Section He-E 501.11 - Informal Resolution(a) An individual who disagrees with an eligibility determination, redetermination, or termination of Title XX services may request an informal resolution of the decision, as follows: (1) The individual or his or her authorized representative, shall submit a written request to the department within 30 calendar days of the eligibility or termination determination; and (2) The written request shall include: a. An explanation of the reason why the decision on the eligibility determination, redetermination or termination determination should be changed; andb. Any supporting documentation. (b) For individuals currently receiving services, Title XX services shall continue during the informal resolution process until a decision is rendered.(c) The department shall review the request in (a) above and provide a written notice within 45 days to the individual, or his or her authorized representative, of the decision to maintain or change the original eligibility or termination decision, including the reason therefor. The Department shall make a redetermination based on the same criteria used in the initial determination and shall take into consideration any new information.(d) If the department or provider's decision is not upheld: (1) Services shall be initiated for individuals requesting services; and(2) Services for individuals currently receiving Title XX services shall continue as long as the Title XX eligibility requirements described in He-E 501.05 are met or until the end of the individual's eligibility period.(e) If the department's or provider's decision is upheld, services for individuals currently receiving services shall end within 30 calendar days of the decision.(f) Requesting an informal resolution shall not: (1) Preclude in any way an individual's right to appeal a disputed eligibility or termination determination in accordance with He-C 200; or(2) Change the timeframes established for filing an appeal.(g) An individual may appeal the decision of the department in accordance with He-C 200 and RSA 541-A:29.N.H. Code Admin. R. He-E 501.11
Amended by Volume XXXIX Number 06, Filed February 7, 2019, Proposed by #12720, Effective 1/29/2019, Expires 7/29/2019.Amended by Volume XL Number 2, Filed January 9, 2020, Proposed by # 12936, Effective 12/7/2019, Expires 12/7/2029.