R539-3-7. Notice of Agency Action and Administrative Hearings

(1) A person has the right to: (a) receive adequate notice of agency action in writing; and (b) present a grievance about an agency action by requesting an administrative hearing. (2)(a)(i) The division shall notify a person in writing at least ten days before taking an agency action, including a change in funding, eligibility, or service. (ii) If the person signs a written statement acknowledging consent to the agency action, the division shall send notice no later than the date of agency action. (b) Notice of agency action that affects a non-waiver service shall include the information required by Sections 63G-4-201 and R497-100-5. (c) Notice of agency action that affects a waiver service shall include the information required by 42 CFR 431.210 (2025), incorporated by reference in this rule, and Sections 63G-4-201, R497-100-5, and R410-14-3. (d) To assist a person with an administrative hearing request, the division shall send the person a Hearing Request Form 490S when the division sends the Notice of Agency Action Form 522-I. (3) A person receiving a non-waiver service may request an informal administrative hearing as described in Rule R497-100. (a) An administrative hearing may be requested within 30 days of the mailing date shown on the Notice of Agency Action Form 522. (b) The person shall file a Hearing Request Form 490S with the division to request a hearing with the Office of Administrative Hearings within the department. (c) If the person files a hearing request before the date of agency action written on the Notice of Agency Action Form 522-I, the person's service or benefit shall continue unchanged during the administrative hearing process. (4) A person receiving a waiver service may request an informal administrative hearing as described in Rule R497-100 or Section R410-14-24. (a) An administrative hearing may be requested within 30 days of the mailing date shown on the Notice of Agency Action Form 522. (b) The person shall file the request as described in Section R410-14-5 to request a hearing with the department. (c) The person shall file a Hearing Request Form 490S with the division to request a hearing with the Office of Administrative Hearings within the department. (d) If the person files a hearing request before the date of agency action written on the Notice of Agency Action Form 522, the person's service or benefit shall continue unchanged during the administrative hearing process. (5) To dispute implementation of a service by a provider, a person receiving that service may request an informal administrative hearing as described in Rule R497-100. (6) A person may request an informal administrative hearing and choose to participate in the division's dispute resolution process before the administrative hearing. (a) If the person chooses to participate in the division's dispute resolution process, the 30-day deadline to request an administrative hearing described in Subsections (3) and (4) applies. (b)(i) If the person requests a hearing and chooses the division dispute resolution process, the person must complete the dispute resolution process before the administrative hearing begins. (ii) The person must submit a written request to the division to end the dispute resolution process before reaching a resolution. (c) The division's dispute resolution process is not an adjudicative proceeding as described in Section 63G-4-201.