Sec. 05.21.01.10. Grievance Procedures

A. This section applies to grantees and providers identified under Regulation .04E of this chapter.

B. Written Grievance Procedures.

(1) Grantees and providers shall maintain written grievance procedures for termination and denial of benefits.

(2) The written procedures shall be submitted with grant applications under Regulation .05 of this chapter and shall be approved by the Department.

(3) A copy of the written procedures shall be provided to applicants upon application for benefits, and to recipients upon award of benefits.

C. Requirements for Grievance Procedures by a Grantee or Provider.

(1) Informal Hearing for Termination of Housing Subsidy and Housing Shelter Benefits.

(a) Grounds for Termination of Benefits. The grantee or provider shall identify grounds for termination of benefits, which shall be approved by the Department prior to enforcement.

(b) Notice of Termination. Before terminating benefits, the grantee or provider shall provide the recipient with notice and opportunity for an informal hearing. The notice shall include:

(i) The date that termination of benefits will be effective;

(ii) A statement of reasons for the decision to terminate benefits;

(iii) Notification that if the client does not agree with the decision, the client may request an informal hearing for review of the decision;

(iv) The procedures for requesting an informal hearing; and

(v) The deadline for requesting an informal hearing, which shall provide no fewer than 14 days for the client to submit the request.

(c) Notice of Hearing. Upon receipt of a timely request for an informal hearing, the grantee or provider shall, within 7 days, schedule an informal hearing and provide notice to the client. The notice shall include:

(i) The date of issuance of the notice;

(ii) The date, time, and location of informal hearing, which shall be conducted within 14 days after the date of the notice;

(iii) The issue to be heard during the informal hearing;

(iv) Notice that the failure to appear will result in the termination decision being upheld;

(v) The client’s right to bring evidence, witnesses, and legal representation to the hearing, at the client’s own expense;

(vi) The client’s right to review relevant documents in the possession of the grantee or provider, prior to the hearing; and

(vii) Notice that the grantee or provider may request to review relevant documents in the possession of the client prior to the hearing.

(d) Conduct of Hearing.

(i) Any hearing under this section shall be conducted by a person who neither made nor approved of the termination decision and is not subordinate to the person that made or approved the termination decision.

(ii) A client shall have the opportunity to provide an opening statement.

(iii) A client shall have the opportunity to present evidence.

(iv) A client shall have the opportunity to question witnesses.

(v) A client shall have the opportunity to examine the documents that are the basis for the termination decision.

(vi) A client shall have the opportunity to request that grantee or provider staff be present to answer questions.

(vii) A client shall have the opportunity to present legal argument.

(viii) The grantee or provider shall have the same opportunities provided to the client in §C(1)(d)(ii)-(vii) of this regulation.

(e) Decision.

(i) The person conducting the hearing shall issue a written decision within 30 days after the hearing. Benefits under this section may not be terminated until a decision is issued under this section affirming the termination decision.

(ii) Any decision affirming termination of benefits shall provide information to the client on the procedure for requesting an appeal.

(2) Informal Review for Termination of Other Benefits.

(a) Grounds for Termination of Benefits. The grantee or provider shall identify grounds for termination of other benefits, which shall be approved by the Department prior to enforcement.

(b) Notice of Termination of Benefits. The grantee or provider shall provide clients with notice of termination of benefits and the opportunity for an informal review relating to termination of nonwelfare benefits. Benefits may be terminated prior to conduct of the informal review. The notice shall inform the client of the following:

(i) The action being taken, the reasons for the action being taken, and the effective date of the action;

(ii) Notification that if the client does not agree with the decision, the client may request an informal review of the decision;

(iii) The procedures for requesting an informal review of the decision; and

(iv) The time for requesting the informal review of the decision.

(c) Notice of Informal Review. Upon receipt of a timely request for informal review under this section, the grantee or provider shall provide the client with a notice of scheduling the informal review. The notice shall include:

(i) The date of notice;

(ii) The date, time, and location of informal review;

(iii) The issue to be heard during the informal review and the client’s right to present information in support of client’s objections; and

(iv) That the failure to appear for the informal review will result in the decision being upheld.

(d) Conduct of Informal Review. The informal review will be conducted by a person that neither made nor approved of the termination decision and is not subordinate to the person that made or approved the termination decision.

(e) Decision.

(i) The decision resulting from the informal review may be provided orally at the informal review or in writing no later than 30 days after the informal review.

(ii) If the decision resulting from the informal review does not uphold the termination of benefits, and benefits have already been terminated, the grantee or provider shall provide retroactive benefits to cover any loss in benefits during the period between the termination and reinstatement of benefits.

(iii) The decision shall provide information to the client on the procedure for requesting an appeal.

(3) Appeal of Grievance Decisions.

(a) The client may appeal a decision provided under §C(1)(e) and (2)(e) within 30 days after issuance of the decision.

(b) Appeals under this section shall be made in writing to the Department.