Cal. WIC § 4712.5 — California Code / Code wic / Division 4.5 / Chapter 7 / Article 3 / Section 4712.5
Section 4712.5
Status: in_force

(a) (1) Within 10 business days of the concluding day of the fair hearing, but not later than 80 days following the date the appeal request form was received by the department or by another agency designated by the department to receive the appeal request form, the hearing officer shall render any final written decision delegated by subdivisions (d) and (e) and shall transmit the decision to each party, to the director of the hearing office, and the department, along with notification that this is the final administrative decision, that each party shall be bound thereby, and that either party may request a reconsideration pursuant to subdivision (b) of Section 4713 within 15 days of receiving the decision or appeal the decision to a court of competent jurisdiction within 180 days of receiving the final decision.

(2) Within 10 days of the concluding day of the fair hearing, but not later than 60 days following the date the appeal request form was received by the department or by another agency designated by the department to receive the appeal request form, the hearing officer shall render any proposed written decision as allowed by subdivisions (d) and (e) and shall electronically transmit the decision to the applicable departments identified in subdivisions (d) and (e).

(b) A continuance granted to a claimant shall constitute a waiver of their Medicaid home- and community-based services right to a decision within 90 days of the date the appeal request form is received by the department or by another agency designated by the department to receive the appeal request form. The extension of time for the final decision resulting from the continuance shall be only as long as the time period of the continuance.

(c) (1) The hearing officer’s decision shall be in ordinary and concise language and shall contain a summary of the facts, a statement of the evidence from the proceedings that was relied upon, a decision on each of the issues presented, and an identification of the statutes, regulations, and policies supporting the decision.

(2) If the claimant’s or their authorized representative’s preferred language is not English, the hearing office shall provide the proposed or final written decision in English and in their preferred language.

(d) (1) In addition to any other delegation of authority granted to the Director of Health Care Services, the director may delegate their authority to adopt final decisions under this chapter to the hearing officers described in subdivision (b) of Section 4712 to the extent deemed appropriate by the director. Any delegation shall be stated in writing.

(2) If the decision involves an issue arising from the federal Medicaid home- and community-based services waiver program, the hearing officer’s decision shall be a proposed decision submitted to the Director of Health Care Services as the single state agency for the Medicaid program. Within 90 days following the date the appeal request form is received, the director may adopt the decision as written or decide the matter on the record. If the Director of Health Care Services does not act on the proposed decision within 90 days, the decision shall be deemed to be adopted by the Director of Health Care Services. The final decision shall be immediately transmitted to each party, along with the notice described in paragraph (1) of subdivision (a). If the decision of the Director of Health Care Services differs from the proposed decision of the hearing officer, a copy of that proposed decision shall also be served upon each party.

(3) If the claimant’s or their authorized representative’s preferred language is not English, the final administrative hearing decision of the director and the proposed decision of the hearing officer shall be provided to that person in English and in their preferred language.

(e) (1) The Director of Developmental Services shall have the authority to review a hearing officer’s proposed decision or to delegate their authority to adopt final decisions to the hearing officers described in subdivision (b) of Section 4712. The authority for hearing officers to adopt final decisions may be made within specified issues or types of cases to the extent deemed appropriate by the director. Any delegation shall be stated in writing.

(2) Within 30 days following receipt of the proposed decision, the Director of Developmental Services may adopt the proposed decision as written or decide the matter on the record, including the recording, with or without taking additional evidence. If the director does not act on the proposed decision within the 30 days, the proposed decision shall be deemed to be adopted by the director. The State Department of Developmental Services shall promptly transmit a final decision to each party, along with the notice described in paragraph (1) of subdivision (a). If the final decision of the director differs from the proposed decision of the hearing officer, a copy of the proposed decision also shall be served upon each party.

(3) If the claimant’s or their authorized representative’s preferred language is not English, the final hearing decision of the director and the proposed decision of the hearing officer shall be provided to that person in English and in their preferred language.

(f) The hearing office shall collect and maintain, or cause to be collected and maintained, redacted copies, that do not include any identifiable information concerning the claimant, of all final administrative hearing decisions issued under this chapter. Hearing decisions shall be searchable by the type of service or support that was the subject of the hearing, by the month and year of issuance, and any other categories identified by the State Department of Developmental Services. The hearing office shall make available to the public on the hearing office’s internet website searchable and downloadable redacted copies of all final administrative hearing decisions. These decisions shall be available no later than 30 days after the date of the final hearing decision. The State Department of Developmental Services shall use this information in partial fulfillment of its obligation to monitor regional centers and in its evaluation of the contract for the provision of independent hearing officers.

(g) This section shall become operative on March 1, 2023.