651 CMR, § 1.06 - Initiation of a Request for Review

(1) The notice of action regarding a reduction or termination shall provide a period of at least 14 calendar days during which services to the Client shall continue prior to the effective date of the Termination of services as set forth in 651 CMR 1.08(2), or Reduction of services as set forth in 651 CMR 1.08(4). An Applicant or Client may request a Review of an action by an ASAP to Deny, Reduce, or Terminate Home Care Program,Services by filing a request for Review with the ASAP within 14 calendar days following his/her receipt of the ASAP's notice of action. Such Review shall be conducted by the ASAP's Internal Case Review Committee.

(2) When an ASAP is notified by an Applicant or Client of a request for Review, the ASAP shall within seven calendar days grant such request and notify the Applicant or Client in writing of the time, date, and location of the Review meeting. Such Review meeting shall be held within 21 calendar days of receipt of the request for Review.

(3) The Applicant or Client, or his/her representative, shall participate in the Review in person or by telephone and shall be strongly encouraged to present all evidence favorable to the Applicant or Client to the Internal Case Review Committee.

(4) At the Review meeting, the parties shall consider information presented by the Applicant or Client including the person's need for Home Care Program Services, Respite Care Services and the ASAP shall fully and clearly explain the reason(s) for the action(s) at issue.

(5) The ASAP shall present information to the Applicant or Client on alternative services which are available in the community and shall take appropriate steps to assist the Applicant or Client in gaining access to such services.

(6) Within seven calendar days after the meeting, the Internal Case Review Committee shall issue a decision which shall briefly state the relevant facts, the applicable regulation(s), and its conclusions. A copy of the decision shall be forwarded to the Applicant or Client.

Notes

651 CMR, § 1.06