Administrative disqualification hearings

(a) Hearing Process (1) The department shall have the option of referring a case for an administrative disqualification hearing if the CCAP administrator determines that an overpayment was caused as the result of an intentional error by the parent to commit fraud in obtaining benefits from CCAP. The purpose of the administrative disqualification hearing is to determine if the error was intentional. The standard of proof that the administrative hearing officer shall use in making his or her decision is by clear and convincing evidence. The administrative disqualification hearing process shall be conducted in the same manner as an administrative hearing and is subject to requirements of section 17b-749-21 of the Regulations of Connecticut State Agencies, except as otherwise stated in this section. (2) The CCAP administrator shall treat overpayments caused by the parent as unintentional until an appropriate authority has confirmed the preliminary decision that the error was intentional. The CCAP administrator shall not impose a disqualification penalty until the decision that the error was intentional becomes final. The decision that the error was intentional shall become final under the following conditions: (A) if a court of competent jurisdiction finds that the parent has committed fraud or grants accelerated rehabilitation; or (B) if an administrative hearing officer determines that the error was intentional; or (C) if the parent waives his or her right to an administrative disqualification hearing. (3) If the administrative hearing officer determines that the error was not intentional, the overpayment shall be treated as unintentional or as an administrative error based on the results of the hearing. If the parent is found to have committed an intentional error, the family shall be subject to a disqualification penalty as specified in subsection (h) of section 17b-749-20 of the Regulations of Connecticut State Agencies. (b) Cases Referred for Administrative Disqualification Hearings (1) A parent's case may be referred for an administrative disqualification hearing under the following circumstances: (A) if a preliminary determination has been made that the parent knowingly and willfully intended to commit fraud to obtain benefits from CCAP; and (B) if the case is not being referred to the state police, a prosecuting authority or to the attorney general; or (C) if the case was referred and has been rejected for prosecution. (2) The parent's case shall not be referred for an administrative disqualification hearing while the case is under consideration for referral to the state police, a prosecuting authority or the attorney general, or if a court of competent jurisdiction has determined that the parent is not guilty or has dismissed the case. (c) Notification (1) The administrative hearing official shall notify the parent in writing that an administrative disqualification hearing has been scheduled. The notice shall be sent to the parent by certified mail at least thirty days prior to the scheduled hearing date. Notice shall be assumed to have been given unless the certified mail return receipt is returned stamped as "undeliverable as addressed" or "forwarding address has expired." (2) The notice shall contain the following information: (A) the time, date, and place of the hearing; (B) a statement of the reasons for the hearing; (C) a summary of the evidence upon which the hearing is being held and how and where the evidence can be examined; (D) a warning that the decision will be based solely on the information provided by the CCAP administrator if the parent does not appear at the hearing; (E) a statement of the parent's administrative hearing rights; (F) a statement that the hearing does not preclude additional civil or criminal action; (G) a statement of the availability of free legal representation; (H) a statement of the availability of a new hearing in the event there is good cause for the individual not to attend the scheduled hearing; and (I) an invitation to contact the department if additional information is needed. (d) Pre-Hearing Interview (1) The CCAP administrator shall send parents referred for an administrative disqualification hearing a notice scheduling a pre-hearing interview and a waiver of administrative disqualification hearing form. The pre-hearing interview shall be conducted by the CCAP administrator at an office of the department closest to where the parent lives. The CCAP administrator shall make a reasonable attempt to accommodate a request made by the parent with regard to the hearing date and time. (2) The purpose of the pre-hearing shall be to provide the parent with the opportunity to review the evidence supporting the CCAP administrator's allegations, to receive an explanation of the hearing process and to dispute the CCAP administrator's findings. The CCAP administrator shall provide the parent with a detailed explanation of the following information: (A) the evidence supporting the overpayment and the determination that the error was intentional; (B) the administrative hearing process and the parent's administrative hearing rights; (C) the waiver process, including that the parent's right to waive the hearing, the right to change the decision to waive the hearing within 10 days, and the fact that signing the waiver is not an admission of guilt; and (D) the recoupment or disqualification penalty that will be applied if the parent signs the waiver. (3) Failure to appear at the pre-hearing interview shall not serve as a basis for delaying the administrative disqualification hearing. A parent who does not appear at the pre-hearing interview shall be sent a formal notice of the scheduled hearing, unless the parent has submitted a signed waiver of his or her right to a hearing. (e) Waiver of Right to Administrative Disqualification Hearing (1) The parent shall have the option