Chapter 5101:6-1 General Provisions

5101:6-1-01 State hearings:- general.

(A) Chapters 5101:6-1 to 5101:6-9 of the Administrative Code describe the hearing and appeal rights and procedures applicable to family services program benefits, pursuant to section 5101.35 of the Revised Code, and to child support services, pursuant to section 3125.25 of the Revised Code, and to the medicaid program, pursuant to section 5160.31 of the Revised Code.

(B) All rules relating to the right to a hearing and limitations on that right shall be liberally construed in favor of the right to a hearing.

(C) When it appears that an individual may not be able to understand or exercise the right to a state hearing due to factors such as limited mental capability or language barriers, the local agency shall assist the individual in naming a responsible party (guardian, relative, legal aid attorney, etc.) to act as authorized representative and receive a copy of notice in addition to the original to the individual. This requirement applies to notice at the time of application and to all subsequent hearing notices. A referral to social services for assistance in naming a responsible party may be appropriate.

(D) In counting the days contained in timely appeal specified in Chapters 5101:6-1 to 5101:6-9 of the Administrative Code, the date on which notice was mailed, sent by electronic means, or otherwise provided is not counted.

If the last day of the time period falls on a Saturday, Sunday, or state or federal legal holiday, then the time period is extended to include the next workday.

(E) Local agencies may modify the format, but not the content, of state hearing notices mandated in Chapters 5101:6-1 to 5101:6-9 of the Administrative Code to accommodate computer generation of the notice. All such modifications must be prior approved by state hearings.

(F) Definitions

As used in Chapters 5101:6-1 to 5101:6-9 of the Administrative Code, the following terms shall have the following meanings unless otherwise specified.

(1) "Local agency" shall refer to any or all of the following:

(a) The county department of job and family services (CDJFS), pursuant to section 5101.35 of the Revised Code.

(b) The county public children services agency (PCSA), pursuant to section 5101.35 of the Revised Code.

(c) The county child support enforcement agency (CSEA), pursuant to section 3125.25 of the Revised Code.

(d) A private or government entity administering, in whole or in part, a family services program benefit on behalf of ODJFS, a CDJFS, a PCSA, or as otherwise designated under law.

(2) "Agency" shall refer to either the local agency, ODJFS, or Ohio department of medicaid.

(3) "Social services" shall refer to any or all of the following:

(a) Learning earning and parenting (LEAP), supportive services, and support services provided to participants in a work activity under the Ohio works first (OWF) program or the food assistance employment and training program.

(b) Publicly funded child care services provided pursuant to Chapter 5101:2-16 of the Administrative Code.

(c) Title XX services provided pursuant to Chapter 5101:2-29 of the Administrative Code.

(4) "Benefits" shall refer to benefits under any or all of the following programs:

(a) Public assistance.

(i) Refugee resettlement program.

(ii) Disability assistance.

(iii) OWF cash assistance.

(iv) Prevention, retention and contingency (PRC) program.

(v) Medicaid.

(vi) Temporary assistance to needy families (TANF) funded programs administered by local agencies or agents of ODJFS or the CDJFS.

(b) Food assistance.

(c) Social services.

(d) State and federal adoption assistance programs.

(5) "Appellant" means an individual who is an applicant, participant, former participant, recipient, or former recipient of a family services program and is entitled by federal or state law to a hearing regarding a decision or order of the agency that administers the program.

(6) "Authorized representative" means an individual, eighteen years or older, who stands in the place of the appellant. The authorized representative may include a legal entity assisting in the application process. ODJFS may request proper identification from the authorized representative.

(7) "Electronic" has the same meaning as in section 1306.01 of the Revised Code.

(8) "Electronic equivalent" means an electronic version of an ODJFS form or application which has not been modified in any way other than format prior to completion and submission of that form to the administrative agency. The administrative agency is not required to accept forms that are materially altered.

(9) "Electronic signature" or "e-sign" has the same meaning as in section 1306.01 of the Revised Code.

(10) "Eligibility system" means a computer program determining benefit levels or amounts for individuals or families. Eligibility systems may also generate paper or electronic applications, forms, and notices related to the benefit determination or an action taken on the case of an individual or family.

Effective: 02/28/2014
R.C. 119.032 review dates: 11/18/2013 and 02/01/2019
Promulgated Under: 119.03
Statutory Authority: 3125.25 , 5101.35
Rule Amplifies: 3125.25 , 5101.35 , 5160.011 , 5160.31
Prior Effective Dates: 9/1/76, 10/1/78, 12/1/79, 4/1/80, 10/1/81, 5/1/82, 10/1/82, 4/1/83, 7/1/83, 11/1/83 (Temp), 12/1/83, 3/1/84 (Temp), 6/1/84, 10/3/84 (Emer), 12/22/84, 7/1/85 (Emer), 9/29/85, 4/1/86, 4/1/87, 12/1/87, 5/1/88, 11/1/88, 11/1/89 (Emer), 1/29/90, 10/1/91, 6/1/93, 10/1/97 (Emer), 12/30/97, 4/1/00, 6/1/03, 9/1/08, 8/1/10

5101:6-1-02 Hearings for the Title IV-A funded home energy assistance program (Title IV-A HEAP).

(A) Hearing procedures for the Title IV-A funded home energy assistance program (Title IV-A HEAP) shall be in accordance with this rule.

