.Purpose

Policy

Background

Release Date:

                 June 7, 2021

Definitions

Requirements

Verification Docs

APPEALS and STATE HEARINGS

ASH 001 – State Hearing Procedures

Purpose

(  ) To release a new policy

(  ) To release a new form

(X) To convert existing policy to new writing style only – No concept changes

(  ) Revision of existing policy and/or form(s).

Policy

The California State Department of Social Services (CDSS) State Hearings Division (SHD) schedules all State hearings and is responsible for conducting each State hearing and rendering a fair, impartial and independent State hearing decision.  A State hearing decision must be adopted and acted upon within 90 days from the filing date, as stated in Manual of Policy & Procedure (MPP) 22-060.  Once Los Angeles County receives a decision which favors the claimant, the County has 30 days to comply with the decision.

Background

The Appeals and State Hearings (ASH) section is responsible for reviewing the appropriateness of each hearing request and to determine if it can be resolved at the lowest possible level.  If the County’s action or inaction is incorrect, the Appeals Hearing Specialist (AHS) will attempt to negotiate a Conditional Withdrawal (CWD) with the claimant and the County will be bound by the agreement to make the correction within 30 days.  If the County action or inaction is correct, the AHS will attempt to negotiate a Straight Withdrawal (WD), wherein the claimant agrees and withdraws their request for a State hearing.  These agreed upon actions alleviate the need for a State hearing.

 

If the claimant wants to proceed with the State hearing, they have the right to do so.  The AHS will prepare a Statement of Position (SOP) which defines the issues for the State hearing, explains the County’s action(s) or inaction(s), and cites all applicable rules and regulations for the appropriate program(s).

 

Definitions

Term

Description

Adequate Notice of Action (NOA)

In accordance with the provisions outlined in the MPP section 22-001(a)(1), a written notice:

1.    Must be in the claimant’s designated preferred written language; otherwise, the County must offer and provide interpretive services in the claimant’s preferred language.  For NOAs not provided in the claimant’s primary language (see MPP section 21-115.2 for language compliant NOAs);

 

2.    Informs the claimant of the action the County intends to take;

 

3.    Provides the reason(s) for the intended action;

 

4.    Includes the specific regulations supporting such action;

 

5.    Informs the claimant’s right to request a State hearing.

 

An Adequate NOA must also:

 

1.    Provide adequate computations, if applicable;

 

2.    Note the effective date of the action;

 

3.    List availability of free legal representation; and

 

4.    Be properly addressed.

 

For the CalFresh program, see MPP section 63-504.2 for certain exceptions to the adequate notice requirements.

Reference:  ASH 004 Adequate and Timely Notices ePolicy for more detailed information.

Administrative Law Judge (ALJ)

 

A person designated by the CDSS and thereafter assigned by the Chief ALJ to conduct State hearings and Administrative Disqualification Hearings (ADH).

 

Aid Paid Pending (APP)

 

Aid paid to a claimant in the amount that they would have continued to receive if the proposed adverse action had not been taken by the County.

 

Note:  In the CalFresh program, benefits can never continue beyond the end of the certification period.  

 

Reference:  MPP section 63-804.642 (a), 22-072.65.

 

Appeals and State Hearings Tracking System (ATS)

System used by ASH and district/regional users to track and process all State hearing requests received by ASH.

Appeals Case Management System (ACMS)

 

Computer system used by the SHD to track all State hearing requests.  It is used by the County, State and the claimant to request, review, and update the State hearing status.

 

Authorized Representative (AR)

An individual or organization that has been authorized verbally and/or in writing by the claimant or designated by the ALJ to act for and represent the claimant in any and all aspects of the State hearing or the ADH.

 

Note:  Individuals who have been convicted of an Intentional Program Violation (IPV) of the CalFresh program are restricted from being designated as an AR, unless that individual meets the exception criteria found in the MPP section 63-402.633.

 

Reference:  ASH 003 Authorized Representative ePolicy for more detailed information.

 

Bifurcation

MPP 22-049.53

 

Prior to the hearing, a party may request in writing to the regional Presiding Administrative Law Judge (PALJ) that a hearing be limited to the jurisdictional issue.  A copy of the request shall be sent to the other party.  The PALJ shall make a preliminary determination and inform the parties that:

 

1.    The hearing shall proceed only on the jurisdictional issue; or

 

2.    If the bifurcation request is denied, the hearing shall proceed on both jurisdictional issues (which relate to the official power to make a legal decision/judgement) and substantive issues (which refers to the actual issue in dispute).

