107 CMR 11.13 - Review of Agency Decision
(1) An
individual, or authorized representative, may request a review of the following
agency decisions:
(a) Case closure under
107
CMR 11.12;
(b) A determination of ineligibility under
107
CMR 11.05; or
(c) A reduction or termination of services
under
107
CMR 11.07.
(2) Upon receiving a request for review, the
matter will be submitted for administrative review in accordance with the terms
set forth in
107
CMR 11.14. If the issues under administrative
review are not resolved by the informal review, the individual may request a
fair hearing, in accordance with the requirements of
107
CMR 11.15.
(3) Unless the parties agree otherwise, the
HCAP services which are the subject of the administrative review , or appeal
under
107
CMR 11.15, shall not be suspended, reduced or
terminated until the resolution of the appeal unless doing so would pose a risk
to the physical safety of the individual, Commission staff, or a home care
worker.
(4) Notwithstanding the
provisions of
107
CMR 11.13(3), services may
be suspended pending the administrative review , and appeal, based any one of
the following:
(a) The individual is residing
with one or more adult(s) responsible for their care in accordance with
107
CMR 11.05(2)(c);
(b) The individual no longer resides in the
commonwealth in accordance with
107
CMR 11.12(3)(b);
or
(c) The individual is no longer
residing in a geographic area where services are available, or services have
been terminated or reduced due to funding.
Notes
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