Or. Admin. Code § 411-318-0025 - Contested Case Hearings for Reductions, Suspensions, Terminations, or Denials
(1) An
individual or an individual's representative may request a hearing, as provided
in ORS chapter 183, if the individual experiences a denial, reduction,
suspension, or termination of a developmental disabilities service, or in
instances when a timely Notification of Planned Action has not been
provided.
(2) HEARING REQUESTS.
(a) A request for a hearing must be made
within 90 calendar days from the date on a Notification of Planned
Action.
(b) The request for a
hearing may be made orally, in writing, or by completing the DD Administrative
Hearing Request (form 0443DD).
(A) ORAL
HEARING REQUESTS.
(i) An individual or the
representative of an individual may orally express a desire for a hearing to
the local program or Department staff.
(ii) Upon receipt of an oral request for a
hearing, the local program or Department staff must complete the DD
Administrative Hearing Request and submit the form and a copy of the
Notification of Planned Action, if applicable, to eXPRS no later than one
business day of receiving the request for a hearing. A copy of the DD
Administrative Hearing Request must be provided to the individual and the
individual's representative.
(B) WRITTEN HEARING REQUESTS.
(i) An individual or an individual's
representative may provide a written request for a hearing to the local program
or Department staff.
(ii) Upon
receipt of a written request for a hearing, the local program or Department
staff must complete the DD Administrative Hearing Request and submit the form
and a copy of the Notification of Planned Action, if applicable, to eXPRS no
later than one business day of receiving the request for a hearing. A copy of
the DD Administrative Hearing Request must be provided to the individual and
the individual's representative.
(c) The Department processes late hearing
requests as described in OAR
411-001-0520.
(3) If a Notification of Planned
Action identifies records used in a decision that is the subject of a hearing
request, the records must be submitted to the Department within three business
days from the date of the hearing request.
(4) CONTINUING SERVICES PENDING A FINAL
ORDER.
(a) In the event of a reduction,
suspension, or termination of a developmental disabilities service, a claimant
or the claimant's representative may request continuing services for the
claimant during the hearing process. To receive continuing services, a claimant
or the claimant's representative must either:
(A) Request a hearing before the effective
date of action; or
(B) Within 10
business days after the effective date of action identified on the Notification
of Planned Action, request a hearing and continuing services.
(b) The Department shall grant a
late request for continuing services when the Department determines a claimant
or the claimant's representative has good cause for the late request.
(c) A claimant may be required to pay back
any benefits received during the hearing process if the Final Order is not in
the claimant's favor.
(5) EXPEDITED HEARINGS.
(a) An individual or the individual's
representative may request an expedited hearing when:
(A) The time otherwise permitted for a
hearing may jeopardize the individual's life, health, or ability to attain,
maintain, or regain maximum function; or
(B) An individual receiving a notice of exit
from a residential setting is not allowed to remain in the setting.
(b) An expedited hearing must be
held within five business days from the date the Office of Administrative
Hearings (OAH) receives the request for an expedited hearing that meets the
criteria of subsection (A) or (B) of section (a).
(c) A written decision shall be issued within
three business days after the hearing record is closed.
(6) INFORMAL CONFERENCE.
(a) The Department staff, Department hearing
representative, and the claimant or the claimant's representative may have an
informal conference, without the presence of an administrative law judge, to
discuss the action that is the subject of a hearing request. An informal
conference may also be used to:
(A) Provide an
opportunity for the Department and the claimant or the claimant's
representative to settle the matter.
(B) Ensure the claimant or the claimant's
representative understands the reason for the action that is the subject of the
hearing request.
(C) Give the
claimant or the claimant's representative an opportunity to review the
information that is the basis for the action that is the subject of the hearing
request.
(D) Inform the claimant or
the claimant's representative of the rules that serve as the basis for the
action that is the subject of the hearing request.
(E) Give the Department and the claimant or
the claimant's representative the chance to correct any misunderstanding of the
facts.
(F) Give the claimant or the
claimant's representative an opportunity to provide additional information to
the Department.
(G) Give the
Department an opportunity to review the action that is the subject of the
hearing request with the claimant or the claimant's representative.
