Current through Register Vol. 54, No. 12, March 23, 2024
(a)
Reconsideration by Division.
(1) An applicant, client or authorized
representative may file with the Division a request for it to reconsider any of
the following decisions made by the Division:
(i) An applicant is not eligible for an
assessment.
(ii) An assessed
applicant is not eligible for enrollment.
(iii) A disapproval or revision of a
rehabilitation service plan.
(iv) A
client is to be discharged from HIP prior to the date specified in the client's
rehabilitation service plan.
(v)
Alternative financial resources are available so that the client must pay for
HIP services.
(2) At the
time a decision is made, the Division will notify the applicant, client or
authorized representative in writing of the right to seek administrative
review. The letter will advise the recipient to seek assistance from legal
counsel, family and others who may serve in an advisory role, and include
contact information for a HIP representative to answer questions.
(3) An applicant, client or authorized
representative shall file a request for reconsideration within 15 calendar days
after the mailing date of the Division's determination. The request shall meet
the following standards:
(i) State the
specific legal and factual reasons for disagreement with the
decision.
(ii) Identify the relief
that is being sought for the applicant or client.
(iii) Include supporting documentation, if
any, to support the factual averments made.
(4) The Division will notify the applicant,
client or authorized representative in writing of its decision within 30 days
after receiving the request for reconsideration.
(b)
Administrative appeal.
(1) An applicant, client or authorized
representative may file an administrative appeal to the Agency Head within 30
days after the mailing date of the Division's decision on the request for
reconsideration. An applicant, client, or authorized representative may not
file an administrative appeal unless reconsideration has been sought and the
requested relief has been denied.
(2) A hearing will be held only if a material
issue of fact is in dispute.
(c)
General rules. The
General Rules of Administrative Practice and Procedure, 1 Pa. Code Part II,
apply except when inconsistent with this section.
(d)
Status of clients and
applicants. A client shall continue to receive HIP services until the
client's right to administrative review has been exhausted, and until the
maximum funds available to a client under §
4.12 (relating to funding limits)
are exhausted, or the maximum duration for enrollment under §
4.7(e) (relating
to enrollment) has expired. An applicant, including one who has completed the
assessment period, will not receive HIP services pending the disposition of the
administrative review.
