<?xml version='1.0' encoding='utf-8'?>
<chapter num="06" heading="Fair Hearing Appeals under the Special Supplemental Food Program for Women, Infants, and Children (WIC)" title_num="10" subtitle_num="01">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>“Appellant” means an individual, an applicant agency, a food vendor, or delegate agency who desires to participate in the WIC Program, who requests a fair hearing for the reasons specified in Regulation .02, of this chapter.</text>
    </paragraph>
    <paragraph num="B.">
      <text>“Applicant agency” means a public or private, non-profit health or welfare agency providing or contracting to provide health services, which has filed with the Department all the information required by the Department to apply to participate in the WIC Program.</text>
    </paragraph>
    <paragraph num="C.">
      <text>“Delegate agency” means a local agency or organization which, pursuant to contractual agreements with the Department, has accepted responsibilities under the WIC Program as defined by federal program regulations.</text>
    </paragraph>
    <paragraph num="D.">
      <text>“Department” means the Maryland Department of Health.</text>
    </paragraph>
    <paragraph num="E.">
      <text>“Food vendor” means an individual or organization licensed to sell food products, who has, or has applied to have, a contractual agreement with the Department or delegate agency to supply approved foods to program recipients.</text>
    </paragraph>
    <paragraph num="F.">
      <text>“Hearing officer” means an impartial official designated by the Secretary of Health to conduct and make administrative decisions in fair hearings. The hearing officer may not have had any prior connection with the action which is the subject of the fair hearing.</text>
    </paragraph>
    <paragraph num="G.">
      <text>“Participant” means pregnant women, breastfeeding women, post-partum women, infants, and children who are receiving supplemental foods or food instruments (benefits) under the WIC Program, and the breastfed infants of participant breastfeeding women.</text>
    </paragraph>
    <paragraph num="H.">
      <text>“State Agency” means that unit of the Maryland Department of Health which is responsible for the administration and operation of the WIC Program in Maryland.</text>
    </paragraph>
    <paragraph num="I.">
      <text>“WIC” means the Special Supplemental Food Program for Women, Infants, and Children, a federally funded program authorized under an amendment to the Child Nutrition Act of 1966 (PL 94-105) to provide supplemental nutritious food as an adjunct to good health care during critical times of growth and development to prevent the occurrence of health problems.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Opportunity for a Fair Hearing.">
    <text>A request for a fair hearing shall be granted in the following cases:</text>
    <paragraph num="A.">
      <text>An individual's application for participation in the WIC Program is denied by the Department or delegate agency;</text>
    </paragraph>
    <paragraph num="B.">
      <text>An eligible participant is required to pay the cash value of improperly issued benefits, or is denied benefits, suspended or terminated from the WIC Program by the Department or delegate agency;</text>
    </paragraph>
    <paragraph num="C.">
      <text>An applicant agency, delegate agency, or food vendor's:</text>
      <paragraph num="(1)">
        <text>Application to participate in the WIC program is denied by the State or local agency,</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Participation in the WIC program is suspended or terminated by the State or local agency,</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Participation in the WIC program is affected by any other adverse action by the State or local agency.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Notification of Right to Request a Fair Hearing.">
    <paragraph num="A.">
      <text>Written notification of the right to obtain a fair hearing shall be given by the Department or delegate agency to each appellant at each time of application.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Written notification of the right to obtain a fair hearing, and the method of obtaining the hearing, shall be given by the Department or delegate agency whenever it notifies an appellant that it intends to recover the cash value of the improperly issued benefits or to deny, suspend, or terminate participation in the WIC Program. If benefits or eligibility for an individual or food vendor are to be denied, suspended, or terminated, written notice shall be mailed or given at least 15 days before the effective date. In the case of a delegate agency, the notice shall be provided 60 days in advance of the effective date. This notification is not required at the expiration of a certification period.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The notification specified in §B, of this regulation, shall give the appellant the following information:</text>
      <paragraph num="(1)">
        <text>The reason for the action which may adversely affect him or his benefits;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The matters which are the proper subject of a fair hearing as provided in Regulation .02, of this chapter;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Any positions or arguments on his behalf may be presented personally or by a representative such as a relative, friend, or legal counsel;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The circumstances under which assistance is continued if a fair hearing is requested, as provided in Regulation .02, of this chapter.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Request for Fair Hearing.">
    <text>An appellant, either himself or through a representative, may request a fair hearing by giving a clear statement, oral or written, to any member of the State WIC Staff or delegate agency, that he desires an opportunity to present for review any matter which is the proper subject of a fair hearing as provided in Regulation .02, of this chapter. The statement shall be forwarded immediately to the hearing officer. The State WIC staff or delegate agency to whom a request for a hearing is made shall assist the appellant in submitting and processing the request.</text>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Acknowledgement of Request.">
