405 IAC 5-21.7-20 Fair hearings and appeals

Sec. 20. (a) CMHW services applicants, members, and their families shall have an opportunity to request a fair hearing to appeal a decision of the office regarding CMHW services eligibility or a request for services as described in this section. (b) Information concerning a member's right to a fair hearing and appeal and how to request such an appeal's hearing shall be provided to an applicant, member, or the family of an applicant or member at the following times: (1) Provided to the applicant and the applicant's family by the local access site following the office's determination of the applicant's eligibility for CMHW services. (2) Provided to the member and family by the wraparound facilitator following the office review of a proposed CMHW services plan of care, or updated plan of care, to document the office authorization or denial of the requested CMHW services. (3) Provided to the member and family by the wraparound facilitator following the member's reevaluation for CMHW services eligibility. (c) Notices of adverse action and the opportunity for a fair hearing shall be maintained in the member's record by the local wraparound facilitation agency and by the office.