AUTHORITY: Implementing Sections 11-8 through 11-8.7, 12-4.9 and 12-4.25 and authorized by Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/11-8 through 11-8.7, 12-4.9, 12-4.25 and 12-13].

SOURCE: Adopted at 25 Ill. Reg. 5335, effective March 15, 2001; amended at 25 Ill. Reg. 14860, effective October 30, 2001; amended at 25 Ill. Reg. 15253, effective October 31, 2001.

SUBPART A: ASSISTANCE APPEAL

 

Section 14.1  Purpose

 

This Part applies to Public Assistance appeals filed by or on behalf of applicants or recipients of  assistance under the Department of Human Services.

 

Section 14.2  Incorporation By Reference

 

Any rules or regulations of an agency of the United States or of a nationally recognized organization or association that are incorporated by reference in this Part are incorporated as of the date specified, and do not include any later amendments or additions.

 

Section 14.5  Definitions

 

"Administrative Disqualification Hearing" means a hearing conducted pursuant to 7 CFR 273.16 regarding alleged intentional program violations of the Food Stamp Program.

 

"Appeal" or "Fair Hearing" means the contesting of an action taken by the Department by an applicant or recipient of Public Assistance services.  Such action may include but is not limited to the following: refusal to accept an individual's application; failure to act on the application; denial of an application; a decision to reduce, suspend or terminate, or change the amount of assistance; failure of the Department to take appropriate action on the individual's request; a decision affecting the basis for issuances of food stamps; and any issues of Department policy that, when applied, aggrieve the individual.

 

"Appellant" means the individual or his/her authorized representative who has applied for, received, or been denied financial assistance, medical assistance or food stamps and is appealing an action or inaction of the Department. All references to appellant include any authorized representative.

 

"Business Day" means any day that the offices of the State of Illinois are open for business.  This would exclude Saturdays, Sundays and State holidays.

 

"Day" means a calendar day unless otherwise specified.

 

"Department" means the Illinois Department of Human Services.

 

"Filed" – a document shall be considered filed on the date it is postmarked, if mailed, or on the business day the action is received by the Department if it is delivered by hand, phone or fax. Contact in person or by phone or fax shall be considered filed on a business day, if it is received prior to the close of business, 5:00 pm, on that date. If receipt is after 5:00 pm, the action shall be deemed filed on the next business day.

 

            "Hearing Officer" means the individual authorized by the Secretary to preside at the hearing.

 

            "Notice" means written correspondence sent by the Department to an individual to inform the individual of actions taken by the Department. (See 89 Ill. Adm. Code 102.70.)

 

            "Party" means the Department or person or agency named or admitted as a party or properly seeking and entitled as of right to be admitted as a party [5 ILCS 100/1-55] or the appellant.

 

            "Public Aid Committee" means the committee of local government that consists of the membership as spelled out in Section 11-8 of the Public Aid Code [305 ILCS 5/11-8] to hear appeals of applicants or recipients of General Assistance as governed by Article VI of the Public Aid Code [305 ILCS 5/Art. VI].

 

            "Public Assistance" means the provision of various programs of financial and medical assistance, including the following:

 

            "AABD" – Aid to the Aged, Blind or Disabled financial assistance and medical assistance available to individuals who have been determined to be aged, blind or disabled as defined by the Social Security Administration. (See 89 Ill. Adm. Code 113.)

 

            "Child Care" – Public Assistance to pay for the child care of eligible families under qualified circumstances.

 

            "Financial Assistance" – Public Assistance paid in the form of a cash benefit to a recipient for income maintenance needs.

 

            "Food Stamps" – Increased food purchasing benefits assistance to eligible recipients. (See 89 Ill. Adm. Code 121.)

 

            "General Assistance" – Financial and medical assistance available to eligible needy families or individuals who are ineligible to receive assistance through a categorical assistance program. (See 89 Ill. Adm. Code 114.)

 

            "KidCare" – Assistance in providing health insurance coverage to eligible children, under age 19, and pregnant women.

 

            "Refugee Resettlement Program" – Assistance for refugees from any country.