(b) At any time prior to the
hearing date, the claimant or the claimant's representative may request an
additional informal conference with a Department hearing representative. A
Department hearing representative may grant, at their discretion, an additional
informal conference to facilitate the hearing process.
(c) The Department may provide a claimant the
reprieve sought at any time before a Final Order is issued.
(7) REPRESENTATION.
(a) A representative may be chosen by a
claimant to represent the interests of the claimant during an informal
conference and hearing.
(b)
Employees for the Department, CDDP, and Brokerage are authorized to appear as a
witness on the Department's behalf during an informal conference and
hearing.
(8) HEARINGS
NOT OPEN TO THE PUBLIC. Non-participants may attend a hearing only with the
consent of the claimant or the claimant's representative and the Department
hearing representative.
(9)
WITHDRAWAL OF HEARING REQUEST. A claimant or the claimant's representative may
withdraw a hearing request at any time prior to the issuance of a Final Order.
The withdrawal is effective on the date the request for the withdrawal is
received by OAH. The Department shall issue an order of withdrawal to the last
known address of the claimant. The claimant or the claimant's representative
may cancel the withdrawal up to 10 business days following the date the order
of withdrawal is issued.
(10)
DISMISSAL FOR FAILURE TO APPEAR. A hearing request is dismissed by order when
neither the claimant nor the claimant's representative appears by phone or in
person at the hearing. The dismissal order is effective on the date scheduled
for the hearing. The Department may cancel the dismissal order on request of
the claimant or the claimant's representative upon a showing that the claimant
or the claimant's representative has good cause for not attending the hearing
or requesting a postponement.
(11)
When the Department refers a hearing under these rules to OAH, the Department
shall indicate on the referral:
(a) Whether
the Department is authorizing OAH to issue a Final Order, a Proposed Order, or
a Proposed and Final Order; and
(b)
If the Department is establishing an earlier deadline for written exceptions
and argument because the hearing request is being referred for an expedited
hearing.
(12) FINAL
ORDER. A Final Order is the final action expressed in writing by OAH or the
Department as described in OAR
137-003-0665. A Final Order is
issued:
(a) Within 90 calendar days from the
request for a hearing; or
(b)
Within 90 calendar days from the receipt of a Proposed Order or a Proposed and
Final Order from OAH.
(13) PROPOSED ORDERS. After OAH issues a
Proposed Order, the Department shall issue a Final Order unless the Department
authorizes OAH to issue the Final Order as described in OAR
137-003-0655 and section (11)(a)
of this rule.
(14) PROPOSED AND
FINAL ORDERS. A Proposed and Final Order becomes a Final Order 21 calendar days
after OAH issues the Proposed and Final Order unless:
(a) The claimant or the claimant's
representative has filed written exception and written argument as described in
section (15) of this rule;
(b) The
Department has issued a revised order; or
(c) The Department has notified OAH and the
claimant or the claimant's representative that the Department shall issue the
Final Order.
(15)
EXCEPTIONS.
(a) Once OAH has issued either a
Proposed Order or a Proposed and Final Order, a claimant or a claimant's
representative may file a written exception and written argument for the
Department to consider. The written exception and written argument must be
postmarked to the location indicated in the OAH order no later than 20 calendar
days after service of the Proposed Order or Proposed and Final Order unless an
earlier deadline has been established according to section (11)(b) of this
rule.
(b) Unless the Department
receives a timely written exception and written argument as described above,
the Department shall issue the Final Order unless the Department authorizes OAH
to issue the Final Order in compliance with OAR
137-003-0655 and section (11)(a)
of this rule.
(16)
PETITION OF FINAL ORDER. A claimant or a claimant's representative may file a
petition for reconsideration or rehearing up to 60 calendar days after a Final
Order is served. The petition must be filed with the entity that issued the
Final Order, unless stated otherwise on the Final Order.
Notes
Statutory/Other Authority: ORS 409.050, 427.104, 427.107 & 430.662
Statutes/Other Implemented: ORS 183.411-183.471, 409.010, 427.007, 427.101, 427.104, 427.107, 427.109, 430.215, 430.610 & 430.662
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