N.H. Admin. Code § He-M 524.25

Current through Register No. 45, November 7, 2024

Section He-M 524.25 - Appeals

(a) An individual or representative may choose to pursue informal resolution to resolve any disagreement with an area agency, or, within 30 business days of the area agency decision, she or he may choose to file a formal appeal pursuant to (e) below. Any determination, action, or inaction by an area agency may be appealed by an individual or representative.

(b) The following actions shall be subject to the notification requirements of (c) below:

(1) Adverse eligibility actions under He-M 524.03;

(2) Area agency disapproval of service agreements or proposed amendments to service agreements pursuant to He-M 524.20(b); and

(3) Denial of services by the bureau pursuant to He-M 524.26(c).

(c) The bureau or an area agency shall provide written and verbal notice to the applicant and representative of the actions specified in (b) above, including:

(1) The specific rules that support, or the federal or state law that requires, the action;

(2) Notice of the individual's right to appeal in accordance with He-C 200 within 30 days and the process for filing an appeal, including the contact information to initiate the appeal with the bureau administrator;

(3) Notice of the individual's continued right to services pending appeal, when applicable, pursuant to (g) below;

(4) Notice of the right to have representation with an appeal by:

a. Legal counsel;

b. A relative;

c. A friend; or

d. Another spokesperson;

(5) Notice that neither the area agency nor the bureau is responsible for the cost of representation;

(6) Notice of organizations with their addresses and phone numbers that might be available to provide legal assistance and advocacy, including the Disabilities Rights Center and pro bono or reduced fee assistance; and

(7) Notice of individual's right to request a second formal risk assessment from a qualified evaluator.

(d) Appeals shall be submitted, in writing, to the bureau administrator in care of the department's office of client and legal services within 30 days following the date of the notification of an area agency's decision. An exception shall be that appeals may be filed verbally if the individual is unable to convey the appeal in writing.

(e) The office of client and legal services shall immediately forward the appeal to the department's administrative appeals unit which shall assign a presiding officer to conduct a hearing, as provided in He-C 200. The burden shall be as provided by He-C 203.14.

(g) If a hearing is requested, the following actions shall occur:

(1) For current recipients, services and payments shall be continued as a consequence of an appeal for a hearing until a decision has been made; and

(2) If the bureau's or area agency's decision is upheld, benefits shall cease 60 days from the date of the denial letter or 30 days from the hearing decision, whichever is later.

N.H. Admin. Code § He-M 524.25

Derived from Volume XLII Number 28, Filed July 14, 2022, Proposed by #13397, Effective 6/18/2022, Expires 6/18/2032 (formerly He-M 524.13)