900 Fair Hearing

Georgia State Seal

Georgia Division of Family and Children Services
CSBG Policy Manual

Policy Title:

Fair Hearing

Chapter:

900

Effective Date:

October 2023

Policy Number:

900

Previous Policy Number(s):

Requirements

All applicants/clients shall receive fair and equitable treatment and may request a fair hearing for the following reasons:

  • Application for assistance is denied

  • Application is not acted upon within a reasonable period of time

  • Benefit level is less than applicant believes it should be

The State requires a due process hearing within the Department. The Office of State Administrative Hearing (OSAH) is responsible for the final decision of the hearing provision.

Community Action Agency must inform each applicant in writing of the following:

  • Right to a fair hearing whenever any action affects his/her application/benefit.

  • Right to be represented by an authorized representative such as legal counsel, relative, friend or another spokesperson

  • Right to represent oneself

  • Right to timely and adequate notice of denial/benefit change

Basic Considerations

A request for a hearing is a clear expression, made verbally or in writing by an applicant, recipient, or his/her protective payee to the effect that he or she wants the opportunity to present their case to a higher authority.

CSBG cases involving an alleged or suspected fraud are referred to the Office of Inspector General’s Benefit Integrity and Recovery Unit (BIRU) for investigation. OIG is responsible for ensuring the appropriate adjudication of these cases either through administrative disqualification hearings or referrals for prosecution.

Fair Hearing Request

  • Is defined as a clear written or oral expression by the applicant or applicant’s authorized representative of the desire to appear before a higher authority.

  • The individual must request a hearing within thirty (30) days of notification of the decision with which s/he disagrees (42 C.F.R. § 431.221(d)). In the event an oral request is made, the individual must submit a written request within fifteen (15) days of the original request. The individuals' freedom to request a fair hearing is a right guaranteed to ensure due process.

  • All fair hearings shall be administered by the Office of State Administrative Hearings (OSAH) Administrative Law Judge (ALJ). OSAH is responsible for scheduling hearings and notifying the parties (the Petitioner and DHS/DFCS) of the date, time, and location of the hearing. An Administrative Law Judge (ALJ) from OSAH conducts hearings.

  • DFCS is prohibited from disclosing Personally Identifiable Information (PII) or Protected Health Information (PHI) to unauthorized individuals. Therefore, DFCS will not disclose, discuss, or allow access to the applicant’s or recipient’s PII or PHI without authorization. DFCS processes hearing requests that are submitted on behalf of an applicant or recipient when DFCS is provided valid legal authorization.

  • A qualified interpreter must be provided to assist customers who have limited English proficiency or who request an interpreter as a form of communication assistance due to a disability. Hearing procedures must be explained in the customer’s preferred language.

Processing a Fair Hearing Request

Follow the steps below when an applicant, or his/her representative requests a fair hearing:

  1. Within three (3) business days of eligible entity’s receipt of a fair hearing request, review the record to determine the following:

    • Was the correct action taken? If not, correct the case and notify the applicant or recipient. S/he may choose to withdraw the request for a hearing.

    • Is the Applicant eligible on all points of eligibility other than the one at issue?

    • Is there enough information in the record to determine the correct amount of issuance? If not, the case worker will request the needed information and/or verification.

  2. Within three (3) business days of State Office/DFCS’s receipt of a fair hearing request, State Office/DFCS will attempt to discuss and resolve the complaint with the Applicant or the representative.

    • If a mutually satisfactory decision can be reached, the Applicant may withdraw the hearing request, in writing. Update the case based on the changes agreed upon during applicant/client contact.

    • If during applicant/client contact, a mutually satisfactory solution cannot be obtained or if unable to contact the applicant to discuss the complaint, electronically submit the following documents to OSAH within five (5) business days of State Office/DFCS receipt of fair hearing request:

      • original Form 118, Request for Hearing, or any written request for hearing presented by the applicant

      • Decision notice to the applicant or recipient of the action in dispute.

