“Adequate notice” means a written notice informing the applicant, recipient, and authorized representative of at least all of the following:
(a) The action that the service agency proposes to take, including a statement of the basic facts upon which the service agency is relying.
(b) The reason or reasons for that action.
(c) The effective date of that action.
(d) The specific law, regulation, or policy supporting the action.
(e) The responsible state agency with whom a state appeal may be filed, including the address of the state agency director.
(f) That if a fair hearing is requested, the claimant has the following rights:
(1) The opportunity to be present in all proceedings and to present written and oral evidence.
(2) The opportunity to confront and cross-examine witnesses.
(3) The right to appear in person with counsel or other representatives of his or her own choosing.
(4) The right to access to records pursuant to Article 5 (commencing with Section 4725).
(5) The right to an interpreter.
(g) Information on availability of advocacy assistance, including referral to the developmental center or regional center clients’ rights advocate, the State Council on Developmental Disabilities, publicly funded legal services corporations, and other publicly or privately funded advocacy organizations, including the protection and advocacy system required under federal Public Law 95-602, the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C.A. Sec. 6000 et seq.).
(h) The fair hearing procedure, including deadlines, access to service agency records under Article 5 (commencing with Section 4725), the opportunity to request an informal meeting to resolve the issue or issues, and the opportunity to request mediation which shall be voluntary for both the claimant and the service agency.
(i) If the claimant has requested an informal meeting, information that it shall be held within 10 days of the date the hearing request form is received by the service agency.
(j) The option of requesting mediation prior to a fair hearing, as provided in Section 4711.5. This section shall not preclude the claimant or his or her authorized representative from proceeding directly to a fair hearing in the event that mediation is unsuccessful.
(k) The fair hearing shall be completed and a final administrative decision rendered within 90 days of the date the hearing request form is received by the service agency, unless the fair hearing request has been withdrawn or the time period has been extended in accordance with this chapter.
(l) Prior to a voluntary informal meeting, voluntary mediation or a fair hearing, the claimant or his or her authorized representative shall have the right to examine any or all documents contained in the individual’s service agency file. Access to records shall be provided pursuant to Article 5 (commencing with Section 4725).
(m) An explanation that a request for mediation may constitute a waiver of the rights of a medicaid home and community-based waiver participant to receive a fair hearing decision within 90 days of the date the hearing request form is received by the service agency, as specified in subdivision (c) of Section 4711.5.
(n) That if a request for a fair hearing by a recipient is postmarked or received by a service agency no later than 10 days after receipt of the notice of the proposed action mailed pursuant to subdivision (a) of Section 4710, current services shall continue as provided in Section 4715. The notice shall be in clear, nontechnical English. If the claimant or authorized representative does not comprehend English, the notice shall be provided in any other language as the claimant or authorized representative comprehends.
(o) A statement indicating whether the recipient is a participant in the home and community-based services waiver.
(Amended by Stats. 2014, Ch. 409, Sec. 54. (AB 1595) Effective January 1, 2015.)
Last modified: October 25, 2018