Current through Register Vol. 35, No. 18, September 24, 2024
A. The
children, youth and families department will follow the administrative appeal
process as described in 8.8.4 NMAC and as required in 7 CFR Part 226.6(k) and
for the following state actions:
(1)
application denial: denial of a new or renewing institution's application for
participation;
(2) denial of
sponsored facility application: denial of an application submitted by a
sponsoring organization on behalf of a facility;
(3) notice of proposed termination: proposed
termination of an institution's agreement (see 7 CFR Part 226.6(c)(2)(iii)(C),
Part 226.6(c)(3)(iii)(C), and Part 226.6(c)(5)(i)(B) dealing with proposed
termination of agreements with renewing institutions, participating
institutions, and participating institutions suspended for health or safety
violations);
(4) notice of proposed
disqualification of a responsible principal or responsible individual: proposed
disqualification of a responsible principal or responsible individual (see 7
CFR Part 226.6(c)(1)(iii)(C), Part 226.6(c)(2)(iii)(C), Part
226.6(c)(3)(iii)(C), and Part 226.6(c)(5)(i)(B) dealing with proposed
disqualification of responsible principals or responsible individuals in new,
renewing, and participating institutions, and participating institutions
suspended for health or safety violations;
(5) suspension of participation: suspension
of an institution's participation;
(6) start-up or expansion funds denial: a
denial of an institution's application for start up or expansion
payments;
(7) advance denial: a
denial of a request for an advance payment;
(8) recovery of advances: recovery of all or
part of an advance in excess of the claim for the applicable period; the
recovery may be through a demand for full repayment or an adjustment of
subsequent payments;
(9) claim
denial: a denial of all or part of a claim for reimbursement, except for late
submission as stated in
7 CFR
226.10(e);
(10) claim deadline exceptions and requests
for upward adjustments to a claim: decision by CYFD not to forward to FNS an
exception request by an institution for payment of a late claim, or a request
for an upward adjustment to a claim;
(11) overpayment demand: a demand for the
remittance of an overpayment, or any other action affecting the participation
of an institution in the program or the institution's claim for
reimbursement;
(12) other actions:
any other CYFD action affecting an institution's participation or its claim for
reimbursement.
B. The
administrative review process procedures are made available in writing each
year to all institutions at the time of application for participation in the
program and when CYFD takes any action which requires an administrative review
as set forth herein.
C. Appellants
shall receive adequate notice of the administrative review date and of the
right to be represented by legal counsel.
D. Decisions are rendered within sixty days
of the administrative review.
E.
The determination by the state administrative review official is the final
administrative determination afforded to the appellant.
F. Actions not subject to administrative
review include FNS decisions on claim deadline exceptions and requests for
upward adjustments to a claim, and other situations as per
7 CFR
226.6(k)(3)
(ii-iv).
