Section 22. Appeals and fair hearings; judicial review  


Latest version.
  • 1. Any person
      described in subdivision  three  of  this  section,  or  any  individual
      authorized  to  act  on  behalf  of  any  such person, may appeal to the
      department from decisions of social services officials  or  failures  to
      make  decisions  upon  grounds  specified  in  subdivision  five of this
      section. The department shall review the case and give  such  person  an
      opportunity  for a fair hearing thereon. The department may also, on its
      own motion, review any decision made or any case in which a decision has
      not been made by a social services official within the time specified by
      law or regulations of the  department.  The  department  may  make  such
      additional  investigation as it may deem necessary, and the commissioner
      shall make such decision as is justified and is in conformity  with  the
      provisions  of  this  chapter,  the  regulations  of  the  department, a
      comprehensive annual services program plan then in  effect  pursuant  to
      title twenty of the federal social security act and any other applicable
      provisions of law.
        2.  In  connection  with  any appeal pursuant to this section, with or
      without a fair hearing, the commissioner may designate and authorize one
      or more appropriate members of his staff to  consider  and  decide  such
      appeals.  Any  staff  member  so  designated  and  authorized shall have
      authority to decide such appeals on behalf of the commissioner with  the
      same  force  and  effect  as if the commissioner had made the decisions.
      Fair hearings held in connection with such  appeals  shall  be  held  on
      behalf  of the commissioner by members of his staff who are employed for
      such purposes  or  who  have  been  designated  and  authorized  by  him
      therefor.  The  provisions  of  this  subdivision  shall  apply  to fair
      hearings conducted pursuant to subdivision eight of section four hundred
      twenty-two of this chapter, and to any hearing required pursuant to this
      chapter concerning the denial, suspension or revocation of  any  permit,
      certificate or license, and to any hearing held pursuant to section four
      hundred fifty-five of this chapter.
        3.  Persons  entitled  to  appeal  to  the department pursuant to this
      section shall include:
        (a) Applicants  for  or  recipients  of  aid  to  dependent  children,
      emergency  assistance for families with dependent children, home relief,
      veteran assistance, medical assistance for needy persons and any service
      authorized or required to be made available in the  geographic  area  in
      which such person resides, pursuant to the provisions of this chapter;
        (b) Applicants for or participants in the food stamp program, pursuant
      to   section   ninety-five  of  this  chapter  and  regulations  of  the
      department;
        (c) Applicants for or recipients of  emergency  assistance  for  aged,
      blind  and  disabled persons, pursuant to title eight of article five of
      this chapter, so long as such emergency assistance is available pursuant
      to such law;
        (d) Aggrieved persons  described  in  section  four  hundred  of  this
      chapter;
        * (e)   Aggrieved  persons,  agencies  or  social  services  districts
      described in section three hundred seventy-two-e of this chapter;
        * NB Effective until June 30, 2012
        * (e)  Aggrieved  persons,  agencies  or  social  services   districts
      described   in   sections   one  hundred  fifty-three-d,  three  hundred
      seventy-two-e and three hundred ninety-eight-b of this chapter;
        * NB Effective June 30, 2012
        (f) Other  persons  entitled  to  an  opportunity  for  fair  hearings
      pursuant to regulations of the department.
        4.  (a)  Except  as  provided  in  paragraph (c) of subdivision two of
      section four hundred twenty-four-a of this chapter and in paragraph  (b)
    
