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Appeals Archive

As part of our commitment to transparency, we make DHS appeals decisions available to the public in this appeals archive.

Results 1 - 10 of 453
Date: December 13, 2018
Docket: 213609
Examiner: Kathleen McDonough
The issue raised in this appeal is: Whether the agency correctly determined personal care assistance (PCA) services. (appellant) is not eligible for Recommended Decision: No, the agency is not correct. PROCEDURAL HISTORY 1. On October 22, 2018 the State Appeals Office received an appeal of the denial of PCA services from appellant’s mother, Exhibit 1. The record does not include a PCA services denial notice from the agency. 2. On December 3, 2018, the Human Services Judge held an evidentiary hearing on the matter by telephone conference. On December 3, 2018, the record closed consisting of the hearing testimony and two exhibits. 2
Date: December 13, 2018
Docket: 213834
Examiner: Kathleen McDonough
Date: December 06, 2018
Docket: 212243
Examiner: Christopher Cimafranca
The issue raised in this appeal is: Whether the agency correctly determined that appellant is eligible for 2.25 hours of personal care assistance (PCA) services. Recommended Decision: The agency’s determination should be reversed. PROCEDURAL HISTORY 1. On April 3, 2018, the agency performed an assessment of appellant’s need for PCA services. Agency Testimony, Exhibit 2, Attachment 4. The agency did not send appellant a written notice of action. Testimony. On October 4, 2018, the appellant’s authorized representative filed an appeal stating appellant was previously eligible for 6.75 hours of PCA services. Exhibit 1. The previous assessment was not available. Agency Testimony 2. On November 19, 2018, Judge McDonough held an evidentiary hearing on the matter by telephone conference. On November 19, 2018, the record closed consisting of the hearing testimony and two exhibits. 2
Date: December 03, 2018
Docket: 213292
Examiner: Kathleen McDonough
The issue raised in this appeal is: Whether the agency correctly determined that appellant is not eligible for a CADI (Community Access for Disability Inclusion) waiver; Whether the agency correctly determined that appellant qualifies for 1.25 hours of personal care assistance (PCA) time per day. Recommended Decision: AFFIRM the agency’s determinations as correct. PROCEDURAL HISTORY 1. On July 31, 2018, County (the agency) sent (appellant) a written notice of action informing her that she was not eligible to receive medical assistance services under a CADI waiver, and she qualified for 1.25 hours of PCA services per day. On August 30, 2018, appellant filed an appeal. 2. On October 3 and 17, 2018, the human services judge held an evidentiary hearing on the matter by telephone conference. On that October 17, 2018, the record closed, consisting of the hearing testimony and five exhibits. 2
Date: November 15, 2018
Docket: 212147
Examiner: KEVIN T. SLATOR
Date: November 15, 2018
Docket: 213069
Examiner: Calynn M.W. Schuck
Date: October 29, 2018
Docket: 212008
Examiner: Calynn M.W. Schuck
The issue raised in this appeal is: Whether the agency correctly determined that appellant is not eligible for services under either a Community Access for Disability Inclusion (CADI) medical assistance waiver or a Community Alternative Care (CAC) medical assistance waiver. Recommended Decision: AFFIRM the decision of the agency as correct. PROCEDURAL HISTORY 1. On July 16, 2018, the agency sent appellant (via his mother and representative, a written notice to inform him that he qualified for 5.5 hours of PCA time under the medical assistance program, but he did not qualify for services under either a CADI waiver or a CAC waiver. On July 30, 2018, appellant filed an appeal. 2. On September 6, 2018, the human services judge held an evidentiary hearing on the matter by telephone conference. On the same date, the record closed, consisting of the hearing testimony and four exhibits. 2
Date: October 22, 2018
Docket: 211195
Examiner: KEVIN T. SLATOR
The issue raised in this appeal is: Whether the agency properly assessed appellant’s needs, resulting in a Consumer Directed Community Supports (CDCS) budget of $25,429.55. Recommended Decision: AFFIRM the decision of the agency except for the rating for appellant’s behavior (LTC question number 45), which should be changed from 03 to 04. PROCEDURAL HISTORY 1. On May 10, 2018, the agency sent a “Notice of Action (Assessments and Reassessments)” to inform appellant that he was approved for 5.25 personal care assistant (PCA) hours per day as a result of a MnCHOICES assessment, and he would be referred for Rule 185 Case Management. 2 Exhibit 1 . On June 25, 2018, appellant filed an appeal. Exhibit A . 2. On July 23, 2018, the human services judge held an evidentiary hearing on the matter by telephone conference. The record was held open after the hearing at the request of appellant’s representative in order to submit two additional documents (Exhibits B and C). 3. The human services judges reopened the record on August 9, 2018, to request additional information and clarification from the agency on four issues, including the calculation of appellant’s Consumer-Directed Community Supports (CDCS) budget. The agency’s reply dated October 10, 2018, was marked as Exhibit 2 provided to appellant for a response. No response was received. On October 15, 2018, the record closed, consisting of the hearing testimony and five exhibits. 3
Date: October 18, 2018
Docket: 210074
Examiner: KEVIN T. SLATOR
The issue raised in this appeal is: Whether the agency properly determined that the appellant’s eligibility for daily personal care assistance services should be reduced from 9.5 hours per day to 5.5 hours per day. PROCEDURAL HISTORY 1. On July 25, 2018, County (agency) sent (appellant) a written notice of action informing the appellant that she had been determined to meet eligibility criteria for CADI waiver services with 5.50 hours of PCA services per day. Exhibit 2. On September 4, 2018, the appellant filed an appeal. Exhibit 9. A hearing was set for September 29, 2018, but was continued at the request of the appellant. 2. On October 4, 2018, the Human Services Judge held an evidentiary hearing on the matter by telephone. On October 4, 2018, the record closed consisting of the hearing testimony and twelve exhibits. 2
Date: October 10, 2018
Docket: 212233
Examiner: Joan G. Hallock
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Disclaimer: As part of its commitment to transparency, DHS makes publicly available this library of appeals decisions. Consistent with the requirements of applicable state and federal laws, protected information is removed from the decisions in this library. This library is not intended to give legal advice. You should not interpret these decisions as binding on anyone except the parties to the decision. The decisions are not precedent for any dispute between parties in the future. The laws affecting these programs may change frequently and information provided in this library of decisions may not reflect the current state of the law. The decisions also may be subject to further review. Therefore, please consult with a knowledgeable expert before you take action in reliance on any information provided here.
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