10-144 C.M.R. ch. 1, § VIII - DECISIONS

A. Decision Making

1. Burden of Persuasion. The burden of persuasion shall be governed by state and federal law and regulations applicable to the subject matter of the hearing. If such law and regulations are silent, the party who asserts the truth of a claim is under a burden to persuade the Hearing Officer that the claim is true.

2. Finding of Fact to be Based Upon a Preponderance of Evidence. After opposing parties have produced evidence and counter- evidence, the Hearing Officer will consider and compare all the evidence on every relevant allegation of fact. Each finding of fact made by the Hearing Officer shall be supported by a preponderance of the evidence unless a different standard is required under regulations applicable to a particular program.

3. Applicable Law

a. The decision must be based on the agency's regulations and the evidence which is a matter of hearing record.

b. Where the agency's regulations are ambiguous or silent on a point critical to a determination, reference to other sources of law for guidance in interpreting the agency's regulations is appropriate. Such other sources of law may include, but are not necessarily limited to, State and Federal statutes, Federal regulations and State and Federal case law. When a Hearing Officer relies upon sources of law other than the agency's regulations, the written decision shall indicate the source of the law upon which the Hearing Officer relied and the reasons for that reliance.

4. Content of Hearing Decision

a. The decision of the Hearing Officer shall contain at least the following:

i. A clear and precise statement of the issues: the dispute under consideration and the specific points which must be resolved to decide the case;

ii. A listing of the date and place of hearing and participants at the hearing;

iii. A listing of all the material, including records, reports and other documents placed into evidence at the hearing, upon which the hearing decision is based;

iv. The findings of fact, based upon the entire hearing record, including testimony, exhibits, etc. The findings must be sufficient to apprise the parties and any interested member of the public of the basis for the decision. If evidence is in conflict on an issue necessary to resolution of a case, the Hearing Officer must set forth the reasoning employed in reconciling the conflict;

v. A clear and precise statement of decision, resolving the dispute (s) under consideration;

vi. A clear explanation of the reasoning underlying the decision, including references to applicable law; and

vii. Written notice of a party's right to review or appeal of a decision within the agency or review of a decision by the courts, as the case may be, and of the action required and the time within which such action must be taken in order to exercise the right of review or appeal.

b. In cases where the parties have mutually agreed to the outcome of a hearing ('consent decisions') the content of a consent decision need not include all of the information required by Section VIII(A)(4)(a) above. Any consent decision, however, shall state with clarity the following: The identity of the parties involved; the subject matter of the decision; the results of the consent decision; and a determination that the result is in accordance with applicable law.

5. Recommended Findings and Decision

In any case in which law or regulation or special instructions from the Commissioner dictate that an individual other than the Hearing Officer will make a final hearing decision, the Hearing Officer will prepare a recommended hearing decision rather than a final hearing decision. A recommended decision will be made on the same basis and in the same form as a final decision. Copies of recommended decisions will be provided to all parties, who will have an opportunity to submit exceptions and responses to the final decision maker.

a. Exceptions and Responses

In any case in which final decision making authority is reserved to the Commissioner or the Commissioner's designee, the parties may file exceptions and responses to the recommended decision.

i. Time for filing. For MaineCare cases, the exceptions and responses must be received by the Division of Administrative Hearings within 15 calendar days after the date the recommended decision was mailed to the parties. For all other cases (unless a statute or rule requires a shorter period), the exceptions and responses must be received by the Division of Administrative Hearings within 20 calendar days after the date the recommended decision was mailed to the parties. The date of mailing will be stamped on the upper right-hand corner of the recommended decision.

ii. Content. The written exceptions and responses filed with the Division of Administrative Hearings shall contain:

(aa.) A clear statement of the party's position and the reason for it;

(bb.) A listing of any errors or omissions made by the Hearing Officer during the decision making process;

(cc.) Any relevant legal arguments the party wishes to offer.

If additional factual information which could have been presented and considered during the decision making process, including the administrative hearing, is made part of the exceptions and responses, it need not be considered by the final decision maker.

iii. Method of filing. Exceptions and responses must be sent to the Division of Administrative Hearings by mail, fax, or e-mail. Copies of written exceptions and responses must be provided to all parties.

iv. Extensions. A reasonable extension of time for the filing of exceptions and responses may be granted by the Chief Administrative Hearing Officer for good cause shown or if all parties agree.

6. Constitutional Issues and Estoppel Issues

An appellant must raise constitutional issues before the administrative agency to preserve them for appeal. If an appellant raises constitutional or estoppel issues, these issues shall be addressed in accordance with these rules, provided that the Hearing Officer shall consult with the Chief Administrative Hearing Officer prior to rendering a final or recommended decision.

