Illinois Administrative Code
Title 59 - MENTAL HEALTH
Part 120 - MEDICAID HOME AND COMMUNITY-BASED SERVICES WAIVER PROGRAM FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES
Subpart C - INDIVIDUAL RIGHTS AND RESPONSIBILITIES
Section 120.110 - Appeals and fair hearings
Current through Register Vol. 48, No. 12, March 22, 2024
For appeals initiated by an individual concerning services, the following procedures apply:
a) The individual, parents, or guardian or the individual's representative may appeal the following actions:
b) The appeal shall be filed with, and received by, the Department's Hearing and Appeals Unit, 401 Stratton Building, Springfield IL 62765 within 10 working days after the date the individual or guardian receives the notice of action following the agency grievance process.
c) Within 30 working days after the notice of appeal is received, the Department shall conduct an informal review of the appealed action and reverse, modify or leave unchanged the decision. The appellant, the appellant's representative (if any) and the service providers shall be notified in writing of the Department's action within 10 working days after the informal review. The written notification shall include:
d) The appeal shall be filed with, and received by, the DPA Assistance Hearings Section, 624 South Michigan Avenue, Chicago IL 60605-1906 within 10 working days after the date the individual or guardian receives the written notification from the Department.
e) The hearing shall be conducted by an impartial hearing officer appointed by the Department of Public Aid (DPA).
f) The hearing shall be held at the DPA office nearest the appellant's home, unless the appellant, the Department's Hearing and Appeals Unit, and the DPA Assistance Hearings Section agree to hold it elsewhere.
g) DPA's hearing rules for assistance appeals, as set forth at 89 Ill. Adm. Code 104, shall apply, except that subsection (c) of this Section shall apply rather than any similar DPA rule.
h) Following the hearing, the Director of the Department of Public Aid shall issue a final administrative decision in accordance with DPA's rule at 89 Ill. Adm. Code 104.70. Copies of the decision shall be mailed to the appellant, the appellant's representative (if any), the service provider, and the Supervisor of the Department's Hearing and Appeals Unit.
i) The receipt of the request for an appeal shall stay the decision pending the final administrative decision or the withdrawal of the appeal. If the decision being appealed is suspension, termination or reduction of services, services shall not be suspended, terminated or reduced until the appeal is resolved, except as described below.