 

            "Repatriate Program" – Assistance for United States citizens and their dependents returned from a foreign country by the U.S. State Department.

 

            "Medical Assistance Grant" (MAG) – Medical assistance paid on behalf of a recipient of financial assistance.

 

            "Medical Assistance No Grant-cases" (MANG) – Medical assistance paid on behalf of a recipient of categorical assistance who is not receiving financial assistance. This assistance includes:

 

            MANG(AABD) – Medical assistance available to individuals who have sufficient income and assets to meet all maintenance needs other than medical care and who are receiving Supplemental Security Income benefits or who are determined to be aged, blind or disabled by the Department of Human Service; and

 

            MANG(C) – Medical assistance to needy families with children is available to families with one or more children who would qualify for TANF on the basis of non-financial eligibility factors but have sufficient income and assets to meet all maintenance needs other than medical care.

 

            "Temporary Assistance to Needy Families (TANF)" – Financial and medical assistance available to eligible families with one or more dependent children. (See 89 Ill. Adm. Code 112.)

 

            "Representative" means an attorney or other individual authorized by the appellant to act on the appellant's behalf in the proceedings contained in this Part. The authorization shall be in writing and specify the scope of the representative's authority.

 

            "Secretary" means the Secretary of the Illinois Department of Human Services.

 

Section 14.10  Initiation of an Appeal

 

a)         For all appeals other than General and Transitional Assistance outside the City of Chicago, the appeal process is initiated by the appellant by:

 

1)         filing a written, signed request with the Bureau of Assistance Hearings;

 

2)         filing a written, signed request with the respective local office; or

 

3)         telephoning a request to the Bureau of Assistance Hearing's toll free number for filing appeals.

 

b)         A food stamp appeal may also be initiated by an oral request of the appellant to the local office.

 

c)         For General and Transitional Assistance outside the City of Chicago, the appeal process is initiated by the appellant filing a written, signed request with the Public Aid Committee. (See Section 14.80.)

 

d)         For purposes of an appellant initiating the appeal process, a facsimile of a written, signed request for a fair hearing is considered the same as the original written, signed request.

 

e)         An appeal may be filed by individuals who apply for or receive financial assistance, medical assistance, or food stamps, or by their authorized representatives. Authorized representatives must provide a written, signed authorization from the individual designating them as the individual's representative.

 

f)         An appeal must be filed within the following time frames:

 

1)         For a public assistance issue, the appeal must be filed within 60 days after the Department's action to notify the client; or

 

2)         For a food stamp issue, the appeal must be filed within 90 days after the Department's action to notify the client.

 

Section 14.11  Pre-Hearing Meeting

 

a)         The local office shall schedule a pre-hearing meeting with the appellant within 10 days after a notice of appeal is received.  If the issue being appealed is a denial for expedited food stamps, the local office shall schedule a pre-hearing meeting within 2 business days after a notice of appeal is received.

 

b)         If the appellant does not withdraw the appeal following the meeting, the Department shall complete a written statement of facts supporting its action or inaction and provide it to the appellant.  The appellant must receive that statement at least 2 business days before the Hearing.  If the statement is mailed, the local office should allow at least 2 business days for receipt.

 

Section 14.12  Review of Case Record

 

Prior to the hearing the appellant shall have the opportunity to examine appellant's case record and obtain copies of case record material. Copies of the parts of the case record relevant to the hearing shall be provided free if requested by the appellant.

 

Section 14.15  Notice of Hearing

 

The Department shall send written notice to the appellant and any authorized representative of the time, date and place of the hearing. This notice shall be provided at least 10 days prior to the Hearing.

 

Section 14.20  Venue and Conduct of Hearings

 

a)         All hearings will be conducted in the county in which the appellant resides or in another county acceptable to the appellant. Hearings under this Section may be conducted with some or all of the parties, including the hearing officer, at different locations connected with each other by telephone [305 ILCS 5/11-8.2].

