Opinion ID: 2805947
Heading Depth: 3
Heading Rank: 3

Heading: The Service Plan

Text: If the participant does not appeal the calculated budget, the participant works with a plan developer or support broker to submit a service plan to the Department. The service plan 8 K.W. V. ARMSTRONG lists the type and frequency of services and outlines their cost relative to the participant’s calculated budget. After the participant submits a service plan, the Department determines whether it meets the needs of the participant, safeguards the participant’s health and safety, and is within the calculated budget. If the plan is inadequate or over-budget, the Department may refer the plan back to the developer for adjustment. If the plan still does not meet the participant’s needs or is not within budget, the Department may either authorize some of the services or deny all of the services in the plan. In such cases, the Department notifies the participant about which services, if any, were approved. The participant may then request an administrative appeal within 28 days. If a participant requests an appeal, a hearing officer is appointed and a hearing is held. The hearing officer may not approve eligibility, modify the budget, or approve denied services. Rather, the hearing officer may only uphold the Department’s decision or remand to the Department to update assessment documents, recalculate a participant’s budget, or reexamine a service denial. If the participant or the Department disagrees with the hearing officer’s decision, either may seek a Director’s Review. The Director’s decision may be appealed to the district court. The approved and finalized cost of services in the service plan becomes the participant’s authorized budget. A participant may change his service plan with the Department’s approval, but may not spend more than his calculated budget. K.W. V. ARMSTRONG 9