Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) Any person determined to be ineligible to receive benefits may appeal such determination as provided by this section.
(b) To be considered, an appeal:
(1) must be submitted in writing to the entity (department, sponsor, or local government) that performed the eligibility verification;
(2) must be either hand delivered or postmarked within 10 calendar days from the date of the written determination of ineligibility; and
(3) must state the reason(s) the person believes the determination was in error.
(c) In the case of a sponsor that has an appeal or grievance procedure that has been approved by the department as part of the sponsor's management plan, the sponsor may use that procedure to process eligibility appeals, or it may use the procedure set forth in subsection (d) of this section.
(d) The Department and sponsors that do not have a department-approved appeal or grievance procedure shall follow the grievance procedures as follows:
(1) Upon receipt of an appeal, the verifying entity shall conduct an administrative review of the decision being appealed, including all documentary information submitted by the appellant in support of his or her appeal. Within 15 calendar days of receipt of an appeal, the administrative review shall be completed and the appellant notified in writing either that the appellant has been found eligible to receive benefits, or that the appellant has been found ineligible to receive benefits and the date, time and location at which an informal hearing will take place. The informal hearing may be by telephone or in person, in which case the hearing will be held in the general geographic area where the benefit would have been conferred.
(2) In the case of the Department, the manager of the affected program shall appoint a person other than the person who performed the initial verification to serve as an Informal Review Officer.
(3) In the case of a sponsor, the sponsor shall designate an employee of the sponsor other than the employee who performed the initial verification to serve as an Informal Review Officer. The program providing the benefit applied for may but is not required to be represented at the informal hearing.
(4) The Informal Review Officer may determine the relevance of the information or testimony, may limit the length of presentations, and may eject threatening or abusive persons from the informal hearing. The Informal Review Officer may request additional evidence, proof, or documentation from the appellant at the time of the informal hearing, or thereafter, and shall set a time after which no additional information will be accepted.
(5) The authority of the Informal Review Officer shall be limited to determinations of eligibility pursuant to this subchapter and he or she shall have no authority to overrule any decision or conclusion of the INS. Pending the Informal Review Officer's decision, any discretionary action in regards to eligibility for public benefits shall be stayed. If, during the appeal process, the appellant is found to be ineligible to receive benefits under the program applied under for reasons other than those set forth in this subchapter, the appeal shall be dismissed.
(6) The Informal Review Officer shall render a decision in writing within 15 calendar working days after the informal hearing and this will be a final administrative decision.
(7) The informal hearing shall be recorded, but only transcribed where the verifying entity deems it necessary. Tapes shall be maintained for one year after a decision is reached.
1. New section filed 9-9-98; operative 9-9-98 pursuant to Government Code section 11343.4(d) (Register 98, No. 37).
Note: Authority cited: Sections 50402, 50406, 50406(h) and (n), 50662, 50668.5(g), 50697(d), 50710, 50771.1, 50786(a), 50801.5, 50806.5, 50884, 50895 and 50896.3(b), Health and Safety Code; and 24 CFR 570.489(b). Reference: (Pub. L. 104-193 (PRAWORA)); and 8 U.S.C. §§
1621, 1622, 1641 and 1642.
