55 Pa. Code § 4000.201 - Generally
(a) County MH/MR
administrators are directed to establish policies providing for documentation
of decisions associated with applications for service and termination of
service. The granting of one service does not relieve the county programs from
the following requirements whenever another service is denied or terminated.
Further, these policies are to provide that:
(1) A client shall receive a timely, written
response to an application for services and timely, written notice of intention
to terminate service. A copy of the written response or notice shall be
retained in the client's file.
(2)
The response contains a statement why any portion of the application could not
be granted and a notice of termination shall contain a statement why the
service is being terminated-for example, client not eligible for MH or MR
services, services are not appropriate, no positions in a program are available
for the applicant, the applicant is not a resident of the county, or other
appropriate reasons. The response or notice of termination shall inform the
client of the availability of the review procedures set forth in this
section.
(3) Without excluding
additional review provided by the county programs, at a minimum an applicant
denied services or a client whose services are being terminated may seek review
of the denial or decision to terminate service by the county administrator or
the administrator's designee. The person conducting the review should not have
participated in the application or termination at issue, as the goal is to
provide a fair, impartial review.
(4) At the review before the county
administrator or designee, the client will be given an opportunity to be
present, present documentation in support of the client's position, present and
question witnesses and be accompanied by other persons to assist in the
presentation. The person who made the decision under review will also be
present and may be questioned by either party. Relevant information or
witnesses may be presented at this review by the county. The entire review
meeting will be tape-recorded by the administrator or a designee at no expense
to the client and the tape retained by the administrator. Either party may have
the meeting transcribed from the tape at the party's own expense.
(5) The decision of the administrator, or
designee, shall be made promptly in writing and contain a statement of the
findings and reasons for the decision, including reasons why the services
sought by the client will not be provided as requested or why the termination
decision was upheld and what criteria were applied. A copy of the decision will
be provided promptly to the client and to the client's representative, if there
is one, by mail or by personal service.
(b) Procedural safeguards developed by the
individual county MH/MR programs will be reviewed as part of the county
management compliance review process.
Notes
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