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Hear from COFAR
Voice your opinion
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The Appeals Process
The DMR regulations (115 CMR 6.30 through 6.34) provide you with both a right and a procedure with which to appeal the following categories of DMR decisions regarding the ISP:
- Whether the goals identified in the ISP are consistent with and promote the outcomes described in the quality of life areas
- Whether the types of supports identified in the ISP are the least restrictive, appropriate and available supports to meet the goals stated in the ISP
- Whether the recommendation of the ISP team with regard to the individual's ability to make personal and financial decisions is consistent with the available evidence and whether the type of decision-making support recommended is consistent with the standards set forth at 115 CMR 5.07
- Whether the ISP was developed, reviewed, or modified in accordance with the procedures set forth in 115 CMR 6.20 through 6.25; and
- Whether the ISP is being implemented.
These same regulations also provide a right and a procedure with which to appeal other types of DMR decisions as well, including the following:
- Whether the decision of the Department as to the individual's eligibility for services is consistent with the standards and procedures stated in 115 CMR 6.01 through 6.10; and
- Whether the DMR's assignment of priority of need is consistent with the standards set forth in 115 CMR 6.07. [Link to our Advocacy Guide Section on Getting Services (Determining Your Eligibility for a discussion of these eligibility regulations.]
NOTE: Appeals of DMR decisions to transfer your ward or family member from their current residence to a new location must be made under a separate regulation (115 CMR 6.63, Transfers: Special Requirements). See the discussion below under Transfer Regulations.
Initiating the Appeal
Under regulation 115 CMR 6.32, an appeal is initiated by notifying your Regional DMR Director in writing within 30 days after receipt of the ISP or the eligibility decision. An appeal that the ISP is not being implemented may be initiated at any time.
The Informal Conference
The Informal Conference represents an attempt to reach agreement on the disputed issues before the more time-consuming stage of the Fair Hearing (see below). Under 115 CMR 6.31(1), the Informal Conference must be held by the Regional Director or designee, or an ombudsperson designated by the DMR Commissioner, if requested by the appellant. The Informal Conference must be held within 30 days of notification of the appeal. Except for agreed-upon statements of fact, all other statements in the Informal Conference are not admissible during the Fair Hearing stage of the appeal or in subsequent court proceedings.
The Fair Hearing
The Fair Hearing represents a formal attempt to resolve the disputed issues, and its procedures resemble to those involved in an appeal to the state Superior Court, which could be your next step in the process if the Fair Hearing decision is not satisfactory to you.
Under 115 CMR 6.33(2), you, as the appealing party, may petition the DMR Commissioner within 30 days of the conclusion of the Informal Conference for the Fair Hearing on your appeal. The DMR must hold a Fair Hearing within 60 days of the filing of your appeal. Within 45 days of the conclusion of the Fair Hearing, the DMR Commissioner must issue a decision. The DMR area director then has 30 days to implement any changes ordered in the ISP or other matters under appeal.
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