 

b)         If the appellant is outside the State, the hearing officer may take depositions from the appellant and the appellant's witnesses or permit the appellant to present all relevant matter in support of this claim. This may be accomplished through witnesses acting in the appellant's behalf, or both by deposition or testimony of witnesses, depending upon the circumstances in each case [305 ILCS 5/11-8.2].

 

c)         All hearings will be conducted by:

 

1)         An impartial hearing officer authorized by the Secretary to consider issues under appeal covered by this Part; or

 

2)         A Public Aid Committee for General and Transitional  Assistance appeals outside the City of Chicago.

 

d)         The hearing shall be open to such persons as the hearing officer or the Public Aid Committee deems necessary and proper for the orderly and efficient conduct of the hearing.

 

e)         The Department shall provide reasonable accommodations under the Americans with Disabilities Act (42 USC 12101) for access to and participation in a hearing.

 

Section 14.21  Representation

 

The appellant may appear without representation at the hearing or may be represented by legal counsel or other authorized representative, in which case the appellant need not be present at the hearing.  The representative must have a written authorization signed by the appellant prior to any action taken on behalf of the appellant.  The action or inaction of an authorized representative shall be deemed to be action or inaction of the appellant.

 

Section 14.22  Appellant Participation in Hearing

 

a)         The appellant shall have the opportunity to:

 

1)         Present evidence and witnesses in the appellant's behalf.

 

2)         Refute testimony or other evidence and cross-examine witnesses.

 

b)         If an appellant dies before the date of hearing, the appeal process may be pursued by someone acting responsibly in the appellant's behalf.

 

Section 14.23  Evidentiary Requirements

 

The hearing shall not be bound by common law or statutory rules of evidence, or by technical or formal rules of procedure, but shall be conducted in a manner best calculated to conform to substantial justice.

 

Section 14.30  Subpoenas

 

Subpoenas must be requested by the appellant prior to the hearing. Subpoenas may be granted at the discretion of the hearing officer or other assistance hearing administrator if a hearing officer has not been appointed.

 

Section 14.35  Amendment of Appeal

 

A request to amend an appeal may be made in writing prior to the hearing, or at the hearing. The appeal may be amended only if, in the judgment of the hearing officer, the amendment is germane to the subject matter of the original request for an appeal hearing.

 

Section 14.40  Consolidation of Appeals

 

a)         The Department may consolidate a number of individual appeals for the purpose of conducting a single group hearing if it is determined that all of the appeals involve the same issue or similar issues, and the only issues in question are the application of State or federal law or policy.

 

b)         An appellant may withdraw from the group and present an appeal individually if, in the judgment of the hearing officer, it is warranted by the circumstances.

 

c)         The Department may consolidate a number of appeals filed by the same individual into a single hearing.

 

Section 14.45  Postponement or Continuation of Hearings

 

a)         The Department may postpone or continue a hearing as provided in this Section.  As used in this Section, a "postponement" is a decision not to convene the hearing on its scheduled date. A "continuance" is a decision not to proceed with a hearing that has convened.

 

b)         A request for postponement or continuance may be made by the appellant or the appellant's authorized representative. Except for the appellant's request for the first postponement of a food stamp appeal, a request to postpone a hearing must be in writing and received by the Bureau of Assistance Hearings at least 2 business days prior to the scheduled hearing date. A request for postponement made less than 2 business days prior to the scheduled hearing date will be granted only upon showing of good cause as defined in Section 14.60(e).

 

c)         If the request for a continuance or postponement is granted, the Bureau of Assistance Hearings shall schedule a hearing as early as is reasonably practicable and shall notify the parties of the new date, time and place of the hearing.

 

d)         Requirements for Requests

 

1)         In a food stamp appeal the appellant's first request for postponement or continuance does not require showing of good cause or timely submission.

 

2)         In a non-food stamp appeal, the appellant's first request for postponement or continuance does not require a showing of good cause, but a request for postponement does require timely submission.

 

3)         All subsequent requests for postponement or continuance will be granted only upon timely submission and showing of good cause.  Good cause to postpone or continue a hearing includes, but is not limited to, the reasons set forth in Section 14.60(e).