to waive his or her right to an administrative disqualification hearing. Waiver of the right to a hearing shall result in the same penalties as would be imposed if a determination of guilt had been rendered by an administrative disqualification officer or a court of law, including benefit reduction and discontinuance penalties. The CCAP administrator shall provide the parent with a waiver form. The form shall include the following information: (A) the date by which the waiver shall be signed and returned to the department; (B) the address where the form shall be returned; (C) a statement of the right of the individual to remain silent and avoid self-incrimination; (D) an option to select admission or denial of guilt; (E) a place for the parent's signature and date; (F) that a benefit reduction or disqualification penalty will automatically be imposed if the waiver is signed, even if the parent does not admit guilt; (G) that waiver of the right to an administrative disqualification hearing results in the same penalties as would be imposed in the event of a determination of guilt by an administrative disqualification hearing officer or a court of law, regardless of whether or not the waiver form indicates an admission of guilt; (H) the fact that the individual may withdraw the waiver within 10 days of the date signed; and (I) telephone numbers for additional information and for free legal services. (2) The parent may withdraw the waiver by submitting a written statement to the administrative hearing officer within ten days of the date the waiver form was signed. If the parent does not withdraw the waiver in a timely manner, the department shall proceed with scheduling the hearing. (f) Time Limits (1) The hearing shall be held and a decision rendered within ninety days from the date the notice of the hearing is mailed to the parent, barring continuances and extensions of the close of the hearing record. (2) The parent or the parent's representative may request and receive a postponement of the scheduled hearing for good cause as determined by the administrative hearing official. The hearing shall not be postponed for more than thirty days. (g) Consolidation of Administrative Hearings with Administrative Disqualification Hearings (1) The administrative hearing officer may combine an administrative hearing and an administrative disqualification hearing into a single hearing if the factual issues arise out of the same or related circumstances and the parent receives prior notice that the hearings will be combined. (2) If the single hearing is held for the purpose of settling the amount of the overpayment as well as determining whether intentional recipient error occurred, the parent shall not be entitled to a separate hearing to contest the amount of the overpayment. (h) Hearing Format (1) The hearing shall be conducted in accordance with the requirements of section 17b-749-21 of the Regulations of Connecticut State Agencies. (2) The hearing official shall advise the parent or the parent's representative of the right to remain silent during the hearing. (3) If the parent or the parent's representative cannot be located or fails to appear at a hearing without good cause, the hearing shall be conducted without the parent being represented. If the parent does not appear at the hearing and is not represented by another person, the hearing official shall make a decision based on the evidence presented. (i) Good Cause for Failure to Appear at Hearing (1) A new hearing shall be scheduled if the parent had good cause for failing to appear. The parent or his or her representative shall submit a good cause request to the administrative hearing official within ten days of the date of the original hearing. (2) Good cause reasons for not appearing at the hearing shall include, but not be limited to illness of the individual or immediate family member, a family emergency, severe weather or the unavoidable loss of transportation where there was no alternative immediately available. (3) The administrative hearing official shall decide if good cause exists and enters the decision into the hearing record. If good cause exists, the administrative hearing official who presided at the initial hearing shall schedule a new hearing. The decision reached as the result of the original hearing shall be rendered null and void when a new hearing is scheduled. (j) Hearing Decision (1) The administrative hearing official shall issue a written decision within ninety days from the date the notice scheduling the hearing was mailed to the parent. The decision shall identify the evidence used to make the decision, specifies the reasons for the decision, cites relevant policy or regulation, responds to the reasoned arguments made by the parent or his or her representative and specifies the penalty. (2) If a disqualification penalty is imposed, the effective date and length of the disqualification period shall be specified. (k) Appealing the Decision (1) The parent shall be entitled to an administrative hearing to dispute an intended action to reduce or terminate benefits or if the parent disagrees with the recoupment plan. The parent shall not be entitled to an administrative hearing to dispute the findings of the administrative disqualification hearing official or the penalty imposed. (2) The parent may contest the hearing official's decision by appealing to the Superior Court within forty-five days of the date the hearing official issues the decision. The disqualified individual shall follow the appeal procedures described in subsection (n) of section 17b-749-21 of the Regulations of Connecticut State Agencies concerning appeals of administrative hearing decisions. (3) If a court reverses the finding of guilt of an intentional recipient error, the CCAP administrator shall reinstate the case if the family is currently eligible and issues payments for any underpayment that may have occurred.