    <paragraph num="A.">
      <text>The Department shall promptly acknowledge a request for a fair hearing and conduct it within 3 weeks from the date the Department received the request for a hearing.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The appellant shall be given notice, in writing, at least 10 days before the date of the fair hearing.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The notification specified in §B, of this chapter, shall include the following information:</text>
      <paragraph num="(1)">
        <text>The date, time, and place of the fair hearing;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>His right to be represented by a lawyer or other person of his choice during the fair hearing process;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>His right to present witnesses and documents in his behalf at the fair hearing;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>A summary of rules for a fair hearing.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Redesignation of Time and Place for Hearing.">
    <text>If a party notifies the Department that either the time or place designated by the Department is not convenient and requests a different time or place for the fair hearing, the hearing officer shall designate another time or place convenient to the parties, if he considers that the party has sufficient reason for requesting the change. If the appellant is employed during the periods when fair hearings are normally held, the hearing officer shall schedule the hearing so that the appellant will not be required to miss employment.</text>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Period of Time for Requesting Hearing.">
    <text>A request for a fair hearing may not be granted unless it is made within 60 days from the date the notification specified in Regulation .03, of this chapter, is mailed or given to the appellant, or when Regulation .03, of this chapter, does not apply, within 60 days following the conclusion of the action or inaction which is the subject of the appeal.</text>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Dismissal of Request for Hearing.">
    <text>The Department may dismiss a request for a fair hearing if:</text>
    <paragraph num="A.">
      <text>It has been withdrawn in writing by the appellant or his representative;</text>
    </paragraph>
    <paragraph num="B.">
      <text>The appellant or his representative fails, without good cause, to appear at the scheduled hearing;</text>
    </paragraph>
    <paragraph num="C.">
      <text>The appellant or his representative does not respond within 10 days to a Department letter asking whether he wishes to withdraw his request for a fair hearing;</text>
    </paragraph>
    <paragraph num="D.">
      <text>The request is not made within the time limits specified in Regulation .07, of this chapter; or</text>
    </paragraph>
    <paragraph num="E.">
      <text>The appellant has been denied participation by a previous hearing and cannot provide evidence that circumstances relevant to program eligibility have changed in such a way as to justify a hearing.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Pre-Hearing Procedures.">
    <paragraph num="A.">
      <text>The Department shall prepare a hearing summary containing pertinent information respecting the specific action or inaction which is the basis for the appeal. The summary shall be forwarded to the appellant or his representative at least 6 days before the hearing date, and shall include notification that the appellant or his representative may examine documents and records to be used at the hearing at the office of the hearing officer, at a reasonable time before the date of hearing.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The appellant and the Department may request the names of all witnesses that the other party intends to call at the fair hearing.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".10" heading="Hearing Procedures.">
    <paragraph num="A.">
      <text>The fair hearing procedures may not be unduly complex or legalistic. The hearing official shall administer oaths or affirmations as required by the State. The appellant, the Department, and the delegate agency shall have the opportunity to present witnesses, documentary evidence, and oral and written argument, and to cross-examine all adverse witnesses. The appellant will have the opportunity to advance arguments without undue interference.</text>
    </paragraph>
    <paragraph num="B.">
      <text>If the appellant wishes to call as witnesses employees of the Department or delegate agency whose action or inaction is being contested by the appellant, or whose testimony, in the judgment of the hearing officer, is relevant to the issues under consideration, the hearing officer shall require their presence at the fair hearing, provided that, when the appellant has knowledge of the names or other identifying description of these employees before the fair hearing, he shall supply the hearing officer with the names or other identifying descriptions at least 3 days before the fair hearing.</text>
    </paragraph>
    <paragraph num="C.">
      <text>If the Department or delegate agency introduces documents as evidence, the appellant shall have the opportunity to examine persons who prepared the documents and to examine the case record or special investigation file for the purpose of discovering information favorable to his case.</text>
    </paragraph>
    <paragraph num="D.">
      <text>When the hearing involves medical issues, an additional medical assessment of the appellant's condition shall be obtained and made part of the record if either the hearing officer or the appellant considers it necessary. This additional medical assessment shall be made by a person satisfactory to the appellant other than the person or persons who made the original medical determination, and shall be obtained at the Department's expense.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".11" heading="The Record.">
