ASH 002 - Pre-Hearing Procedures

.Purpose

Policy

Background

Release Date:

July 26, 2021

Definitions

Requirements

Verification Docs

APPEALS and STATE HEARINGS

ASH 002 - Pre-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).

The purpose of this release is to provide a clear understanding of the responsibilities and performance expectations for staff assigned to the Appeals and State Hearings (ASH) section, who are required to follow the policies and procedures outlined in this release and ePolicy handbook.

Policy

The Appeals Hearing Specialist (AHS) determines the appropriateness of the County’s action when an applicant or participant requests a State hearing for a program administered by the State and under the jurisdiction of the California Department of Social Service’s (CDSS’) State Hearings Division (SHD). AHS have the authority to either instruct the district/regional/contracted offices to take corrective action or defend the County’s action at a State hearing, as needed.

Prior to the State hearing, the AHS is to provide the claimant/Authorized Representative (AR) with information regarding the Administrative Hearing Process, including the Statement of Position (SOP) which provides information regarding the action(s) taken by the County. This includes access to the case file as it pertains to the issue under appeal as well as copies of regulations and policies, at no charge to the claimant/AR.

In accordance with Manual of Policies and Procedures (MPP) section 22-073.2

prior to the hearing, the ASH representative shall:

1. Determine the issue(s) raised by the claimant/AR for the hearing request;

2. Review the applicable statutes, regulations, and policies considering the evidence which exists in the case record;

3. Make a determination concerning the appropriateness of the County action or inaction and the need for and advisability of a hearing;

4. Resolve any disagreements and misunderstandings quickly and at the lowest possible administrative level to avoid unnecessary hearings;

5. If the County action is correct, contact the claimant to inquire if they will attend the hearing and determine if there are any issues that will be raised at the hearing;

6. Advise SHD if an interpreter will be needed for the State hearing;

7. Prepare a written SOP to summarize the facts of the case and set forth the regulatory justification for the County’s action. The SOP must be made available to the claimant no later than two (2) workdays before the scheduled hearing; and

8. Determine if the presence of the Eligibility Worker (EW), Social Worker (SW), Contracted staff, or other County witnesses will be needed for the State hearing and send out the Request to Appear as a Witness (ASH 274) at least one (1) week before the scheduled State hearing.