 

4)         Except for the first request for a postponement in a food stamp appeal, unless notified that the postponement has been granted, the appellant and representatives are expected to appear at the hearing.  Failure to appear shall cause the dismissal of the appeal as set forth in Section 14.60.

 

e)         At the hearing, the hearing officer may grant a request to continue when the party or representative shows that good cause exists for not proceeding with the hearing.  If the request is based on the unavailability of witnesses and/or documentary evidence, the hearing officer may defer ruling on the request until after the available evidence on the issues of the case has been presented.

 

(Source:  Amended at 25 Ill. Reg. 14860, effective October 30, 2001)

 

Section 14.50  Withdrawal of Appeal

 

An appeal may be withdrawn by the appellant either prior to or at the hearing.  A withdrawal must be in writing and signed by the appellant or entered on the record.

 

Section 14.55  Closing of Hearing Record

 

At the adjournment of the hearing, the record shall be closed and no further evidence may be submitted. Prior to adjournment of the hearing, a request to leave the record open for a specified period for the submittal of additional evidence specifically identified during the hearing may be granted by the hearing officer.  Copies of any evidence presented after the hearing shall be provided to all parties.

 

(Source:  Amended at 25 Ill. Reg. 14860, effective October 30, 2001)

 

Section 14.60  Dismissal of Appeal

 

a)         An appeal shall be dismissed if:

 

1)         The appellant or the appellant's authorized representative does not appear at the time, date and place designated for the hearing; or

 

2)         The appellant or the appellant's authorized representative fails or refuses to proceed with the hearing.

 

b)         The appellant shall be informed of the dismissal by written notice.

 

c)         When an appellant whose assistance has been continued unchanged as a consequence of a request for a hearing does not appear at a scheduled hearing, and fails to advise the Department or Public Aid Committee of his or her  inability to attend, the Department shall proceed with the planned change in assistance and/or food stamp benefits.  This action will not be taken if the Department determines that there was good cause for the appellant's absence. (See subsection (e) below).

 

d)         Request to vacate a dismissal must be in writing and signed  by the appellant or the appellant's authorized representative.  Such requests must be filed with the Bureau of Assistance Hearings not more than 10  days after the date of the dismissal notice.

 

e)         Dismissals shall be vacated only if good cause for non-appearance is shown.  Good cause is defined as:

 

1)         death in the family;

 

2)         personal injury or illness that reasonably prohibits the appellant from attending the hearing; or

 

3)         sudden and unexpected emergency or other circumstances beyond the appellant's control that reasonably prevent the appellant from attending the hearing.

 

f)         Disposition by dismissal is a Final Administrative Decision.

 

Section 14.70  Final Administrative Decision

 

a)         Following the hearing, a Final Administrative Decision will be made by the Secretary that either upholds or does not uphold the appealed action or determines that the Department lacks jurisdiction.  A copy of the decision shall be mailed to the appellant and any representative.

 

b)         If the appeal involves Public Assistance issues or both food stamp and Public Assistance issues, the Department shall issue and implement a Final Administrative Decision within 90 days after receipt of a notice of appeal and request for a hearing, unless additional time is required and allowed by the program's rules for a proper disposition of the appeal.  This time period shall be extended by any delay in the hearing process caused by the appellant.

 

c)         If the appeal involves food stamps but not Public Assistance, the Department shall issue and implement a Final Administrative Decision within 60 days after receipt of a notice of appeal and request for a hearing, unless additional time is required and allowed by the program's rules for a proper disposition of the appeal.  This time period shall be extended by any delay in the hearing process caused by the appellant.

 

d)         When the appealed action is not upheld, the Department shall take appropriate action, in accordance with the decision, including authorization of retroactive assistance benefits, if necessary.  In food stamp cases, if the decision results in an increase in household benefits, the increase shall be reflected in the food stamp benefit amount within 10 days after receipt by the local office of the hearing decision. If the decision results in a decrease of food stamp benefits, the decrease shall be reflected in the next scheduled issuance following receipt of the hearing decision.

