Current through Register Vol. 54, No. 45, November 9, 2024
Section 4.15 - Administrative review(a)Reconsideration by Division. (1) An applicant, client or authorized representative may file with the Division a request for it to reconsider any of the following decisions made by the Division: (i) An applicant is not eligible for an assessment.(ii) An assessed applicant is not eligible for enrollment.(iii) A disapproval or revision of a rehabilitation service plan.(iv) A client is to be discharged from HIP prior to the date specified in the client's rehabilitation service plan.(v) Alternative financial resources are available so that the client must pay for HIP services.(2) At the time a decision is made, the Division will notify the applicant, client or authorized representative in writing of the right to seek administrative review. The letter will advise the recipient to seek assistance from legal counsel, family and others who may serve in an advisory role, and include contact information for a HIP representative to answer questions.(3) An applicant, client or authorized representative shall file a request for reconsideration within 15 calendar days after the mailing date of the Division's determination. The request shall meet the following standards:(i) State the specific legal and factual reasons for disagreement with the decision.(ii) Identify the relief that is being sought for the applicant or client.(iii) Include supporting documentation, if any, to support the factual averments made.(4) The Division will notify the applicant, client or authorized representative in writing of its decision within 30 days after receiving the request for reconsideration.(b)Administrative appeal. (1) An applicant, client or authorized representative may file an administrative appeal to the Agency Head within 30 days after the mailing date of the Division's decision on the request for reconsideration. An applicant, client, or authorized representative may not file an administrative appeal unless reconsideration has been sought and the requested relief has been denied.(2) A hearing will be held only if a material issue of fact is in dispute.(c)General rules. The General Rules of Administrative Practice and Procedure, 1 Pa. Code Part II, apply except when inconsistent with this section.(d)Status of clients and applicants. A client shall continue to receive HIP services until the client's right to administrative review has been exhausted, and until the maximum funds available to a client under § 4.12 (relating to funding limits) are exhausted, or the maximum duration for enrollment under § 4.7(e) (relating to enrollment) has expired. An applicant, including one who has completed the assessment period, will not receive HIP services pending the disposition of the administrative review.