      • Original OSAH Form 1

Make sure that any available contact information, including phone numbers and an email address for the applicant or recipient are included on the OSAH Form 1

The Fair Hearing

The individual may have an authorized representative such as legal counsel, a relative, friend or other spokesperson, or he/she may represent himself/herself at the hearing. The individual and/or the authorized representative should have an adequate opportunity to:

  1. Examine the releasable contents of the application and all documents/records to be used by DFCS/Eligible Entity at the hearing at a reasonable time before the date of the hearing and/or at the hearing

  2. Present the case and establish all pertinent facts and circumstances

  3. Bring witnesses

  4. Advance any arguments without undue interference; and

  5. Question or refute any testimony or evidence, including the opportunity to confront and cross-examine adverse witnesses.

Once rendered, the decision of the ALJ becomes effective immediately. However, if an adverse decision is issued, the individual has a right to a further appeal to the DHS Commissioner through the DHS Appeals Reviewer. The DHS Appeals Reviewer shall notify the individual and his/her legal representative of the final decision and of the individual’s right to pursue a separate legal action for judicial review outside of DHS.

Requirements

OSAH has specific duties regarding the requirements for and conduct of a hearing, which are consistent with Georgia’s Administrative Procedure Act, other applicable laws, regulations, and OSAH’s Administrative Rules of Procedure found at 616-1-2-.01 et seq.

Office of State Administrative Fair Hearings Responsibilities

OSAH initiates the following actions as needed:

  • provides, at least ten days prior to the hearing, advance written notice to all involved parties in order to permit adequate preparation of the case.

  • changes the time and/or location of the hearing upon its own motion or for good cause shown by the applicant, recipient, or protective payee.

  • consolidating cases for which the sole issue is one of state and/or federal law, regulations, or policy.

  • conducts a single hearing for multiple programs, if determined appropriate.

  • determines numbers of persons who may attend the hearing.

  • denies or dismisses a hearing request and grants continuances.

  • utilizes only the facts and opinions that are evidence of record or which may be officially noticed and are, therefore, subject to the rights of objection, rebuttal, and/or cross examination by the involved parties.

  • makes a decision within ninety days from the date of DFCS' receipt of the request for a fair hearing.

  • mails the final hearing decision and related hearing notices to all involved parties.

  • informs the Petitioner of his/her Superior Court appeal rights, if the Petitioner disagrees with the final decision.

Upon receipt of a hearing request, OSAH notifies the State Office/ DFCS and the applicant of the date and time of the hearing. The hearing may be conducted in the county at the DFCS or other government office, at the OSAH office in Atlanta or by telephone. State law prohibits the ALJ from providing legal advice to either party, including the state agency. As such, OSAH cannot assist the agency or the petitioning applicant or recipient in determining who should be present as witnesses at the hearing or what evidence is necessary to establish the case.

Rights and Responsibilities of Both Parties at the Fair Hearing

The applicant, or the applicant’s representative also has the right to do the following:

  • present the case with or without the aid of a representative, including legal counsel, a relative, friend or other spokesperson.

  • request assistance from the agency for transportation to/from the hearing.

  • present arguments without undue interference.

The applicant, and the agency present its case by (list is not exhaustive):

  • bringing and/or requesting the appearance of witnesses by subpoena (if needed),

  • establishing all pertinent facts and circumstances,

  • questioning and refuting any testimony or evidence, including the opportunity to question and cross-examine adverse witnesses.

The eligible entity is responsible for the following:

  • ensure the presence at the hearing of staff members with direct knowledge of the facts in dispute

  • ensure that all relevant agency records and copies are legible and available as evidence

The Final Hearing Decision

The final hearing decision is issued within ninety days from the date the written request for a hearing is received by DFCS, except in the event of a postponement or continuance. Hearing decisions are based on the evidence presented at the hearing.

An ALJ shall have all the powers of the ultimate decision maker in the agency with respect to a contested case. Hearing decisions specify the reason for the decision, which includes findings of fact, conclusions of law, and a disposition of the case.

The following shall be a part of the hearing record:

  1. all rulings, orders, and notices issued by the court.

  2. all pleadings and motions.

  3. all recordings or transcripts of oral hearings or arguments.

  4. all written direct testimony.

  5. all other data, studies, reports, documentation, information, other written material of any kind, and physical evidence submitted in the proceedings.

  6. a statement of matters officially noticed.

  7. all proposed findings of fact, conclusions of law, and briefs; and

  8. the Decision issued in the matter