    <paragraph num="A.">
      <text>A verbatim recording of the fair hearing shall be made. One transcribed copy of the recording shall be supplied to the appellant, at no cost, if the appellant takes a further appeal. The recording, together with all exhibits and papers admitted into evidence, shall constitute the exclusive record for decision. Nonrecorded or confidential information which the appellant does not have an opportunity to hear or see may not be made a part of the hearing record. The written record of the hearing shall be preserved for a period of 3 years and shall be available for examination by the person or his representative at any reasonable time or place during this period.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The recording and copies of all exhibits and papers shall remain in the custody of the hearing officer for at least 3 years, or until all litigation involving the decision is terminated.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".12" heading="Findings, Conclusions, and Decision.">
    <paragraph num="A.">
      <text>The hearing officer shall prepare a written summary of findings and conclusions based exclusively on the record, and shall state the policies, regulations, or laws upon which the hearing officer's decision is based. The hearing officer's decision shall become a part of the record.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A copy of the findings, conclusions, and decision shall be forwarded to the appellant or his representative no later than 45 days after the date of receipt of the initial request for a fair hearing; except that, if the date of the fair hearing is postponed at the appellant's request, the length of the postponement may not be counted as part of the 45-day period. The hearing officer further shall provide written notice to the appellant or his representative that if he is not satisfied with the decision, he may seek administrative review as provided in Health-General Article, §2-207, Annotated Code of Maryland, and judicial review as provided in Article 41, §225, Annotated Code of Maryland, or any other provision of law.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The decision of the hearing officer shall be final and binding upon the Department and the delegate agency, and shall be implemented immediately unless otherwise specifically indicated in the decision, or unless the appellant takes an appeal as provided in Health-General Article, §2-207, Annotated Code of Maryland. However, if the decision being appealed is in favor of a delegate agency seeking to recover the cash value of improperly issued benefits, the delegate agency shall resume its claim collection efforts during pendency of the appeal. When the decision requires action by the delegate agency, that agency shall notify the Department of compliance with the decision.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The hearing officer shall maintain a copy of the decision, with the name of the appellant and witnesses deleted, in a reference file or hearing decisions that will be accessible to the public. Copies of all decisions, either in full text or in summary form, shall be forwarded to the delegate agency and any agency or physician with which it has contracted to fulfill its program responsibilities and is involved in this fair hearing.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".13" heading="Confidentiality as to Fair Hearings.">
    <text>If the appellant waives in writing his privilege of confidentiality as to the fair hearings, the hearing officer shall permit members of the public to attend the hearing; however, the hearing officer may cause the removal of any member of the public whose conduct impedes the orderly progress of the hearings, or may recess the hearings until a time when it may proceed in orderly fashion. The hearing officer also may exclude from the hearing persons who have given the Department no advance notice of their intention to attend, if the size of the hearing room is too small to accommodate them.</text>
  </regulation>
  <regulation prefix="Regulation" num=".14" heading="Continuation of Benefits or Participation Pending Hearing Decision.">
    <paragraph num="A.">
      <text>Whenever an individual, applicant agency, delegate agency, or food vendor is notified of a proposed action as provided in Regulation .03, of this chapter, the proposed action may not be taken unless at least one of the following occurs:</text>
      <paragraph num="(1)">
        <text>A fair hearing is not requested in a timely manner, as provided by Regulation .07, of this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A request for a fair hearing has been withdrawn in writing by the appellant or a representative;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The appellant or representative fails, without good cause, to appear at the scheduled hearing;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The appellant or representative, after failing to appear at a scheduled hearing, does not respond within 10 days to a departmental letter asking whether the appellant wishes to continue with the appeal;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>A decision affirming the proposed action of the Department or delegate agency is made by the hearing officer following a fair hearing;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>The Department has made a determination that the request for a fair hearing is not appropriate as provided for by Regulation .02, of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Whenever an eligible participant is notified during a certification period that benefits are to be denied, suspended, or terminated, those benefits will continue to be provided if the participant requests a fair hearing within the 15 day advance notice period provided by Regulation .03B, of this chapter. Those benefits will continue until one of the conditions specified in Regulation .14A, of this chapter, occurs.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Whenever an eligible participating food vendor is notified that participation is to be denied, suspended, terminated, or affected by any other adverse action, the food vendor shall be allowed to continue to participate if the food vendor requests a fair hearing at least 10 days before the effective date of the proposed adverse action. Participation shall continue until one of the conditions specified in §A, of this chapter, occurs.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Applicants who are denied benefits at initial certification or at subsequent certifications may appeal the denial but may not receive benefits while awaiting a hearing.</text>
