Review of Agency Decision

(1) An individual, or authorized representative, may request a review of the following agency decisions: (a) Case closure under 107 CMR 11.12; (b) A determination of ineligibility under 107 CMR 11.05; or (c) A reduction or termination of services under 107 CMR 11.07. (2) Upon receiving a request for review, the matter will be submitted for administrative review in accordance with the terms set forth in 107 CMR 11.14. If the issues under administrative review are not resolved by the informal review, the individual may request a fair hearing, in accordance with the requirements of 107 CMR 11.15. Unless the parties agree otherwise, the HCAP services which are the subject of the administrative review, or appeal under 107 CMR 11.15, shall not be suspended, reduced or terminated until the resolution of the appeal unless doing so would pose a risk to the physical safety of the individual, Commission staff, or a home care worker. (4) Notwithstanding the provisions of 107 CMR 11.13(3), services may be suspended pending the administrative review, and appeal, based any one of the following: (a) The individual is residing with one or more adult(s) responsible for their care in accordance with 107 CMR 11.05(2)(c); (b) The individual no longer resides in the commonwealth in accordance with 107 CMR 11.12(3)(b); or (c) The individual is no longer residing in a geographic area where services are available, or services have been terminated or reduced due to funding.