 

Claimant

 

A person who has requested a State hearing and is or has been either:

 

1.    An applicant for or recipient of aid;

 

2.    A foster parent or foster care provider who requests a hearing on behalf of the foster child whose aid was affected by a County action and who resides with, or has resided with the foster parent or foster care provider;

 

3.    A foster care provider, including group homes and foster family agencies, who request a hearing to challenge a County action to recover an overpayment;

 

4.    A representative of the estate of a deceased applicant or participant/recipient;

 

5.    The guardian or conservator of an applicant or recipient;

 

6.    The caretaker relative of a child with regard to the child’s application for or receipt of aid; or

 

7.    The sponsor of an alien.

Fair Hearing Liaison (FHL)

 

Staff located in district offices; Greater Avenues for Independence (GAIN) Regions/Contracted staff; Fiscal Operations Division; and In-Home Supportive Services (IHSS) Regional Offices.  FHLs work collaboratively with ASH to implement necessary corrective action(s) and issue APP timely and efficiently.

 

Jurisdiction

 

The request for a State hearing shall be filed within 90 days after the date of the action or inaction with which the claimant is dissatisfied.

 

Except as provided for in MPP section 45-306.3, if the claimant received an adequate and language compliant notice of the county action, the request for hearing shall be filed within 90 days after the notice was mailed or given to the claimant.  If adequate notice was required but a notice was not provided, or if the notice is not adequate and/or language-compliant, any hearing request (including an otherwise untimely hearing request) shall be deemed to be a timely hearing request.

 

In the CalFresh program, the time limits for State hearing requests are set forth in MPP sections 63-802.4 and 63-804.5.

 

A recipient shall have the right to request a State hearing to review the current amount of aid.  At the claimant’s request, such review shall extend back as many as 90 days from the date the request for the hearing is filed, and it shall include review of any benefits issued during the entire first month in the 90-day period.  This review shall only apply to facts that occurred during the review period.

 

Reference:  MPP section 22-009

 

Requirements

Language Services

 

Staff assigned to the ASH section is required to follow the policies and procedures outlined in this release, except as otherwise instructed by the District Director of the ASH section, or by a designated Deputy District Director (DDD).

 

Staff must take reasonable steps to ensure that claimants are provided effective services in their self-declared preferred language.

 

Staff must always document the Daily Activities on ATS with the claimant’s self-declared preferred language for both verbal and written communication.

 

Note:  If a claimant is able to communicate effectively in English, they must still be given the option to designate the language of preference for both verbal and written communication.

 

To ensure that claimants are provided with effective language services, the AHS must complete the following steps:

 

1.    Before contacting the claimant, identify the claimant’s preferred spoken and written language and prepare to assist the claimant in the preferred language;

 

2.    Be prepared to inform the claimant that free interpreter services can be provided;

 

3.    Use forms translated in the claimant’s preferred language or provide verbal translation of English forms if they are not available in the claimant’s preferred written language;

 

4.    If a form is not available in the claimant’s preferred language, provide the form in English, along with a Notice of Language Services form (GEN 1365); and

 

5.    Confirm the claimant’s spoken and written language preferences and inform the Case Carrying Worker (CCW) of any changes to the claimant’s language preferences.

 

If the claimant decides to use an interpreter provided by the County, the AHS must:

 

1.    Call the Language Services vendor: Language Line Solutions at 1-855-267-1141, and

 

2.    Provide the following information:

 

a.    ISD Language Services Cost Center Code;

 

b.    Employee Number; and

 

c.    Department Name.

 

If the preferred language of the claimant is American Sign Language (ASL), the ASH Civil Rights Liaison shall submit an “ASL Interpreter Services Request” form to the Civil Rights section at least three (3) workdays prior to the requested service appointment date.  Refer to Civil Rights Memo CRM 13-03 (December 9, 2013) for additional information.

 

If the claimant decides to use their own interpreter, staff must:

 

1.    Inform the claimant of the Department’s free interpretive services, offer free interpretive services, and advise that a free interpreter can be provided at any time;

 

2.    Inform the claimant of potential problems with using their own interpreter, such as: ineffective communication, conflict of interest, and inaccurate interpretation;

 

3.    Inform the claimant about the need to disclose private/confidential information to their interpreter;

 

4.    Obtain a written statement or utilize the Affidavit Form (PA 853); and

 

5.    Use an Interpreter Services Statement and Confidentiality Agreement (PA 6181) as needed.

 

Case Documentation:

 

1.    Document the Daily Activities on ATS to detail the steps taken above and include the claimant’s self-declared preferred written and spoken language;

 

2.    This includes claimants who designated English as their primary language for verbal and written communication;

 

3.    Update ATS accordingly if any changes to the claimant’s preferred spoken and/or written language have been made;

 

4.    Complete the Language Line Solutions log when Language Line Solution’s services were requested.

 

Please see the sample case documentation below:

 

“The claimant’s preferred spoken language is [insert language] and preferred written language is [insert language].  Offered free interpretive services; the claimant [insert accepted or declined] the services.  Language services provided by [insert Language Services Method].  [Include any other relevant information specific to the case].”

 

Reference: 40-103.03 - Application

Verification Documents

N/A