Section 152-7-3 - ILS PROGRAM APPEALS PROCESSAn applicant for or recipient of the IL Services who is dissatisfied with any determination made by an ILS Program staff concerning the furnishing or denial of services may request (or, if appropriate, may request through the individual's duly authorized representative) a timely review of the determination. ILS Program services shall make reasonable accommodation as required in the conduct of the appeals process.
1. Whenever possible, ILS Program staff shall 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 a Client Assistant Program (CAP) representative, if desired, to explore options for resolving any conflicts.2. Continuation of Services Pending Completion of the Hearing Pending a final determination of an appeal hearing, the ILS Program may not suspend, reduce, or terminate services being provided under an Independent Living Plan (ILP), unless the services were obtained through misrepresentation, fraud or collusion of the individual or duly authorized representative, or the individual or duly authorized representative requests suspension, reduction, or termination of services.
3. Time Frames The time frames listed under Section 3.3 M ediation and 3.4 Due Process Hearing may be waived if both parties agree to an extension of time in order to conduct the Mediation or Hearing or to render a decision.
4. Mediation A. The Department of Labor Mediation process is an option to resolve conflicts when a resolution is not possible informally. Mediation is voluntary for both parties and either party may withdraw at any time. The goal of the mediation is to help the parties reach a mutually satisfactory resolution of their dispute.B. An individual must request Mediation within thirty (30) calendar days of the ILS Program notice regarding the provision or denial of services that are in question. The request shall be in writing and the request shall describe the complaint. The request should be sent to the Director of DVR who will immediately forward it to the Department of Labor, Division of Administrative Hearings.C. The Division of Administrative Hearings will commence a mediation meeting within fifteen (15) calendar days of receipt of the request and shall be held in a location that is convenient to the parties in the dispute.D. Mediation will be conducted in accordance with the Court Alternative Dispute Resolution Service's (CADRES) standards on ethics and neutrality.E. An agreement reached in the mediation process shall be set forth in a written mediation agreement and shall be included in the case record.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 confidentiality standards.G. The individual may be represented at the mediation. Representation may include but is not limited to, representation by the Client Assistance Program.5. Due Process Hearing A. A Due Process Hearing is a procedure whereby an individual who is dissatisfied with any determination concerning the provision or denial of ILS Program services may seek a re-determination of ILS Program action before an impartial hearing officer.B. The individual must request a Due Process Hearing within thirty (30) calendar days of the ILS Program notice regarding the provision or denial of service if Mediation was not requested.C. If no request for Due Process Hearing is made within thirty (30) calendar days, the ILS Program decision is considered final.D. The request for Due Process Hearing shall be in writing and shall describe the complaint. The ILS Program will accommodate an individual's disability and offer assistance in this process. The request should be sent to the Director of DVR who will immediately forward the request to the Department of Labor, Division of Administrative Hearings.E. A pre-hearing conference will be held to clarify issues and explore options for resolving the dispute.F. The Due Process Hearing shall be conducted within sixty (60) calendar days of receipt of the request for Due Process Hearing.G. A Due Process Hearing shall be conducted by an impartial hearing officer assigned on a random basis, from the pool of qualified persons identified jointly by the Director of DVR and the State Rehabilitation Council.H. The ILS Program and DVR 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 Due Process 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's Administrative Procedure Act, 5 M.R.S.A., Chapter 375, subchapter IV. J. The Due Process Hearing Officer shall issue a full written report of the findings and grounds for the decision within thirty (30) days of the completion of the hearing.K. The Hearing Officer's decision is final unless either party brings a civil action.5. Civil Action Any party who disagrees with the final decision of the Due Process Hearing has the right to file a petition in Superior Court under Rule 80C of the Maine Rules of Civil Procedure.
12- 152 C.M.R. ch. 7, § 3