    </paragraph>
    <paragraph num="E.">
      <text>An applicant agency or food vendor which is denied participation at time of application may appeal the denial but may not participate while awaiting a hearing.</text>
    </paragraph>
    <paragraph num="F.">
      <text>Whenever an eligible participant, participating delegate agency, or food vendor requests a fair hearing following the expiration of the time period as provided in §§B and C, of this regulation, the hearing officer, in his discretion, may provide an additional period during which time a request for a fair hearing shall result in continuation of benefits or participation until one of the conditions specified in §A, of this regulation, occurs.</text>
    </paragraph>
    <paragraph num="G.">
      <text>The adverse action affecting a participating delegate agency shall be postponed until a hearing decision is reached.</text>
    </paragraph>
    <paragraph num="H.">
      <text>Appealing an action does not relieve a delegate agency or food vendor permitted to continue in the program while its appeal is in process from the responsibility of continued compliance with the terms of any written agreement or contract with the State or local agency.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".15" heading="Criminal or Civil Sanctions.">
    <text>This fair hearing procedure may not be construed as excluding or replacing any criminal or civil sanctions or other remedies that may be applicable under any federal or State statute or local ordinance.</text>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §2-104; State Government Article, §10-215; Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: February 2, 1977 (4:3 Md. R. 146)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01 amended effective November 3, 1978 (5:22 Md. R. 1673); July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01A amended effective August 22, 1980 (7:17 Md. R. 1672)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01E amended effective August 22, 1980 (7:17 Md. R. 1672)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01G amended effective January 23, 1989 (16:1 Md. R. 69)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02 amended effective November 3, 1978 (5:22 Md. R. 1673); July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02A amended effective June 26, 1981 (8:13 Md. R. 1138)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02B amended effective January 23, 1989 (16:1 Md. R. 69)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02C amended effective March 24, 1986 (13:6 Md. R. 682)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03 amended effective November 3, 1978 (5:22 Md. R. 1673)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03A amended effective March 7, 1980 (7:5 Md. R. 474)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03B amended effective March 7, 1980 (7:5 Md. R. 474); July 18, 1983 (10:14 Md. R. 1262); March 24, 1986 (13:6 Md. R. 682); January 23, 1989 (16:1 Md. R. 69)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03C amended effective August 22, 1980 (7:17 Md. R. 1672); July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended effective November 3, 1978 (5:22 Md. R. 1673); August 22, 1980 (7:17 Md. R. 1672)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05 amended effective June 26, 1981 (8:13 Md. R. 1138); April 12, 1982 (9:7 Md. R. 711); July 18, 1983 (10:14 Md. R. 1262); October 24, 1983 (10:21 Md. R. 1901)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05C amended effective March 24, 1986 (13:6 Md. R. 682)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .07 amended effective November 3, 1978 (5:22 Md. R. 1673); March 7, 1980 (7:5 Md. R. 474); July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .08 amended effective March 7, 1980 (7:5 Md. R. 474)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .08D adopted effective July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .08E adopted effective March 24, 1986 (13:6 Md. R. 682)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .10A amended effective June 26, 1981 (8:13 Md. R. 1138)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .12 amended effective November 3, 1978 (5:22 Md. R. 1673)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .12A amended effective June 26, 1981 (8:13 Md. R. 1138)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .12B amended effective April 12, 1982 (9:7 Md. R. 711)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .12C amended effective January 23, 1989 (16:1 Md. R. 69)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14 amended effective March 7, 1980 (7:5 Md. R. 474)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14A amended effective July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14B amended effective July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14C amended effective March 24, 1986 (13:6 Md. R. 682)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14D adopted effective July 18, 1983 (10:14 Md. R. 1262)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .14E—H adopted effective March 24, 1986 (13:6 Md. R. 682)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .15 adopted effective November 3, 1978 (5:22 Md. R. 1673)</annotation>
  </annotations>
</chapter>