptness on a claimant's application for benefits; and • an action by the department denying, suspending, and reducing or terminating benefits of a claimant, or an action by the department demanding repayment of or to recover an overpayment of benefits to a claimant. • Notification letters regarding receipt of application, approvals, denials, and missing information are sent to each household. The notification letters will be generated from the Low Income Home Energy Assistance Program (LIHEAP) Chimes System. The LIHEAP application and notification letters contain language explaining the household's right to a fair hearing. At the time of any action affecting the recipient's benefits, the subgrantee notifies the applicant of their fair hearing rights. The subgrantee shall notify every household: 1. of the eligibility determination of the LIHEAP application and of the right to a fair hearing. If any of the above questions require further explanation or clarification that could not be made in the fields provided, attach a document with said explanation here.