Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) Any person who has applied for benefits
and/or services provided under a grant award from a contractor or a
subcontractor whose application has been denied or not acted upon within
fifteen (15) working days or has not received satisfactory performance
according to the agreed upon program requirements of the contract has the right
to first appeal such action to the contractor and, if not satisfied,
subsequently appeal to DEO. For purposes of this section, DEO shall consider
that there has been a denial of assistance when the following exists and a
client has been refused service:
(1) The
benefits, services and/or funds are currently available; and
(2) The contractor has the authority to
provide or disburse such benefits, services and/or funds; and
(3) The applicant meets or believes that
he/she can prove that he/she meets program eligibility criteria; and
(4) The applicant meets the conditions of the
approved priority service plan.
(b) A written appeals process shall be
established by each contractor and shall be provided to all applicants who are
denied assistance.
(1) Procedures for the
review of partial or complete denial of assistance to any person or household
shall include the following:
(A) Provisions
for notifying the applicant in writing of the reasons for denial of assistance
and advising the applicant that he/she may request a review of the denial and
may submit additional information (in writing or orally) which the applicant
believes would warrant a favorable determination.
(B) Provisions for reviewing the denial of an
application for assistance in an expeditious manner if such is requested by the
applicant. This shall include the specific assignment of responsibility to a
senior level official or standing committee other than the person making the
initial determination.
(C)
Provisions for notifying the applicant of the contractor's final
decision.
(D) The methods the
contractor will employ to notify applicant of the existence of the appeals
process.
(E) Provisions for
ensuring that every effort will be made to provide persons who do not
comprehend English with written materials and/or procedures in the appropriate
language(s).
(F) Provisions for the
retention of documents relating to specific denials of assistance and action(s)
taken by the contractor. Such records must be maintained in the contractor's
files for three years and shall be available for review by DEO officials upon
request.
(G) Provisions to inform
applicants that an appeal to DEO may be requested as part of the fair hearing
process and provisions for providing a description to the applicant of the
process and criteria for appeal to DEO as outlined in subsections (c) and (d)
of this section.
(2) A
written description of the aforementioned required procedures shall be
maintained on file by the contractor and shall be available for public
inspection.
(c) Should
the applicant decide to appeal to DEO, the applicant shall submit a written
appeal request to DEO within ten (10) working days from the date of the
contractor's final decision. Upon request from DEO, the contractor shall
provide all supportive documentation to DEO, postmarked within ten (10) working
days of the request.
(d) DEO shall
provide an opportunity for an administrative fair hearing if an applicant's
concern is not resolved by appeal to the contractor. Within five (5) working
days, upon receipt of a request for a fair hearing, DEO shall schedule a fair
hearing to be conducted no later than fifteen (15) working days from receipt of
a request for a fair hearing. The fair hearing shall be conducted in accordance
with the following criteria:
(1) The hearing
shall be held in a place reasonably convenient to the applicant and open to the
public.
(2) The applicant shall
receive notification of the hearing no less than five (5) working days before
the scheduled hearing, to enable a proper preparation of the applicant's
appeal.
(3) The applicant shall
have an opportunity to review his/her claim file, which contains all the
evidence to be presented, prior to the hearing.
(4) The hearing officer shall be an impartial
adjudicator who has not participated in the decision being appealed.
(5) The applicant is guaranteed the right to:
(A) Have a representative at the
hearing;
(B) Present evidence,
including oral and/or written statements on his/her behalf;
(C) Present witnesses; and
(D) Cross-examine
witnesses.
(6) The
applicant shall be given the opportunity to elect to have the matter determined
through use of a declaration in lieu of personal appearance.
(7) The hearing officer shall issue a final
decision, in writing, within thirty (30) calendar days following the conclusion
of the fair hearing.
1. New section
filed 5-8-92; operative 6-8-92 (Register 92, No.
20).
Note: Authority cited: Section 16367.6(b), Government Code.
Reference: Section 16367.55(b), Government
Code.
