a handbook for parents of children with autism spectrum disorders
a handbook for parents of children with autism spectrum disorders
a handbook for parents of children with autism spectrum disorders
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ANSWERS TO YOUR QUESTIONSWhat is a Fair Hearing?In some cases you or your representative can ask the Department <strong>of</strong> PublicWelfare to hold a hearing because you are unhappy about, or do not agree<strong>with</strong>, something Community Care did or did not do. These hearings are calledFair Hearings. You can ask <strong>for</strong> a Fair Hearing at the same time you file acomplaint or grievance, or you can ask <strong>for</strong> a Fair Hearing after CommunityCare decides your First or Second Level complaint or grievance.What kinds <strong>of</strong> things can I request a Fair Hearing <strong>for</strong>, and when do Ihave to ask <strong>for</strong> a Fair Hearing?Commoncharacteristics <strong>of</strong>Autism include:Difficulty mixing andrelating <strong>with</strong> otherpeople.Inappropriatelaughing andgiggling.No fear <strong>of</strong> realdangers.Apparentinsensitivity to pain.Inappropriateattachment toobjects.Extreme emotionaldistress <strong>for</strong> nodiscernible reason.If you are unhappy because …Community Care decided to deny aservice because it is not a coveredserviceCommunity Care decided not to paya provider <strong>for</strong> a service you receivedAND the provider can bill you <strong>for</strong> theserviceCommunity Care did not decide yourFirst Level complaint or grievance<strong>with</strong>in 30 days <strong>of</strong> when you filed itCommunity Care decided to deny,decrease, or approve a servicedifferent than the service yourprovider requested because it wasnot medically necessaryCommunity Care’s provider did notgive you a service by the time youshould have received itAnd you ask <strong>for</strong> a Fair Hearing,you must do so …<strong>with</strong>in 30 days <strong>of</strong> getting a letterfrom Community Care telling you <strong>of</strong>this decision OR <strong>with</strong>in 30 days <strong>of</strong>getting a letter from Community Caretelling you its decision after you fileda complaint about this issue.<strong>with</strong>in 30 days <strong>of</strong> getting a letterfrom Community Care telling you <strong>of</strong>this decision OR <strong>with</strong>in 30 days <strong>of</strong>getting a letter from Community Caretelling you its decision after you fileda complaint about this issue.<strong>with</strong>in 30 days <strong>of</strong> getting a letterfrom Community Care telling you thatwe did not decide your complaint orgrievance <strong>with</strong>in the time frame wewere supposed to follow.<strong>with</strong>in 30 days <strong>of</strong> getting a letterfrom Community Care telling you <strong>of</strong>this decision OR <strong>with</strong>in 30 days <strong>of</strong>getting a letter from Community Caretelling you its decision after you fileda grievance about this issue.<strong>with</strong>in 30 days from the date youshould have received the serviceOR <strong>with</strong>in 30 days <strong>of</strong> getting a letterfrom Community Care telling you itsdecision after you filed a complaintabout this issue.- Page 26 -
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