Current through Register Vol. 42, No. 11, August 30, 2024
(1)
Availability of hearings.
The Department shall provide a hearing procedure through which any individual
may appeal a state or local agency action that:
(a) Results in a claim against the individual
for repayment of the cash value of improperly issued benefits.
(b) Results in the individual's denial of
participation in the Alabama WIC Program
(c) Results in the individual's
disqualification from the Alabama WIC Program.
(2)
Informal resolution of adverse
action. The aggrieved individual should discuss his or her problem with
a staff member of the county health department, WIC clinic, area office, or
State WIC Program prior to requesting a formal hearing. Staff members at the
local clinic, area office, or State WIC Program may not limit or interfere with
a person's right to request an appeal hearing.
(3)
Notification of appeal
rights. At the time of a claim against an individual for improperly
issued benefits or at the time of participation denial or of disqualification
from the WIC Program, the Department shall inform the individual in writing of
the right to a fair hearing, of the method by which a hearing may be requested,
and that any positions or arguments on behalf of the individual may be
presented personally or by a representative such as a relative, friend, legal
counsel, or other spokesperson. This notification is not required at the
expiration of a certification period. Notification is required at:
(a) Time of Application, Income. When an
applicant's income exceeds the maximum allowed for the WIC Program, the
applicant must be informed of his ineligibility and how an appeal may be
requested using the WIC Notification Form, ADPH-WIC-119.
(b) Time of Application, Medical Assessment.
If after screening, the applicant does not meet the medical requirements for
participation in the WIC Program, the applicant must be informed of his
ineligibility and how an appeal may be requested using the WIC Notification
Form, ADPH-WIC-119.
(c) Termination
from the WIC Program. When terminating a participant from the WIC Program, the
participant must be informed of how to request an appeal. Use the WIC
Notification Form, ADPH-WIC-119, when removing a participant between
certification or a time of categorical ineligibility. Except for a participant
who will be disqualified for not picking up cash-value vouchers, supplemental
foods, or food instruments in accordance with
7 CFR §
246.7(h)(3)(i), the client
must receive 15 days advance notice of this adverse action.
(d) Suspension from the Program. Suspension
shall be done through formal written notification. Except for a participant who
will be disqualified for not picking up cash-value vouchers, supplemental
foods, or food instruments in accordance with
7 CFR §
246.7(h)(3)(i), the client
must receive 15 days advance notice of this adverse action.
(e) Denial of Participation. Use the WIC
Notification Form ADPH-WIC-119 at certification attempt to inform the applicant
why he or she is not being allowed to participate and how an appeal may be
requested.
(4)
Request for hearing. An individual may request an appeal hearing
by contacting any staff member in the county health department, WIC clinic,
area office, or the WIC director. A request may be made by any clear verbal or
written expression. If the request is made verbally, a staff member will assist
in reducing the request to writing so that a record is available. Written
appeal hearing requests must be sent to the following address: Alabama
Department of Public Health; Bureau of Family Health Services; Division of WIC;
The RSA Tower, Suite 1300; P.O. Box 303017; Montgomery, AL
36130-3017.
(5)
Time limit
for request. A request for a hearing must be made within 60 days from
the date of the receipt of the notification of the adverse action.
(6)
Acknowledgment of request.
The Division of WIC shall provide written acknowledgment of the receipt of the
request for an appeal hearing within ten days from the date the request is
received.
(7)
Notice of
hearing. The person requesting an appeal hearing must receive at least
ten days advance written notice of the time and place of the formal
hearing.
(8)
Scheduling the
hearing. The Department shall schedule a hearing within 21 calendar days
from the date the request is first received unless that time period is waived
by the aggrieved party. The place of the hearing must be accessible to the
appellant.
(9)
Hearing
decision. Within 45 days of the receipt of the request for the hearing,
unless this time period is waived by appellant, the Department shall notify the
appellant or his or her representative in writing of the decision and the
reasons for the decision.
(a) If the decision
is in favor of the appellant and benefits were denied or discontinued, benefits
must resume immediately.
(b) If the
decision concerns disqualification and is in favor of the Department, as soon
as administratively feasible, the continued benefits terminate, as decided by
the hearing official.
(c) If the
decision regarding repayment of benefits by the appellant is in favor of the
Department, the Department shall resume its efforts to collect the
claim.
(d) Time frames established
for issuing review decisions are only administrative requirements and do not
provide a basis for overturning the adverse action if a decision is not
rendered within the specified time period. The decision of the hearing official
is the final state agency action.
(10)
Denial or dismissal of
request. The State may deny or dismiss a request for a hearing if:
(a) The request is not received within the
time limit set by the Department.
(b) The appellant or a representative of the
appellant withdraws the request in writing.
(c) The appellant or representative fails,
without good cause, to appear at the scheduled hearing.
(d) The appellant has been denied
participation by a previous hearing and cannot provide evidence that
circumstances relevant to WIC Program eligibility have changed in such a way as
to justify a hearing.
(11) Continuation of benefits.
(a) Except for participants whose
certification period has expired, participants who appeal the termination of
benefits within the 15 days advance adverse notice period provided by
7 CFR §
246.7(j)(6) must continue to
receive WIC Program benefits until the hearing official reaches a decision or
the certification period expires, whichever occurs first.
(b) Applicants who are denied benefits at
initial certification or because of the expiration of their certification may
appeal the denial but may not receive benefits while awaiting the
hearing.
Authors: James M. Richard, Carolyn Battle,
Stacey Neumann
Statutory Authority:
Code of Ala.
1975, §§
22-2-2(6),
22-12c-2 and 3.
