(a) Notice of Agency, Aging Services Access Point (ASAP), or Veterans' Agent Action

  1. Requirements: Notice of action by an Agency, ASAP or Veterans' agent to deny, terminate, reduce, or suspend services or Benefits to a Recipient or to deny Benefits or services to an applicant shall include but not be limited to:
    1. clear and plain statement of the action to be taken;
    2. the date on which the action shall become effective;
    3. an explanation of reasons for the action;
    4. the regulation or other legal authority on which such action is based;
    5. the telephone number and address where further information may be obtained;
    6. an explanation of the applicant's or recipient's right to request a hearing (including the time limits and manner for request);
    7. a copy of the form used to request a hearing;
    8. an explanation of the circumstances, if any, under which Benefits or services will continue pending an Adjudicatory Proceeding;
    9. an explanation of the right to be represented, including if applicable, the availability of assistance; and
    10. the mailing address, telephone number and office hours of the office responsible for receiving and/or hearing appeals from the Agency action.
  2. Exceptions for ASAP
    1. If a Recipient voluntarily assents in writing to a termination, reduction or suspension of services, the ASAP shall implement the change in service in accordance with the terms of that assent, without sending notice of action. ASAP shall use a written assent format provided by Elder Affairs.
    2. If a recipient is hospitalized or otherwise institutionalized, ASAP shall suspend the Recipient's services as soon as feasible, without sending notice of action. Upon discharge, the ASAP shall reassess the Recipient's service needs.
    3. If an ASAP has actual knowledge that a Recipient is temporarily absent from the ASAP service area and is therefore unavailable to receive services, the ASAP may suspend services for the period of the Recipient's absence without sending notice of action.

(b) Grounds for Appeal

A right to request an Adjudicatory Proceeding shall arise when controversy exists which by law or Agency regulation requires an Adjudicatory Proceeding, or when a Person is aggrieved by an Agency, ASAP, or veterans' agent action or failure to act.

(c) Adjudicatory Proceedings - How Taken

A Person entitled to an Adjudicatory Proceeding or his or her Authorized Representative must request a hearing in writing in the form prescribed, or on the form provided by the Agency or the Presiding Officer, and must sign and date the request. At the discretion of the Agency, the request for hearing may be filed by Electronic Medium. The requesting Party must file with the Agency or the Presiding Officer within the time limit prescribed by law. In the absence of any time limit, the requesting Party must file within 60 days after receipt of the notice of action or, for failure to act, within 120 days from application, unless the Agency has established a longer period.

(d) Continuation of Benefits Pending Appeal

Benefits shall continue when required by applicable statute or regulation, if the Recipient or Institution has met the standard set forth by applicable statute or regulation.

(e) Termination of Continued Benefits

Benefits continued in accordance with 801 CMR 1.02(6)(d) shall be terminated if:

  1. a determination is made at the hearing that the sole issue is a challenge to the validity of a particular law or regulation; or
  2. a change affecting the Recipient's Benefits occurs subsequent to the Adjudicatory Proceeding request which makes the previously filed Adjudicatory proceeding request moot, and the Recipient fails to request a hearing on the subsequent matter within the applicable time period; or
  3. a determination is made at the hearing that the Agency action to terminate Benefits was correct.

This information was last updated on 12/22/2008.