With the statewide effort to maintain accuracy and timeliness levels with less staff by centralizing and sharing work across county lines, some regular caseload responsibilities, such as writing hearing summaries and representing DHS at fair hearings need adjustment. This memo is provided to inform you of hearing responsibilities and procedure changes approved by AFS leadership effective upon receipt of this memo.
The worker who took the action being appealed is responsible for:
- preparing Form 13MP002E, Hearing Summary, per instructions on the form;
- providing a copy of the hearing summary to the Legal Services Appeals Unit and the client or authorized representative no later than the fifth business day before the hearing;
- representing DHS at the hearing.
The current worker of record is responsible for preparing and providing the hearing summary to the Appeals Unit and the client or authorized representative as well as representing DHS at the hearing when:
- the worker who took the action being appealed has left AFS;
- the appeal is based on an overpayment decision by AFS Benefit Integrity and Recovery (BIR) staff; or
- the appeal is based on an Office of the Inspector General (OIG) decision.
The responsible worker’s supervisor is responsible for:
- reviewing the prepared hearing summary for completeness and pertinence to the point(s) at issue before the worker provides it to the Appeals Unit and the client;
- attending the hearing with the worker by phone or in the office. This experience can be utilized as a Gemba observation and/or coaching opportunity and a way to reacquaint the supervisor with what is expected and occurs at a hearing.
County Director responsibilities
The Appeals Unit will send all hearing notices to the County Director of the current office of record instead of the worker and supervisor of record. When the County Director or his or her designee receives a hearing notice, they are responsible for:
- determining which worker is responsible for the hearing;
- getting the information to the appropriate worker within two business days via imaging and email. If this does not occur within two business days and the responsible worker works in a different office, the worker of record is responsible for completing the hearing summary and representing DHS at the hearing;
- reserving a room for the hearing;
- notifying the hearing officer when the client and/or other parties are present;
- establishing the conference call connection; and
- arranging for someone to be available for technical difficulties, giving the parties paperwork, and helping with anything else needed.
The LIHEAP Unit Program Field Representative (PFR) is responsible for the LIHEAP hearing requests. This includes preparing and sending a copy of the 13MP002E (H-1-A) hearing summary and supporting documents to the Appeals Unit and the client as well as representing DHS at the hearing.
When the county staff receives a LIHEAP hearing request send an email to the LIHEAP2 mailbox with the following client information:
- Case number
- Email address
- Telephone number
- LIHEAP decision the client wants to appeal
All communication with the client will be verbal and/or electronic (email).
Upon confirmation, email or verbal, of the request for a hearing the PFR will notify the Appeals Unit. Once the hearing date is set by the Appeals Unit the PFR will complete the hearing summary and represent DHS at the hearing.
Note: If the hearing is OIG or BIR related and no documentation is in the case, contact the appropriate unit for documentation to support the action taken.
If you have questions regarding any of these procedures, please contact your local administrator or regional director.
Long Term Care hearings are handled the same way as any other hearing would be handled with the exception that hearings on the medical determination for ADvantage are handled by OHCA. DHS handles the financial determination hearings for ADvantage.
The worker will send the “Request for a Hearing” (13MP001E) to the client/responsible party for completion. Once that is received back the worker will forward it to Appeals Unit. Refer to article Fair Hearings: How Do I Submit a Hearing Notice?
At that time, the worker should begin working on the “Hearing Summary” (13MP002E)
The worker (and client) will receive acknowledgement from the Appeals Unit that the Request has been received. Shortly after, the worker and client will receive a date/time notice for the hearing. The worker will need to have the Hearing Summary with all pertinent documentation ready. A copy will be kept by the worker, a copy send to the Appeals Unit, and a copy sent to the client. It is a good idea to certify mail to make sure it is received.