Florida Regulations 65-2.043: Hearings Request and Notification of Right to Hearings
Current as of: 2024 | Check for updates
|
Other versions
(1) Every applicant or recipient shall be informed in writing at the time of application and at the time of any action on his/her claim, of the right to a hearing, the method of obtaining this hearing, and that he/she may present his/her case or have legal counsel or an authorized representative present it.
(2) In cases of intended action to discontinue, terminate, or reduce assistance, the Department shall give timely and adequate notice.
(3) In Supplemental Nutrition Assistance Program (SNAP) cases:
(a) The notice of adverse action shall be considered timely if the advance notice period provides at least 10 days from the date the notice is mailed to the date upon which it becomes effective. Also, if the advance notice period ends on a weekend or holiday, and a request for a fair hearing is received the day after the weekend or holiday, the Department shall consider the request timely.
(b) The notice shall be considered adequate if it explains in easily understandable language: the proposed action; the reason for the proposed action; the household right to request a fair hearing; the telephone number and if possible name of the person to contact for additional information; the availability of continued benefits; and the liability of the household for any overissuance received while awaiting a fair hearing if the decision is adverse to the household. If there is an organization that provides free legal representation, the notice shall also advise the household of the availability of the service.
(c) Individual notice of case actions are not required when:
1. The Department initiates a mass change based on the following: Federal adjustments to eligibility standards, allotments, and deductions, state adjustments to utility standards; mass changes in public assistance; and mass changes in Federal benefits.
2. The Department receives a written statement from the household or the authorized representative which either states that SNAP benefits are no longer desired or which acknowledges that information the household has provided will result in a reduction of benefits and waives the right to notice of adverse action.
3. The Department determines that all of the members of the household have died.
4. The household has been receiving an increased allotment to restore benefits, the restoration is complete, and the household was previously notified in writing of when the increased allotment would terminate.
5. The household’s allotment varies from month to month with the certification period to take into account changes which were anticipated at the time of certification and the household was so notified at the time of certification.
6. The household applied jointly for public assistance and SNAP benefits pending approval of the public assistance grant and was notified at the time of certification that SNAP benefits would be reduced upon approval of the public assistance grant.
7. A household member is disqualified for fraud in accordance with Federal Regulation, or the benefits of the remaining household members are reduced or terminated to reflect the disqualification of that household member.
8. The household contains a member subject to a lockout or strike and, for purposes of receiving a longer certification period than is otherwise allowed for such households, signs a waiver of his/her right to notice of adverse action to enable the Department to reduce or terminate benefits when the lockout or strike is settled and the household has begun receiving income from employment again.
9. The Department determines that the household has moved from the project area.
(4) In all other cases, “”timely”” means that the notice is mailed at least 10 days before the date of action, that is, the date upon which the action would become effective. “”Adequate”” means a written notice that includes a statement of what action the agency intends to take, the reasons for the intended agency action, explanation of the individual’s right to request an evidentiary hearing (if provided) and a state agency hearing, and the circumstances under which assistance is continued if a hearing is requested. The specific regulations supporting the action must be included for Medicaid actions.
(5) The Department shall dispense with timely notice but shall send adequate notice to be received no later than the effective date of the action when:
(a) The Department has factual information confirming the death of a recipient or of the Temporary Assistance of Needy Families (TANF) payee when there is no relative available to serve as new payee;
(b) The Department receives a clear written statement signed by a recipient that he or she no longer wishes to receive assistance, or that gives information which requires termination or reduction of assistance, and the recipient has indicated, in writing, that he understands that this must be the consequence of supplying such information;
(c) The recipient has been admitted or committed to an institution, and further payments to that individual do not qualify for Federal financial participation under the State plan;
(d) The recipient has been placed in skilled nursing care, intermediate care or long-term hospitalization;
(e) The claimant’s whereabouts are unknown and Department mail directed to him has been returned by the post office indicating no known forwarding address. The claimant’s check must, however, be made available to him/her if his/her whereabouts become known during the payment period covered by a returned check;
(f) A recipient has been accepted for assistance in a new jurisdiction and that fact has been established by the jurisdiction previously providing assistance;
(g) A TANF child is removed from the home as a result of a judicial determination, or voluntarily placed in foster care by his/her legal guardian;
(h) A change in level of medical care is prescribed by the recipient patient’s physician;
(i) A special allowance granted for a specific period is terminated and the recipient has been informed in writing at the time of initiation that the allowance shall automatically terminate at the end of the specified period.