 

e)         A Final Administrative Decision, released by the Department or a Public Aid Committee, is reviewable only through the Circuit Courts of the State of Illinois.

 

f)         After a Final Administrative Decision is released, no petition for rehearing or reconsideration is allowed. Neither the filing of any such motion, or correspondence in the nature of such a motion, nor any response by the Department to such correspondence or motion will delay the time for filing of a complaint in the Circuit Court.

 

Section 14.80  Public Aid Committee

 

In each county a Public Aid Committee to consider appeals shall have the following composition:

 

a)         In counties under township organization (except Cook County), the Committee shall consist of the Chairman of the County Board and 4 County Board members.

 

b)         In Cook County, the Public Aid Committee shall consist of 5 Supervisors of General Assistance appointed by the President of the Cook County Board of Commissioners from townships outside the City of Chicago.

 

c)         In Commission form counties, the Public Aid Committee shall consist of the County Board of Commissioners.

SUBPART B: RESPONSIBLE RELATIVE AND JOINT PAYEE PETITIONS

 

Section 14.100  Responsible Relative and Joint Payee Petitions

 

Sections 14.101 and 14.102 apply to all petitions of responsible relatives for release from or modification of Administrative Support Orders, or to contest determinations of the amount of past-due support or of the share of jointly-owned funds (see 305 ILCS 5/10-13).

 

Section 14.101  Petition for Hearing

 

a)         Any responsible relative aggrieved by an administrative support order entered, determination of past-due support or determination of the share of jointly-owned funds made by the Department may petition for a hearing for release from or modification of the order or to contest the determination.

 

b)         The petition under subsection (a) above shall be filed within 30 days after the date of mailing of such order or determination.  The day immediately following the mailing of the order or determination shall be considered as the first day and the day the petition is received by the Department shall be considered as the last day in computing the 30 day appeal period.

 

Section 14.102  Conduct of Administrative Support Hearings

 

a)         Hearing De Novo

            The hearing shall be de novo and the Department's determination of liability or non-liability pursuant to the hearing shall be independent of the prior determination of liability.

 

b)         Rules Governing Hearing

            Hearings on petitions for release from or modification of the Administrative Support Order shall be governed by Sections 14.10 through 14.70, except that "appellant" as used within those Sections shall refer to the responsible relative who petitions.

SUBPART C: FOOD STAMP ADMINISTRATIVE DISQUALIFICATION HEARINGS

 

Section 14.300  Suspected Intentional Violation of the Program

 

If the documentation supports the claim of intentional violation of the program, the Department shall send the individual a notice of suspected intentional violation of the program and of the opportunity to waive the administrative disqualification hearing. Examples of this documentation include statements made by a household member on his application, statements made by a household member and recorded in his case record by the caseworker, and statements made by an employer indicating employment of a household member that conflicts with information on the household member's application.  Based upon an evaluation of the facts, the Department may refer cases of suspected intentional violation for criminal prosecution.  Factors considered by the Department in its evaluation include, but are not limited to, the dollar amount at issue, evidence of willful intent to defraud, and the weight of the evidence.

 

Section 14.310  Advance Notice of Administrative Disqualification Hearing

 

The Department shall provide written notice to a household member suspected of intentional violation of the food stamp program at least 30 days in advance of the date an administrative disqualification hearing has been scheduled.  The notice shall contain:

 

a)         The date, time and place of hearing.

 

b)         The charge against the household member.

 

c)         A summary of the evidence and how and where it can be examined.

 

d)         A warning that the decision will be based solely on information provided by the food stamp office if the household member fails to appear.

 

e)         A statement that the household member or representative will have 10 days after the date of the hearing to present good cause for failure to appear in order to receive a new hearing.  (See Section 14.60(e) for definition of good cause.)

 

f)         A warning that a determination of intentional violation of the program will result in a 12 month disqualification for the first violation, 24 month disqualification for the second violation, and a permanent disqualification for the third violation, and a statement of which penalty the Department believes is applicable to the case scheduled for hearing.

 

g)         A listing of the household member's rights.

