HEARING REQUEST PROTOCOLS
Revised September 2017
APD/AAA Hearing Requests
When customers disagree with a decision to approve, deny, reduce or close a benefit or service, review the action with them to make sure the decision is correct and they understand why. If an issue can be resolved to the customer’s satisfaction at the branch level, there is no need for a hearing. Do not dissuade customers from filing a hearing request. Make sure they understand their right to ask for a hearing.
Customers may ask for form MSC 443, Administrative Hearing Request, in case they decide to appeal a decision in the future. Requesting the form is not the same as requesting a hearing. When this happens, complete the top portion of the 443 except for “Date Received by DHS or OHA” and narrate in OACCESS they requested the form but did not request a hearing.
When the customer requests a hearing, either verbally or in writing, complete the entire MSC 443 as follows:
° Date Received by DHS or OHA: This is either the date the branch received the 443, or the date the customer made a verbal request for a hearing.
° Date of Notice: “Date sent” from the notice being contested. If the notice was sent by the system, this date is on LOGI.
° Program: Usually one of the following: 1, A1, 3, B3, 4, D4, P2, 5, 6 (SNAP),
DD (Developmental Disability).
° Cost Center/branch #: The branch number, unless it refers to a DD program.
If DD case, leave field blank.
° Case Number: For medical or service eligibility use the UCMS case number;
for SNAP, use “F” and/or the EBT number; for Health Systems Division (formerly DMAP) requests use the prime number.
° Worker ID: For APD/AAA use the worker load code. For DD cases the ID is
the program coordinator’s initials.
If the hearing request is made face to face, ask the customer to sign the 443; however it is not required.
Hearing requests are considered complete when the claimant requests a hearing verbally or in writing; customers are not required to submit a completed 443 for APD programs. Any hearing request, regardless of the timeframes of its filing must be referred to a hearings representative. If a hearing representative determines it is too late, the representative will issue appropriate notification to the customer.
When the customer makes a verbal request for a hearing, complete the following:
· “Claimant”
· “Name of Lawyer or representative”
· “I am asking for a hearing because I do not agree with the decision to: Ask the customer to briefly explain why they disagree.
· “I did, did not, receive a written notice to deny my application or to reduce or close my benefits”: If the customer received a decision notice, indicate the date of the notice.
· “Hearing requested for” Medical, Long-Term Care, SNAP, Other, etc.
· Review with the customer “part 3”. If the customer thinks they meet the requirements for an expedited hearing, check the appropriate box.
· If the customer verbally requests APP, and read “Part 2” on the back of the 443. Check the appropriate box and narrate the customer requested continuing benefits and part 2 was reviewed with the customer.
Referrals to the APD Hearings Unit
Hearings requests should be referred to the APD Hearings Coordinator by scanning all documents listed below and emailing them immediately (within 24 hours) to . Please do not fax requests.
Send only these required documents to the hearings coordinator. Please do not send additional material at this time.
1. APD Hearings cover sheet
2. All pages of the MSC 443 Administrative Hearing Request.
3. The notice being appealed in one of the following forms:
° A copy of the notice. Include both sides of all pages, including blank pages, and the page titled “Your Hearing Rights.”
° LOGI screen print indicating which system-generated notice was sent;
° If no notice is being contested, clearly indicate on the cover sheet what issue is being contested, and that there was no notice sent;
4. Documents associated with the customer’s request for hearing, such as additions to the 443, or other supporting documents provided by the customer.
Aid Paid Pending (APP)/Continuing Benefits
Customers can request their benefits to continue until a hearing decision is made APP. They can request APP verbally, in writing, or on the 443. If the claimant verbally requests APP, read part 2 on the back of the 443 and narrate that the customer requested continuing benefits and part 2 was reviewed. Management in the local office must review eligibility for APP before benefits can be restored to a case. The following are the APP eligibility criteria:
· The contested decision must entitle the customer to a continuing benefit notice or a timely continuing benefit notice, per OAR 461-175-0200.
· To be entitled to continuing benefits, the customer must complete a hearing request the later of these two dates:
i) The tenth day following the date of the notice; or;
ii) The effective date of the action proposed in the notice.
The hearings representative will review the APP decision and issue appropriate notification to the claimant.
Expedited Hearings
If the local office receives a request for a hearing to challenge the denial of APP/continuing benefits, an MSC 443 should be completed as an expedited hearing request.
Send APD expedited hearing requests to the APD Hearings Coordinator. A hearing representative will determine if the claimant is entitled to an expedited hearing.
Contested Eviction of a Customer from a Facility
If a customer is contesting a facility move-out notice, the customer must complete the MSC 443, Administrative Hearing Request. The APD Hearings Unit does not represent DHS for these types of hearing requests. Send these types of hearing requests to the appropriate Program Coordinator as referenced below.
Adult Foster Homes:
The Licensee must sign and deliver a completed involuntary move-out notice, using the Department’s form SDS 901, in all cases of involuntary move-out, including when the Department is taking an action which requires residents to transfer to another care setting.
If an involuntary move-out notice is contested, please fax the completed form MSC 443 to the Office of Licensing and Regulatory Oversight, AFH Program Coordinator, at 503-373-2228. Include a copy of the SDS 901 and any supporting documents.
Assisted Living Facilities and Residential Care Facilities:
Facilities are required to send copies of move out notices to the ALF/RCF Licensing Unit in Salem.
If an MSC 443 is received contesting a move out notice, fax the form to APD ALF/RCF Licensing at (503) 378-8966; a copy of the move-out notice is not required, since the ALF/RCF Licensing Unit should already have a copy.
Nursing Facilities:
The Safety, Oversight and Quality Unit (formerly Office of Licensing & Regulatory Oversight) has jurisdiction over transfers from nursing facilities. Direct hearing requests and questions regarding this process to Renee Shearer:
· Phone: (503) 373-2164
· Fax: (503) 378-8966
· Email:
Health Systems Division Hearing Requests
Health Systems Division hearing requests that are not MAGI related still require a written request and are forwarded directly to their hearings mailbox, .
The local office is responsible for completing the top portion of the MSC 443 as indicated for APD/AAA hearing requests. The case number is the customer’s prime number. Narrate in OACCESS the request was referred to Health Systems Division hearings.
Homecare Worker Enrollment Terminations (for reasons other than criminal history)
Refer to the links below:
· Homecare Worker Terminations;
· APD-PT-14-032
· APD-PT-15-015
Self-Sufficiency (SSP) Hearing Requests
If a customer wants to contest a decision or benefits issued by an SSP branch:
· Complete the MSC 443, including the “Date Received by DHS or OHA” field, based on the customer’s written or verbal request for a hearing;
· Send via email to the SSP hearings coordinator immediately (within 24 hours) to .
· Narrate in OACCESS the request was referred to the SSP Hearings coordinator.
MAGI Hearing Requests
MAGI programs are administered by OHA (Oregon Health Authority) and no longer require a written appeal. They can also be verbally requested.
· Send MSC 443 to The 5503 Hearings Reps will process these requests.
· Narrate in OACCESS the request was referred to the 5503 hearings.
Links
· Generic Program Elements I: Hearings
· APD Hearings
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