B. Facts To Be Determined Anew

1. General Principles. The Hearing Officer is to determine anew the relevant facts and apply the law to those facts. Therefore, no presumptions are to be made for or against the Department concerning the validity of the factual or legal basis for the action or inaction which is the subject matter of the hearing.

2. Application to New Information. The provisions of Section VIII(B)(3) shall apply to new information. New information is information, which was not available to, or was not considered by, or was not shared with, one or more of the parties prior to its being introduced as evidence at the hearing.

(a) The Hearing Officer shall not exclude otherwise admissible evidence on the grounds that it is new information.

(b) If new information is offered as evidence, the party against whom it is offered is entitled to a reasonable opportunity to review it and to prepare responses. When necessary, a hearing will be continued for this purpose.

3. Effect of New Information in Matters Involving Benefit Programs. The effective date of any adjustments to an applicant's or recipient's grant level or eligibility status shall be the date on which all eligibility conditions were met, regardless of when the supporting information was submitted, except to the extent that a different eligibility date is required pursuant to state or federal law.

4. Limitations. Nothing in this subsection shall be interpreted as allowing for the introduction of additional evidence where a review is being taken which is based solely upon review of a written record.

5. Expansion. Absent the consent of the parties, new information may be excluded if its admission would result in an expansion of issues or the subject of the hearing.

C. Reopening of Hearing

1. At any time prior to the issuance of the decision on the merits, the Hearing Officer may reopen the record to receive relevant, non-duplicative testimony, evidence, arguments or exhibits not previously received, if the Hearing Officer determines that such testimony, evidence, arguments, or exhibits are necessary to a full consideration of the issues presented in the hearing.

2. Prior to the decision becoming final agency action, the Hearing Officer (when the Commissioner has not reserved final decision making authority) or Commissioner, upon their own or the request of the party, and upon notice to all parties may reopen the record of any hearing under the following circumstances:

a. A party to the original hearing has discovered new evidence which could have reasonably affected the outcome of the proceeding but could not have been discovered by the use of due diligence in time to present the evidence during the original proceeding, or;

b. There was fraud, or misrepresentation regarding an issue of material fact to the original proceeding, which could reasonably be determined to have affected the outcome of the proceeding, if known at the time, or;

c. All parties to the hearing agree to reopen the hearing.

If the Commissioner has reserved final decision making authority, a Hearing Officer cannot reopen a hearing after the Hearing Officer has issued a recommended decision. After the recommended decision has issued, the Commissioner may remand the matter back to the Hearing Officer for the purpose of reopening the record.

3. The reopening of the hearing shall not expand the issues that were the subject matter of the original hearing. The reopening of a hearing shall not constitute a waiver of the sovereign immunity of the state agency, nor shall it provide an individual with retrospective relief in the form of recoupment of monies paid to the state agency.

4. The Hearing Officer shall set a time within which other parties or intervenors may respond to or rebut the items made part of the record under this section.

D. Correction or Amendment of Hearing Decision

1. Correction of the hearing decision. Prior to a decision becoming final agency action, the Hearing Officer, upon their own, or at the request of a party, may at any time amend a decision or recommended decision to correct a ministerial or typographical error. All parties shall be notified in writing of the correction or revision.

2. Amendment of the hearing decision. Prior to a decision becoming final agency action, the Hearing Officer, upon their own, or at the request of a party, may amend a hearing decision in order to clarify or correct the decision or to rule upon any issue that was heard but not ruled upon, provided all parties are notified of the proposed revision and given an opportunity to comment. If the Commissioner has reserved final decision making authority, a Hearing Officer cannot amend a recommended decision other than to correct a typographical error as noted above.

E. Final Agency Action.

1. Commissioner. Decisions where the Commissioner or the Commissioner's designee has reserved final decision making authority shall become final agency action when the Commissioner or the Commissioner's designee has issued the decision.

2. Hearing Officer. Decisions issued by a Hearing Officer shall become final agency action ten days after the Hearing Officer issues the decision.

3. Decisions on Motions to Correct or Amend. Decisions granting or denying a Motion to Correct or Amend become final agency action when issued by the Hearing Officer.

4. Intra Agency appeals. If a statute or a rule provides for an appellate process in which a Hearing Officer conducts an appeal hearing regarding a different Hearing Officer's decision, the decision by the Hearing Officer conducting the appeal hearing becomes final agency action when issued.

5. Expedited Hearings. Hearings shall be expedited only if required by a state or federal statute or governing federal regulation. The expedited decision shall become final agency action when issued by the Hearing Officer.

Notes

10-144 C.M.R. ch. 1, § VIII