Section 150-105-7 - APPEALS PROCESSAn applicant for or recipient of the Program who is dissatisfied with any determination made by Program staff concerning the furnishing or denial of services may request (or if appropriate, may request through the individual's representative) a timely review of the determination. The Program shall make reasonable accommodation to the individual's disability in the conduct of the appeals process. Written notification of appeal rights shall be provided to individuals at application, when a plan is developed, and whenever services are reduced, suspended, or terminated. Notification shall include the name and address of the person with whom an appeal may be filed and the availability of the Client Assistance Program. Mediation and/or due process hearings are provided at no cost to the individual, but costs related to legal representation are not provided by DBVI.
1. Informal Review Whenever possible, DBVI will attempt to resolve conflicts informally prior to mediation or a due process hearing. An individual may request a meeting with the counselor, the appropriate supervisor, and/or a Client Assistance Program representative, if desired, to explore options for resolving any conflicts. An individual may request mediation or a due process hearing immediately without having to go through the informal process.
2. Continuation of Services Pending Completion of the Appeals Process Pending completion of the appeals process, DBVI may not suspend, reduce, or terminate services being provided under a Service Plan, unless the services were obtained through misrepresentation, fraud or collusion or the individual or individual's representative requests or agrees to, suspension, reduction or termination of services.
3. Mediation A. Mediation is a voluntary process conducted by a qualified and impartial mediator.B. An individual must request mediation within thirty (30) calendar days of the agency notice regarding the provision or denial of services that are in question. The request shall be in writing and shall describe the basis for the grievance. The request should be sent to the Director of DBVI who will immediately forward it to the Department of Labor, Division of Administrative Hearings.C. The Division of Administrative Hearings will schedule a mediation within fifteen (15) days of receipt of request. The mediation will be held at a location that is convenient to the parties to the dispute.D. Mediation shall be conducted in accordance with the Court Alternative Dispute Resolution Service's (CADRES) standards on ethics and neutrality. At any point during the mediation process, either party or the mediator may elect to terminate the mediation.E. Any agreement reached in the mediation process shall be set forth in a written mediation agreement and shall be signed by both parties.F. Discussions that occur during the mediation process shall be confidential and may not be used as evidence in any subsequent due process hearing or civil proceeding in accordance with CADRES confidentially standards.G. The individual may be represented at the mediation, including but not limited to representation by the Client Assistance Program. DBVI is not obligated to cover the cost of applicant's legal representative.H. The mediation process may not be used to deny or delay the individual's right to pursue resolution of the dispute through a due process hearing within the specified time period. 4. Due Process Hearing A. A due process hearing is a proceeding whereby an individual who is dissatisfied with any determination concerning the provision or denial of services may seek a review of agency action before a hearing officer.B. The individual must request a due process hearing within thirty (30) calendar days of the agency notice regarding the provision or denial of service if mediation is not requested.C. If no request for due process hearing is made within thirty (30) calendar days, the Agency decision becomes final.D. The request for due process hearing shall be in writing and shall describe the basis for the grievance. DBVI will accommodate an individual's disability and offer assistance, if appropriate, in this process. The request should be sent to the Director of DBVI who will immediately forward the request to the Department of Labor, Division of Administrative Hearings.E. A pre-hearing conference shall be held to clarify issues and explore options for resolving grievances.F. The due process hearing shall be conducted within sixty (60) calendar days of the receipt of the request for a due process hearing.G. A due process hearing shall be conducted by an impartial hearing officer from the pool of qualified persons identified jointly by the Director of DBVI and the State Rehabilitation Council of DBVI.H. The DBVI program may not deny or dismiss a request for due process hearing unless the individual or his/her representative:(1) withdraws the request in writing; or(2) is adjudged by the hearing officer to be in default for failure to appear at the hearing without good cause.I. The due process hearing shall be conducted and will include an opportunity for the individual or the individual's representative to present witnesses and relevant evidence. A decision shall be issued in accordance with Maine Administrative Procedure Act.J. The hearing officer shall issue a written decision containing the findings and grounds for the decision within thirty (30) days of the completion of the hearing.K. The hearing officer's decision becomes final unless one of the parties requests a Judicial Review.5. Judicial Review Any party who disagrees with the decision resulting from due process hearing has the right to file a petition in Superior Court under Rule 80C of the Maine Rules of Civil Procedure.
12-150 C.M.R. ch. 105, § 7