Rulemaking Authority 409.285 FS. Law Implemented Florida Statutes § 409.285. History-New 5-17-78, Amended 3-1-79, Formerly 10-2.43, Amended 4-28-86, Formerly 10-2.043, Amended 10-30-00, 4-2-18.
Terms Used In Florida Regulations 65-2.043
- Fraud: Intentional deception resulting in injury to another.
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
(3) In Supplemental Nutrition Assistance Program (SNAP) cases:
(a) The notice of adverse action shall be considered timely if the advance notice period provides at least 10 days from the date the notice is mailed to the date upon which it becomes effective. Also, if the advance notice period ends on a weekend or holiday, and a request for a fair hearing is received the day after the weekend or holiday, the Department shall consider the request timely.
(b) The notice shall be considered adequate if it explains in easily understandable language: the proposed action; the reason for the proposed action; the household right to request a fair hearing; the telephone number and if possible name of the person to contact for additional information; the availability of continued benefits; and the liability of the household for any overissuance received while awaiting a fair hearing if the decision is adverse to the household. If there is an organization that provides free legal representation, the notice shall also advise the household of the availability of the service.
(c) Individual notice of case actions are not required when:
1. The Department initiates a mass change based on the following: Federal adjustments to eligibility standards, allotments, and deductions, state adjustments to utility standards; mass changes in public assistance; and mass changes in Federal benefits.
2. The Department receives a written statement from the household or the authorized representative which either states that SNAP benefits are no longer desired or which acknowledges that information the household has provided will result in a reduction of benefits and waives the right to notice of adverse action.
3. The Department determines that all of the members of the household have died.
4. The household has been receiving an increased allotment to restore benefits, the restoration is complete, and the household was previously notified in writing of when the increased allotment would terminate.
5. The household’s allotment varies from month to month with the certification period to take into account changes which were anticipated at the time of certification and the household was so notified at the time of certification.
6. The household applied jointly for public assistance and SNAP benefits pending approval of the public assistance grant and was notified at the time of certification that SNAP benefits would be reduced upon approval of the public assistance grant.
7. A household member is disqualified for fraud in accordance with Federal Regulation, or the benefits of the remaining household members are reduced or terminated to reflect the disqualification of that household member.
8. The household contains a member subject to a lockout or strike and, for purposes of receiving a longer certification period than is otherwise allowed for such households, signs a waiver of his/her right to notice of adverse action to enable the Department to reduce or terminate benefits when the lockout or strike is settled and the household has begun receiving income from employment again.
9. The Department determines that the household has moved from the project area.
(4) In all other cases, “”timely”” means that the notice is mailed at least 10 days before the date of action, that is, the date upon which the action would become effective. “”Adequate”” means a written notice that includes a statement of what action the agency intends to take, the reasons for the intended agency action, explanation of the individual’s right to request an evidentiary hearing (if provided) and a state agency hearing, and the circumstances under which assistance is continued if a hearing is requested. The specific regulations supporting the action must be included for Medicaid actions.
(5) The Department shall dispense with timely notice but shall send adequate notice to be received no later than the effective date of the action when:
(a) The Department has factual information confirming the death of a recipient or of the Temporary Assistance of Needy Families (TANF) payee when there is no relative available to serve as new payee;
(b) The Department receives a clear written statement signed by a recipient that he or she no longer wishes to receive assistance, or that gives information which requires termination or reduction of assistance, and the recipient has indicated, in writing, that he understands that this must be the consequence of supplying such information;
(c) The recipient has been admitted or committed to an institution, and further payments to that individual do not qualify for Federal financial participation under the State plan;
(d) The recipient has been placed in skilled nursing care, intermediate care or long-term hospitalization;
(e) The claimant’s whereabouts are unknown and Department mail directed to him has been returned by the post office indicating no known forwarding address. The claimant’s check must, however, be made available to him/her if his/her whereabouts become known during the payment period covered by a returned check;
(f) A recipient has been accepted for assistance in a new jurisdiction and that fact has been established by the jurisdiction previously providing assistance;
(g) A TANF child is removed from the home as a result of a judicial determination, or voluntarily placed in foster care by his/her legal guardian;
(h) A change in level of medical care is prescribed by the recipient patient’s physician;
(i) A special allowance granted for a specific period is terminated and the recipient has been informed in writing at the time of initiation that the allowance shall automatically terminate at the end of the specified period.
Rulemaking Authority 409.285 FS. Law Implemented Florida Statutes § 409.285. History-New 5-17-78, Amended 3-1-79, Formerly 10-2.43, Amended 4-28-86, Formerly 10-2.043, Amended 10-30-00, 4-2-18.