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(10.21) What are the appeal process steps?

(10.21) What are the appeal process steps?

  1. Ask for a Hearing – You can ask for a hearing in person, over the phone, or in writing.
  2. Regional Center Response – The regional center must send you a notice that recognizes your request for a hearing.[1]§§ 4710.6(a)-(c). If you did not get a notice from the regional center, they must send you one with all the information required for an “adequate notice.”[2]§§ 4710.6(a)-(c).
  3. Fair Hearing Request Form – When you tell the regional center you want a fair hearing, the regional center must give you a fair hearing request form. If you need help filling out the form, the regional center must help you.[3]§ 4710.5(b) & (c).
  4. Informal Meeting – If you want to have an informal meeting, regional center must hold one. You and the regional center must agree on a time for the meeting.[4]§ 4710.6(a). The regional center must send you a written notice to confirm the date, time, and place of your informal meeting. The notice must also say you can refuse to have an informal meeting.[5]§ 4710.6(b).
  5. Mediation – Mediation is when an independent, trained person (“mediator”) helps you come to an agreement that is fair and okay for you and the regional center. We recommend mediation. Both you and the regional center can decide not to mediate. If you ask for mediation in writing, the regional center has 5 working days to decide if they want mediation.[6]§ 4711.5(a). Even if you choose not to have mediation, you still have a right to a fair hearing. It is your choice.[7]§ 4710.9(b).
  6. Fair Hearing – You have a right to a hearing before a judge no more than 50 days after the regional center receives your request for hearing.[8]§ 4712(a). The judge is called an Administrative Law Judge (ALJ). If you or the regional center asks, and has a good reason, the ALJ may let the hearing be later. (See Question 26.)
  7. Fair Hearing Decision – The judge must give a decision no more than 10 working days after your hearing ends. This cannot be more than 80 days after you ask for a hearing.[9]§ 4712.5(a). If the hearing is about rights or services under the Medi-Cal Home and Community Based Waiver (“DD Waiver”), the Department of Health Services reviews the decision. They can accept the judge’s decision or make a new decision. They have to do this no more than 90 days after you ask for a hearing.[10]§ 4712.5(c). See Chapter 11 for information on the DD Waiver.
  8. Appeal a Fair Hearing Decision – If you disagree with the hearing decision, you have 90 days to file a Writ of Administrative Mandamus in superior court.[11]§ 4712.5(a).

References
1 §§ 4710.6(a)-(c).
2 §§ 4710.6(a)-(c).
3 § 4710.5(b) & (c).
4 § 4710.6(a).
5 § 4710.6(b).
6 § 4711.5(a).
7 § 4710.9(b).
8 § 4712(a).
9 § 4712.5(a).
10 § 4712.5(c).
11 § 4712.5(a).