713.07 IPV Administrative Disqualification Hearing SR 95-47, 07/95 (FSM-A)

An administrative disqualification hearing is one method for deciding if an individual committed an intentional program violation.

Waiver of Hearing: The individual may waive the right to an administrative disqualification hearing. If they do, they will be notified of the automatic disqualification by OSI. The individual’s only opportunity for further appeal is a court of appropriate jurisdiction.

The accused member must sign the waiver. When the accused is not the head of household, the case head must also sign the waiver.

The Hearing: To begin proceedings, OSI must convince the Hearings Office of the need for a hearing by showing convincing documentation.

A pending hearing has no effect on the individual’s eligibility or benefit level. An individual need not be currently eligible to be the object of a hearing.

OSI cannot begin hearing proceedings against an individual whose case has already been referred to a court of appropriate jurisdiction for the same or related circumstances.

The Hearings Office may combine a fair hearing with an administrative disqualification hearing when case circumstances are the same. The household must be given advance notice and the time frames of the administrative disqualification hearing must be followed (see below). Regardless of the outcome, when a household submits to combined hearings to settle the amount of the claim, it cannot later request another fair hearing based on the same circumstances to resettle the amount of the claim.

The hearing may be conducted without the household present when the household neither appears nor notifies the Hearings Office of good cause for not appearing.

A determination of guilt for an intentional program violation must be based on "clear and convincing evidence" that an individual purposefully committed the violation. Hearing decisions cannot be reversed by a subsequent fair hearing, but only by a court having appropriate jurisdiction.

Time Frames:

Recipient notification: The Hearings Office must notify the household at least 30 days in advance of a scheduled date for a disqualification hearing.

Decision: Within 90 days of the notification, the Hearings Office must conduct the hearing and inform the household and appropriate Department of Health and Human Services (DHHS) offices of the decision.

Postponements: The household may postpone the hearing according to the criteria below:

• The new hearing date cannot be more than 30 calendar days after the initial date.

• The household must request a postponement at least 10 days before the scheduled hearing. This requirement may be waived for good cause.

• The 90-day limit imposed upon the Hearings Office is extended by as many days as the hearing is postponed.

Before the Hearing:

Notice of the Recipient’s Right to Waive the Hearing

OSI sends a notice that the individual may waive their right to an administrative disqualification hearing. The notice must contain all the following:

• the date by which OSI must receive the signed waiver. The accused individual has 10 days from the mailing of the notice to waive the hearing,

• a signature block for the accused individual and a signature block for the head of household or authorized representative,

• a statement of the accused individual’s right to remain silent concerning the charges,

• a statement that signing the waiver results in disqualification and reduction in benefits,

• an opportunity for the individual to admit or deny the facts as presented by DHHS,

• a telephone number for further information,

• that any remaining FS household members will be held responsible for repayment of the resulting claim, and

• all the information included in the Notice of Hearing below.

Notice of Hearing:

If the individual chooses not to waive the hearing, the Hearings Office must send a notice 30 days before the hearing containing all of the following:

• date, time, and place of the hearing,

• charges against the individual,

• summary of evidence; how and where it can be examined,

• that the decision will be based solely on information provided by the state if the individual fails to appear at the hearing,

• that the individual will have up to 10 days after the date of the scheduled hearing to present good cause for failure to appear,

• that a determination of intentional program violation will result in a specific disqualification penalty,

• the procedures of the hearing and the individual’s rights and responsibilities there,

• that the hearing does not preclude the state or federal government from prosecuting the individual in a civil or criminal court for the violation, or from collecting the overissuance, and

• that free legal services are available.

After the Hearing:

The Hearings Office writes a decision on the case. The decision must include all the following:

• the decision,

• reasons for the decision,

• supporting evidence,

• pertinent FS regulations, and

• responses to reasoned arguments made on behalf of the individual.

The Hearings Office also provides a written notice to all affected parties of the hearing decision. The written notice need only include the actual decision.

OSI notifies all parties if there is a disqualification period or collection action. OSI’s notice must specify all the following:

• the decision,

• reasons for the decision, and

• the date the disqualification will take place.

OSI provides a notice to remaining members of the household explaining one of the following:

• the allotment amount they will receive during the period of disqualification, or

• that the household must reapply because the certification period has expired.

OSI also sends a demand letter for repayment.