New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 46D - CONTRIBUTION TO CARE AND MAINTENANCE REQUIREMENTS
Subchapter 6 - APPEALS PROCESS
Section 10:46D-6.1 - Appeals

Universal Citation: NJ Admin Code 10:46D-6.1

Current through Register Vol. 56, No. 6, March 18, 2024

(a) A request for an adjustment shall not be considered to be an appeal. No adjustment other than those permitted in 10:46D-3.1(g) shall be permitted. Such requests shall be directed to the interdisciplinary team.

(b) Any change to unearned income or income from wages shall not be a basis for an appeal. Changes to income shall be addressed according to 10:46D-2.2(h).

(c) Annual increases to Social Security benefits shall not be the basis for an appeal. Such increases will be addressed at the time of the annual assessment.

(d) Any request for an appeal shall be made within 60 days from the date of the letter notifying the individual, legal guardian, or the LRR of the calculated amount, in accordance with the procedure set forth below:

1. The request for an appeal shall clearly identify the individual receiving services, the provider agency or developmental center where the individual resides and the specific issue under appeal. The appeal shall specify all material facts that the individual, legal guardian or LRR(s) or his or her attorney disputes.

2. Requests for an appeal shall also set forth all issues that the individual, legal guardian, or LRR(s) is raising on appeal and shall present all arguments on those issues that the individual, legal guardian, or LRR(s) wishes the Division to consider. The individual, legal guardian, or LRR(s) shall explain in detail why they disagree with the calculated amount.
i. If the individual is receiving residential services, he or she or the LRR(s) shall be responsible to begin to pay the assessed amount unless otherwise agreed to by the Division.

ii. The request for an appeal shall be sent to:

Administrative Practice Officer

Division of Developmental Disabilities

PO Box 726

Trenton, NJ 08625-0726

3. All termination proceedings shall be suspended during the pendency of the appeal process.

(e) The Division shall acknowledge receipt of the appeal within 60 days of receipt.

(f) Where an appeal request appears to set forth disputed material facts, the Assistant Commissioner or designee shall request an informal meeting to administratively resolve this matter. The Assistant Commissioner shall appoint a designee to meet with the appellant. If the matter cannot be resolved, the Assistant Commissioner or designee shall transmit this matter to the Office of Administrative Law (OAL) for a hearing in accordance with the Administrative Procedure Act, 52:14B-1 et seq., and the Uniform Administrative Procedure Rules, N.J.A.C. 1:1.

(g) The Division shall transmit this matter to the OAL within 60 days of the informal meeting.

(h) In the event an individual, legal guardian or LRR(s) fails to attend an informal conference wherein an adjournment has not been granted, the Division shall determine that the individual, legal guardian or LRR(s) has abandoned the request for a hearing and shall issue a final decision.

(i) Where there are no disputed material facts and an appeal sets forth one or more disputed legal issue(s) and presents arguments on these issues, the Assistant Commissioner may consider those legal issues and arguments in a paper review of the written record. There shall be no discovery, but the individual, legal guardian, or LRR(s) shall have the opportunity to submit written arguments. The Assistant Commissioner shall consider these arguments, if any, the materials presented at the pre-transmittal conference, if any, and all prior documents regarding the determination of fees. The Assistant Commissioner shall render a written determination that shall constitute the final agency decision in the matter.

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