Subchapter B. PROCEDURES FOR REVIEW OF SERVICE
ELIGIBILITY AND TERMINATION DECISIONS


Sec.


4000.201.    Generally.

§ 4000.201. Generally.

 (a)  County MH/MR administrators are directed to establish policies providing for documentation of decisions associated with applications for service and termination of service. The granting of one service does not relieve the county programs from the following requirements whenever another service is denied or terminated. Further, these policies are to provide that:

   (1)  A client shall receive a timely, written response to an application for services and timely, written notice of intention to terminate service. A copy of the written response or notice shall be retained in the client’s file.

   (2)  The response contains a statement why any portion of the application could not be granted and a notice of termination shall contain a statement why the service is being terminated—for example, client not eligible for MH or MR services, services are not appropriate, no positions in a program are available for the applicant, the applicant is not a resident of the county, or other appropriate reasons. The response or notice of termination shall inform the client of the availability of the review procedures set forth in this section.

   (3)  Without excluding additional review provided by the county programs, at a minimum an applicant denied services or a client whose services are being terminated may seek review of the denial or decision to terminate service by the county administrator or the administrator’s designee. The person conducting the review should not have participated in the application or termination at issue, as the goal is to provide a fair, impartial review.

   (4)  At the review before the county administrator or designee, the client will be given an opportunity to be present, present documentation in support of the client’s position, present and question witnesses and be accompanied by other persons to assist in the presentation. The person who made the decision under review will also be present and may be questioned by either party. Relevant information or witnesses may be presented at this review by the county. The entire review meeting will be tape-recorded by the administrator or a designee at no expense to the client and the tape retained by the administrator. Either party may have the meeting transcribed from the tape at the party’s own expense.

   (5)  The decision of the administrator, or designee, shall be made promptly in writing and contain a statement of the findings and reasons for the decision, including reasons why the services sought by the client will not be provided as requested or why the termination decision was upheld and what criteria were applied. A copy of the decision will be provided promptly to the client and to the client’s representative, if there is one, by mail or by personal service.

 (b)  Procedural safeguards developed by the individual county MH/MR programs will be reviewed as part of the county management compliance review process.

Source

   The provisions of this §  4000.201 deposited for direct codification by the Department of Public Welfare under 1 Pa. Code §  9.301 (relating to unpublished statements of policy adopted prior to January 1, 1985).



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