16 Del. Admin. Code § 5000-5500

Current through Register Vol. 28, No. 7, January 1, 2025

Section 5000-5500 - Issuing Fair Hearing Decisions

7 CFR 273.15(c), (q); 42 CFR 431.244, 431.245; 45 CFR 205.10(16)

This policy applies to applicants and recipients of any public assistance program administered by the Division of Social Services (DSS) or the Division of Medicaid and Medical Assistance (DMMA).

1. Hearing Decisions Are Made Promptly

The Hearing Officer has sole authority to make hearing decisions. The Hearing Officer must take prompt, definitive, and final administrative action within 90 days from the date the appeal is filed. The decision must be in writing and must be sent to the appellant as soon as it is made.

Exception: Food Supplement Program decisions must be made within 60 days from the date the appeal is filed

Exception: Expedited hearing decisions for medical assistance must be made within 3 working days from receipt of the appeal which meets the criteria for an expedited appeal process. See Section 5304.3

2. Decisions Are Binding on the Department of Health and Social Services

3. Decisions Comply with Laws and Regulations

The Hearing Officer's decision will comply with State and federal laws and regulations and are based on the hearing record.

4. Decisions Must Contain Specific Information

The written decision will contain, at a minimum, the following information.

A. Information to enable a reader to understand how the decision was reached.

B. Supporting evidence

C. Food Supplement Program cases will state whether benefits will be issued or terminated.

The decision contains:

1. A statement of the appellant's right to judicial review

2. The identity of the individual

3. A summary of evidence

4. Findings of fact

5. A discussion or analysis of facts and arguments presented at the hearing

6. A discussion of how the applicable rules apply to the facts in the case

7. The resulting conclusions

8. The hearing officer's decision and/or order

9. Applicable rules involved in reaching the decision

16 Del. Admin. Code § 5000-5500

14 DE Reg. 618 (01/01/11)
15 DE Reg. 86 (07/01/11)
16 DE Reg. 419 (10/01/12)