 

h)         A statement that the hearing does not preclude a prosecution for civil or criminal fraud.

 

i)          A statement that the individual can call the food stamp office to get the name and phone number of someone who can give free legal advice.

 

The household member is also sent a waiver of right to an administrative disqualification hearing pursuant to 7 CFR 273.16(f).  If the household member wishes to waive the right to a hearing, that individual must sign the waiver and return it to the Department within 20 days after the date of notification.

 

Section 14.320  Postponement of Hearing

 

The household member is entitled to one postponement of up to 30 days.  If the hearing is postponed, the 90 day time limit for issuing a decision shall be extended for as many days as the hearing is postponed.

 

Section 14.330  Administrative Disqualification Hearing Procedures

 

a)         The Department shall conduct a hearing, issue a decision, and notify the household member and local office of the decision within 90 days after the date the household member is notified in writing of the scheduling of an administrative disqualification hearing.

 

b)         The hearing shall be conducted by an impartial hearing officer.

 

c)         The household has the same rights during an administrative disqualification hearing that it has during a fair hearing.  (See Section 14.22.) In addition to the fair hearing rights, the household member shall be informed of the individual's right to remain silent concerning the charge, and that anything said or signed by the individual concerning the charge can be used against him or her in a court of law.

 

d)         The hearing procedures shall be published and made available to any interested party.

 

Section 14.340  Failure to Appear

 

If the household member or representative cannot be located or fails to appear at the scheduled hearing without good cause, the hearing shall be conducted without the household member represented.  Even though the household member is not represented, the hearing officer is required to consider the evidence and determine if an intentional violation of the program was committed based on clear and convincing evidence.  If a determination of intentional violation of the program is made, and no proof of receipt of the scheduling notice has been obtained, the household member has 30 days after the date of the written notice of the hearing decision to request a new hearing based on a showing of non-receipt of the scheduling notice.  In all other instances, the household member has 10 days after the date of the scheduled hearing to present reasons showing good cause for failure to appear.  (See Section 14.60(e) for definition of good cause.) The Bureau of Assistance Hearings  shall determine if the household member had good cause for not appearing and make a determination as to whether a new hearing should be scheduled.

 

(Source:  Amended at 25 Ill. Reg. 15253, effective October 31, 2001)

 

Section 14.350  Participation While Awaiting a Hearing

 

A pending administrative disqualification hearing shall not affect the individual's or the household's right to be certified and participate in the program.  Eligibility and level of benefits are determined in the usual manner while the administrative disqualification hearing is pending.  The household member suspected of intentional violation of the program is eligible until a hearing officer issues a decision that the individual committed an intentional violation of the program.

 

Section 14.360  Consolidation of Administrative Disqualification Hearing with Fair Hearing

 

A  fair hearing and an administrative disqualification hearing may be combined into a single hearing if the factual issues arise out of the same or related circumstances and the household received prior notice that the hearings will be combined.  If a single hearing is held, the time line standards for administrative disqualification hearings, as set out in this Subpart, shall be followed.

 

Section 14.370  Administrative Disqualification Hearing Decision and Notice of Decision

 

a)         The hearing officer shall base the decision on whether there is clear and convincing evidence that the household member intentionally violated the program.

 

b)         If the hearing officer finds that the household member intentionally violated the program, that member shall be sent a notice which shall include the decision and the reason for the decision.

 

c)         The Department shall notify the household of the date the disqualification takes effect and the status of remaining eligible household members.

 

d)         If the hearing officer finds that the household member did not intentionally violate the program, the household member shall be sent a notice informing that member that any over-issuance received by that household will be collected through an unintentional household error claim by the Department.

 

Section 14.380  Appeal Procedure

 

The hearing officer's decision is the Final Administrative Decision.  No further administrative appeal procedure exists after a finding of intentional violation of the program by an administrative disqualification hearing or after a household member signs a waiver of right to an administrative disqualification hearing.  A fair hearing decision cannot reverse a disqualification decision under Subpart C. However, a household member is entitled to seek relief from a disqualification decision in a court having appropriate jurisdiction.