9 CCR 2503-5-3.586 - DISPUTE RESOLUTION

The dispute resolution process is available for disputes concerning county department actions related to eligibility, reduction of grant payment amounts, redetermination procedures, and other county actions that do not involve allegations of fraudulent acts or IPV on the part of the client. If there is a dispute regarding fraudulent actions or IPV, that dispute must be handled according to Sections 3.583 and 3.584 regarding IPVs and fraudulent acts.

In order to resolve disputes between county departments and/or the local service delivery agency and clients, county departments and local service delivery agencies shall adopt procedures for the resolution of disputes consistent with this section. The procedures shall be designed to establish a simple non-adversarial format for the informal resolution of disputes.

A. The county department or local service delivery agency, prior to taking action to deny, terminate, recover, initiate vendor payments or modify financial assistance provided under the Adult Financial program to a client, shall, at a minimum, provide the client an opportunity for a county conference.

1. The right of a client to a county conference is primarily to ensure that the proposed action is valid, to protect the client against an erroneous action concerning grant payments, and to ensure reasonable promptness of county action. The client may choose, however, to bypass the county conference and appeal directly to the State Office of Administrative Courts, pursuant to Section 3.587.

2. The client is entitled to:

a. Representation by an authorized representative retained at his or her own expense, such as legal counsel, relative, friend, or another spokesperson, or he or she may represent himself or herself;

b. Examine the contents of the case file and all documents and records used by the county department or agency in making its decision. Examination of the file is available at a reasonable time before the conference and during the conference. However, the file shall not include names of confidential informants, privileged communications between the county department and its attorney, or the nature and status of pending criminal prosecutions and any other information that is confidential or privileged; and c. Present new information or documentation to support reversal or modification of the proposed adverse action.

3. Failure of the client to request a county conference within ninety (90) calendar days from the date timely notice of the proposed action was mailed to the client without making a request for postponement within that same ninety (90) days, shall constitute abandonment of the right to a conference. The client does not lose the right to appeal directly to the OAC pursuant to Section 3.587.

4. Failure of the client to appear at the scheduled county conference without making a request for postponement prior to the scheduled date of the conference shall constitute abandonment of the right to a conference unless the client can show good cause for his or her failure to appear. The client does not lose the right to appeal directly to the OAC pursuant to Section 3.587.

B. The county conference shall be held before a person who was not directly involved in the initial determination of the action in question in the county department or agency where the proposed decision is pending. The county worker or contractor who initiated the action in dispute shall not conduct the county conference.

1. The person designated to conduct the conference shall be in a position which, based on knowledge, experience, and training, would enable him or her to determine if the proposed action is valid. This could include, but is not limited to, a supervisor, quality assurance personnel, or a manager with no previous knowledge of the case.

2. Two or more county departments/local service delivery agencies may schedule a joint county conference related to the same client. If two or more counties/local service delivery agencies schedule a joint county conference, the location of the conference need not be held in the county or agency taking the action, and the conference location shall be convenient to the client.

3. The county conference may be conducted either in person, by telephone, or video conference. A telephonic or video conference must be agreed to by the client.

4. The county/agency worker or other county or department employee or contractor shall attend the county conference and present the factual basis for the disputed action.

5. The county conference shall be conducted on an informal basis. The county department/agency must provide specific reasons for the proposed action, and the applicable State Department's rules, or county policy. In the event the client does not speak English, an interpreter shall be provided by the county department/agency.

6. The county/agency shall have available at the conference all pertinent documents and records in the case file relevant to the specific action in dispute.

7. To the extent possible, the county conference shall be scheduled and conducted prior to grant payments being reduced or terminated.

8. The county department/local service agency shall provide notice to the client at least four (4) days prior to the scheduled time and location for the conference, or the time of the scheduled telephone or video conference. Notice should be in writing. The client may provide a written or verbal waiver that written notice of the scheduled conference is not necessary when the county department is able to conduct the conference within four (4) days.

9. The county department may consolidate a client's disputes regarding the Adult Financial program, the food assistance program, or any other public assistance program if the facts are similar and consolidation would facilitate resolution of all disputes.

10. The goal of the county conference is to reach an agreement between the client and the county department and/or the local service delivery agency.

C. At the conclusion of the conference, the person presiding shall summarize the discussion in writing. The summary shall include whether the issue was resolved and include the client's appeal rights as described in Section 3.587.A . A copy of the written summary shall be provided to the client and/or his or her representative within eleven (11) calendar days. A copy of the summary will also be maintained in the client's case file.

Notes

9 CCR 2503-5-3.586

37 CR 13, July 10, 2014, effective 8/1/2014 37 CR 17, September 10, 2014, effective 10/1/2014 38 CR 04, February 25, 2015, effective 3/20/2015 38 CR 04, February 25, 2015, effective 4/1/2015 38 CR 09, May 10, 2015, effective 6/1/2015 38 CR 15, August 10, 2015, effective 9/1/2015 38 CR 23, December 10, 2015, effective 1/1/2016 39 CR 17, September 10, 2016, effective 10/1/2016 40 CR 03, February 10, 2017, effective 2/14/2017 41 CR 05, March 10, 2018, effective 4/1/2018 41 CR 15, August 10, 2018, effective 9/1/2018 41 CR 19, October 10, 2018, effective 11/1/2018 42 CR 01, January 10, 2019, effective 2/1/2019 43 CR 01, January 10, 2020, effective 1/1/2020 43 CR 03, February 10, 2020, effective 3/1/2020 43 CR 11, June 10, 2020, effective 7/1/2020 43 CR 23, December 10, 2020, effective 1/1/2021 44 CR 03, February 10, 2021, effective 3/2/2021 44 CR 13, July 10, 2021, effective 8/1/2021 45 CR 03, February 10, 2022, effective 3/2/2022 45 CR 05, March 10, 2022, effective 4/1/2022 45 CR 13, July 10, 2022, effective 7/1/2022 45 CR 15, August 10, 2022, effective 8/10/2022 45 CR 15, August 10, 2022, effective 8/30/2022 46 CR 01, January 10, 2023, effective 12/10/2022 46 CR 01, January 10, 2023, effective 1/1/2023 46 CR 03, February 10, 2022, effective 3/2/2023