New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-M - Former Division of Mental Health and Developmental Services
Chapter He-M 500 - DEVELOPMENTAL SERVICES
Part He-M 522 - ELIGIBILITY DETERMINATION AND SERVICE PLANNING FOR INDIVIDUALS WITH AN ACQUIRED BRAIN DISORDER
Section He-M 522.19 - Challenges and Appeals

Universal Citation: NH Admin Rules He-M 522.19

Current through Register No. 40, October 3, 2024

(a) An individual or guardian 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. Any determination, action, or inaction by an area agency may be appealed by an individual or guardian.

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

(1) Adverse eligibility actions under He-M 522.05(g) , He-M 522.06(b) , and He-M 522.07(b) ;

(2) Area agency determinations regarding an individual's or guardian's selection of provider under He-M 522.09(f) or removal of provider under He-M 522.09(g) and (h) ;

(3) Area agency determinations regarding the removal of an individual or guardian's selected service coordinator under He-M 522.10(e) (2) and (3) ; or

(4) A determination to terminate services under He-M 522.17(f) .

(c) An area agency shall provide written and verbal notice to the applicant and guardian of the actions specified in (b) above, including:

(1) The specific facts and 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 business 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 (f) 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; and

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

(d) Appeals shall be forwarded, in writing, to the bureau administrator in care of the department's office of client and legal services. An exception shall be that appeals may be filed verbally if the individual is unable to convey the appeal in writing.

(e) The bureau administrator shall immediately forward the appeal to the department's administrative appeals unit which shall assign a presiding officer to conduct a hearing or independent review, as provided in He-C 200. The burden shall be as provided by He-C 203.14.

(f) 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 decision is upheld:
a. Benefits shall cease 60 days from the date of the denial letter or 30 days from the hearing decision, whichever is later; or

b. In the instance of termination of services, services shall cease one year after the initial decision to terminate services or 30 days from the hearing decision, whichever is later.

#9734, eff 6-25-10 (from He-M 522.15)

The amended version of this section by New Hampshire Register Volume 38, Number 50, eff. 11/30/2018 is not yet available.

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