Background

N/A

Definitions

Term	Description
Aid Paid Pending (APP)	When the claimant files a request for a State hearing prior to the effective date of the action, aid shall be continued to the claimant in the amount that they would have continued to receive if the proposed adverse action had not been taken by the County. Aid Paid Pending (APP) shall be released by the regular scheduled payment date or within five (5) working days from the filing (whichever is later) per MPP section 22-073.122. This does not apply to CalWORKs supportive services payments when timely Notice of Action (NOA) has been sent; however, child care services may continue when appropriate under section 47-420.32. For additional information, reference MPP 22-072.5 and MPP 22-073. Note: In the CalFresh program, APP must not exceed the recipient’s certification period. Reference: 7CFR 273.15(k)(2)(i), MPP sections 63-804.642(a), 22-072.65. In the CalWORKs program, APP must be repaid after the hearing, when the County action is upheld. Reference: MPP 22-001(a)(1). Also refer to the ASH 005 Aid Paid Pending ePolicy for more detailed information.
Appeals and State Hearings Tracking System (ATS)	System used by ASH to process, document, and upload verifications for all State hearing requests received by ASH.
Authorized Representative (AR)	An individual or organization that has been authorized verbally and/or in writing by the claimant or designated by the Administrative Law Judge (ALJ) to act for and represent the claimant in all aspects of the State hearing or Administrative Disqualification Hearing (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. Refer to the ASH 003 Authorized Representative ePolicy for more detailed information.
Bifurcation MPP 22-049.53	A prehearing written request to the Presiding ALJ to hold a hearing limited to only the jurisdictional issues. With this request, the County seeks a dismissal of the issue in dispute (substantive issue) because it is not within the jurisdiction of the State hearing process. It is a suitable request when the jurisdiction over the disputed claim is at least questionable, if not inexistent. See MPP 22-009. Any party can request bifurcation; however, they must notify the other party of the request being made. The Presiding ALJ in Los Angeles County or their designee will make a preliminary determination and inform both parties of whether the hearing will proceed on jurisdictional issues only (if bifurcation is granted) or, both, jurisdictional and substantive issues (if not granted).
Case Record Retention	In accordance with Welfare and Institutions Code (W&IC) section 10851(a): Each County shall establish and maintain a case record for each public social services case and shall retain the record for a period of three (3) years. The three-year retention period begins on the day in which public social services were last provided. The records shall be retained beyond the three-year retention period when the County is notified by CDSS or the Department of Health Care Services (DHCS), whichever has jurisdiction over the records, to retain records for a longer period of time. CDSS or DHCS, whichever has jurisdiction over the records, shall instruct a County to retain records beyond the three-year period when the retention is necessary to a pending civil or criminal action. For additional information on access to public assistance case records, reference MPP section 19-005.1. Note: All County Letter (ACL) 04-06 is a reminder of the legal requirements for records retention and the identification of certain records which require extended retention periods. MPP sections 23-353 through 23-356 set forth the requirements for certain records, which have retention periods that vary from the general rule. A complete list of records exempt from the three (3) year rule can be found in the same ACL.
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 receipt of aid; or 7. The sponsor of an alien.
Conditional Withdrawal (CWD)	An agreement reached between the County and the claimant/AR, whereby the County agrees to take specific corrective actions within 30 days from the date the agreement is signed by both parties, to resolve any issue(s) in dispute and the claimant/AR agrees to withdraw their hearing request. Refer to the ASH 006 Withdrawals ePolicy for more detailed information.
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) Region 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 a 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. Notwithstanding MPP section 22-009.11 and .12 above, the claimant may request a hearing after 90 days, but no more than 180 days (except as provided in MPP section 22-009.14), after the notice was mailed or given to the claimant if the claimant has good cause for the delay. Good cause means a substantial and compelling reason beyond the claimant’s control, considering the length of the delay, the diligence of the claimant, and the potential prejudice to the other party. The claimant’s inability to understand the adequate and language-compliant notice, in and of itself, shall not constitute good cause. Nothing in MPP section 22-009 shall preclude the application of the principles of equity jurisdiction as provided by law. 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 hearing is filed and shall include review of any benefits issued during the entire first month in the 90-day period.
Jurisdictional Issue	A State hearing on jurisdictional issues refers to the determination of the hearing filing as timely by an ALJ and therefore admissible or, as not timely and not admissible. It is conditioned by the CDSS regulations requiring the provision of adequate and timely notice of action (i.e., timely notice when it is required provided 10 days prior to the County action takes effect) and adequate notice, meaning language compliant, or containing the effective date, the reasons and supportive regulations for the proposed negative action, as provided on MPP sections 22-071.1 and .2.
Doctrine of Laches	An unreasonable delay in making a claim. In a State hearing, the party asserting the laches defense is an affirmative argument of the ALJ’s finding of jurisdiction based on a lack of due process and the inability to defend its action, because of the other party’s unreasonable delay in asserting its rights, which caused circumstances to change, and evidence to be lost or become irrelevant. In invoking the Doctrine of Laches, the County must show, by a preponderance of the evidence (see Note), that: 1. There was a delay in bringing the action by the claimant/AR; 2. The reason for the delay was unreasonable; and 3. The delay caused prejudice to the County which is asserting Laches. Note: Preponderance of evidence – Considering the evidence as a whole, the existence of the fact to be proven is more likely than not.
Straight Withdrawal (WD)	The claimant/AR cancels the hearing request because their issues are resolved (either the County’s action has been corrected or the action was originally correct) and the claimant/AR is satisfied with the County’s action. Upon confirmation from the State, the hearing request will be immediately dismissed. Refer to the ASH 006 Withdrawals ePolicy for more detailed information.

Requirements

N/A

Verification Documents

N/A