State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_122C > GS_122C-151_4

§ 122C‑151.4.  Appeal toState MH/DD/SA Appeals Panel.

(a)        Definitions. – Thefollowing definitions apply in this section:

(1)        "AppealsPanel" means the State MH/DD/SA Appeals Panel established under thissection.

(1a)      "Client"means an individual who is admitted to or receiving public services from anarea facility. "Client" includes the client's personal representativeor designee.

(1b)      "Contract"means a contract with an area authority or county program to provide services,other than personal services, to clients and other recipients of services.

(2)        "Contractor"means a person who has a contract or who had a contract during the currentfiscal year, or whose application for endorsement has been denied by an areaauthority or county program.

(3)        "Former contractor"means a person who had a contract during the previous fiscal year.

(b)        Appeals Panel. – TheState MH/DD/SA Appeals Panel is established. The Panel shall consist of threemembers appointed by the Secretary. The Secretary shall determine the qualificationsof the Panel members. Panel members serve at the pleasure of the Secretary.

(c)        Who Can Appeal. – Thefollowing persons may appeal to the State MH/DD/SA Appeals Panel after havingexhausted the appeals process at the appropriate area authority or countyprogram:

(1)        A contractor or aformer contractor who claims that an area authority or county program is notacting or has not acted within applicable State law or rules in denying thecontractor's application for endorsement or in imposing a particularrequirement on the contractor on fulfillment of the contract;

(2)        A contractor or aformer contractor who claims that a requirement of the contract substantiallycompromises the ability of the contractor to fulfill the contract;

(3)        A contractor or formercontractor who claims that an area authority or county program has actedarbitrarily and capriciously in reducing funding for the type of servicesprovided or formerly provided by the contractor or former contractor;

(4)        A client or a personwho was a client in the previous fiscal year, who claims that an area authorityor county program has acted arbitrarily and capriciously in reducing fundingfor the type of services provided or formerly provided to the client directlyby the area authority or county program; and

(5)        A person who claimsthat an area authority or county program did not comply with a State law or arule adopted by the Secretary or the Commission in developing the plans andbudgets of the area authority or county program and that the failure to complyhas adversely affected the ability of the person to participate in thedevelopment of the plans and budgets.

(d)        Hearing. – Allmembers of the State MH/DD/SA Appeals Panel shall hear an appeal to the Panel.An appeal shall be filed with the Panel within the time required by theSecretary and shall be heard by the Panel within the time required by theSecretary. A hearing shall be conducted at the place determined in accordancewith the rules adopted by the Secretary. A hearing before the Panel shall beinformal; no sworn testimony shall be taken and the rules of evidence do notapply. The person who appeals to the Panel has the burden of proof. The Panelshall not stay a decision of an area authority during an appeal to the Panel.

(e)        Decision. – TheState MH/DD/SA Appeals Panel shall make a written decision on each appeal tothe Panel within the time set by the Secretary. A decision may direct acontractor, an area authority, or a county program to take an action or torefrain from taking an action, but it shall not require a party to the appealto pay any amount except payment due under the contract. In making a decision,the Panel shall determine the course of action that best protects or benefitsthe clients of the area authority or county program. If a party to an appealfails to comply with a decision of the Panel and the Secretary determines thatthe failure deprives clients of the area authority or county program of a typeof needed service, the Secretary may use funds previously allocated to the areaauthority or county program to provide the service.

(f)         Chapter 150BAppeal. – A person who is dissatisfied with a decision of the Panel maycommence a contested case under Article 3 of Chapter 150B of the GeneralStatutes. Notwithstanding G.S. 150B‑2(1a), an area authority or countyprogram is considered an agency for purposes of the limited appeal authorizedby this section. If the need to first appeal to the State MH/DD/SA AppealsPanel is waived by the Secretary, a contractor may appeal directly to theOffice of Administrative Hearings after having exhausted the appeals process atthe appropriate area authority or county program. The Secretary shall make afinal decision in the contested case.

(g)        This section doesnot apply to providers of community support services who appeal directly to theDepartment of Health and Human Services under the Department's communitysupport provider appeal process.  (1993, c. 321, s. 220(o); 2001‑437, s. 1.17(c);2008‑107, s. 10.15A(h).)