(1) The home energy assistance program (HEAP) is an annual benefit to low-income individuals to assist with winter home-heating costs. HEAP is administered by the Ohio department of development (ODOD), which receives a federal block grant to fund HEAP.

(2) In Ohio, the Title IV-A program, authorized under Title IV-A of the Social Security Act, is administered by the Ohio department of job and family services (ODJFS).

(3) Through an interagency agreement between ODOD and ODJFS, the department of job and family services will supplement the HEAP block grant with Title IV-A funds to provide HEAP benefits to applicants eligible for Title IV-A benefits.

(4) The department of development shall provide notice to the Title IV-A HEAP applicant as described in paragraph (B) of this rule.

(5) When a Title IV-A HEAP applicant disagrees with a determination made by the department of development as described in paragraphs (B)(2) and (B)(3) of this rule, the applicant has the right to request an agency review. The department of development shall conduct the agency review as described in paragraph (C)(1) of this rule and issue notice of the results of the agency review as described in paragraph (B)(4) of this rule.

(6) When a Title IV-A HEAP applicant disagrees with the results of the agency review, the applicant has the right to request a state hearing. The bureau of state hearings shall conduct the state hearing and issue a decision pursuant to paragraph (C)(2) of this rule.

(B) The department of development shall provide notice to the Title IV-A HEAP applicant in accordance with this paragraph. The department of job and family services, bureau of state hearings, shall review the content of the notices described in this paragraph. The department of development shall obtain approval of its notice from the bureau of state hearings.

(1) Notice at the time of application. At the time of application for Title IV-A HEAP, the department of development shall provide written instructions to all applicants of their right to request an agency review, of their right to request a state hearing, the method by which an agency review and state hearing may be requested, and that the applicant may be represented at an agency review or state hearing by the assistance group or by an authorized representative, such as, legal counsel, relative, friend, or other spokesperson.

(2) Notice at the time of denial or approval of application. The department of development shall provide prompt written notice of its decision to deny or approve Title IV-A HEAP benefits. The notice shall contain a clear and understandable statement of the action the department of development has taken and the reasons for it, the amount of all benefits, the applicable regulations, an explanation of the applicant's right to request an agency review and a state hearing, the method for obtaining an agency review and a state hearing, and a telephone number to call concerning free legal services.

(3) Notice of suspension. The department of development shall provide prompt written notice of its decision to suspend a Title IV-A HEAP applicant from HEAP. The notice shall contain a clear and understandable statement of the suspension, the reasons for it, cite the applicable regulations, an explanation of the applicant's right to request a state hearing, the method for obtaining a state hearing, and a telephone number to call concerning free legal services.

(4) Notice following the agency review. The department of development shall provide prompt written notice of its eligibility decision following the agency review. The notice shall contain a clear and understandable statement of the action the agency has taken and the reasons for it, the amount of all benefits, the applicable regulations, an explanation of the applicant's right to request a state hearing, the method for obtaining a state hearing, and a telephone number to call concerning free legal services.

(C) The department of development shall conduct the agency review, and the department of job and family services, bureau of state hearings, shall conduct the state hearing in accordance with the procedures described in this paragraph.

(1) Agency review. The applicant shall have ninety days from the mailing date of the notice to request an agency review. Within thirty days of receipt of an applicant's request for an agency review, the department of development shall review the Title IV-A HEAP application and any new documentation or information and send a written notice of the review decision to the applicant and the applicant's representative, if any. The notice shall contain the elements listed in paragraph (B)(4) of this rule. The department of development shall fulfill all the responsibilities of the local agency under the hearing procedures in Chapters 5101:6-3 to 5101:6-8 of the Administrative Code.

(2) State hearing. The applicant shall have ninety days from the mailing date of the agency review notice to request a state hearing. The department of development shall forward all state hearing requests it receives for Title IV-A HEAP applicants to the department of job and family services, bureau of state hearings, within twenty-four hours of receipt. Chapters 5101:6-3 to 5101:6-8 of the Administrative Code shall govern all matters related to state hearings for Title IV-A HEAP.

(a) An applicant may request a state hearing following an agency review for only the following reasons:

(i) An application for Title IV-A HEAP benefit is denied;

(ii) An application for Title IV-A HEAP benefit is neither approved nor denied within thirty days after the application date, unless such delay was the result of the household's lack of cooperation in providing necessary and reliable evidence with which to determine eligibility;

(iii) The amount of the Title IV-A HEAP benefit is less than what the notice of approval stated, or the Title IV-A HEAP applicant disagrees with the amount of the Title IV-A HEAP benefit.

(iv) The issuance of the Title IV-A HEAP benefit was unduly delayed after the notice of approval; or

(v) The Title IV-A HEAP applicant was suspended from HEAP for violation of HEAP rules and regulations, and contests that suspension.

(b) An applicant may request a state hearing when ODOD fails to complete an agency review within thirty days of the request.

(D) An individual who disagrees with the state hearing decision, has the right to request an administrative appeal as defined in Chapter 5101:6-8 of the Administrative Code. The administrative appeal decision will be final and binding on the issues presented. The judicial review process, as defined in Chapter 5101:9 of the Administrative Code, does not apply to Title IV-A HEAP appeals.

R.C. 119.032 review dates: 10/23/2013 and 10/01/2018
Promulgated Under: 119.03
Statutory Authority: 5101.35 , 5101.801
Rule Amplifies: 5101.35 , 5101.801
Prior Effective Dates: 01/27/06