      of  this  subdivision,  any  appeal  pursuant  to  this  section must be
      requested within sixty days after the date of the action or  failure  to
      act complained of.
        (b)   Unless  a  different  period  is  mandated  by  federal  law  or
      regulations, a person is allowed to request a fair hearing on any action
      of a social services district relating to food stamp benefits or loss of
      food stamp benefits which occurred in  the  ninety  days  preceding  the
      request  for  a  hearing.  For  purposes  of this paragraph, such action
      includes a denial of a request for restoration of any benefits lost more
      than ninety days but less than a year prior to the request. In addition,
      at any time within the period for which a person is certified to receive
      food stamp benefits, such person may request a fair hearing  to  dispute
      the current level of benefits.
        5.  Grounds  for such appeals shall be specified in regulations of the
      department, but shall include at least the following:
        (a) Denial of any application.
        (b) Failure to act upon  any  application  within  thirty  days  after
      filing,  except  applications for home relief, or failure to comply with
      laws and  regulations  requiring  that  priority  be  given  to  certain
      applications  for  assistance,  or failure to act on any application for
      home relief within forty-five days after filing.
        (c) Inadequacy in amount or manner of payment of assistance.
        (d) Discontinuance in whole or in part of assistance,  or  termination
      of a service authorized or required to be made available pursuant to the
      comprehensive annual services program plan then in effect.
        (e)  Failure  to  permit  a  parent  or guardian to visit the child or
      failure to provide supportive services, which shall  include  preventive
      and  other supportive services authorized to be provided pursuant to the
      state consolidated services plan, to the child  and  to  the  parent  or
      guardian, pursuant to an instrument executed under section three hundred
      eighty-four-a of this chapter.
        (f)   Failure   to  provide  adoption  services  or  assistance  to  a
      prospective adoptive parent on behalf of a child freed for  adoption  as
      defined  in  subdivision (b) of section one thousand eighty-seven of the
      family court act pursuant to section three hundred seventy-two-b of this
      chapter and the local social services district's  consolidated  services
      plan.
        6.  In scheduling fair hearings on appeals concerning applications for
      emergency assistance pursuant to section three hundred fifty-j or  title
      eight  of  article  five  of  this  chapter,  the  department shall give
      priority to the hearing and determination of such appeals.
        7. For the purposes of this section, except subdivision  nine,  social
      services  officials  shall  include the persons described in subdivision
      fourteen of section two of this chapter and also the head of any  bureau
      of  the  department  which  exercises  responsibility  pursuant  to this
      chapter for determining eligibility for and furnishing public assistance
      and care to persons in family  care  pursuant  to  section  one  hundred
      thirty-eight-a  of  this chapter, or for determining eligibility for and
      furnishing medical assistance pursuant to subdivision two, three or four
      of section three hundred sixty-five of this chapter, or for  determining
      eligibility  for and furnishing services pursuant to section two hundred
      fifty-three of this chapter.
        8. The department shall promulgate such regulations, not  inconsistent
      with  federal  or  state  law,  as  may  be  necessary  to implement the
      provisions of this section. Such regulations shall require that  a  copy
      of  all decisions made concerning appeals pursuant to this section shall
      be sent to each party to such appeals and their representatives, if any.
    
        9. (a) All decisions of the  commissioner  pursuant  to  this  section
      shall  be  binding upon the social services districts involved and shall
      be complied with by the social services officials thereof.
        (b)  Any  aggrieved  party  to  an appeal, including a social services
      official provided an application by any such  social  services  official
      has  not  been  determined  by  any federal agency to be in violation of
      federal law, may apply for review as provided in  article  seventy-eight
      of the civil practice law and rules.
        (c)  The  provisions  of paragraph (a) shall be applicable to a social
      services official after the decision of the commissioner  becomes  final
      and  binding  unless  a court stays such decision. No such stay shall be
      issued by any court unless the social services official establishes that
      irreputable harm  will  result  if  a  stay  is  not  granted,  and  the
      probability  that  he  will  succeed  on  the  merits.  In  an action or
      proceeding to review a decision of the commissioner,  the  applicant  or
      recipient and his representative, if any, shall be served with copies of
      all  pleadings  and  shall  be  allowed  to  intervene in such action or
      proceeding as a matter of right. Notwithstanding any  provision  of  the
      civil  practice  law  and  rules  or  any other law to the contrary, any
      application by a social services official for a  stay  in  a  proceeding
      commenced  by such official pursuant to this section shall be determined
      by the appropriate appellate division, and  not  by  a  justice  of  the
      supreme  court.  Whenever  the commissioner has sustained an appeal by a
      recipient of public assistance or care with respect  to  benefits  which
      were continued pending the fair hearing decision, the appellate division
      shall   not  stay  the  fair  hearing  decision  prior  to  the  initial
      determination of the proceeding initiated pursuant to this  section  for
      the review of such fair hearing decision.
        (d)  Every  person entitled to a benefit pursuant to a decision of the
      commissioner under  this  section,  shall  be  advised  to  contact  the
      department in a manner specified by department regulations, in the event
      that  a  local  social  services  district  does  not  comply  with such
      decision.
        10. In connection with every determination of an  appeal  pursuant  to
      this  section,  the department shall inform every party thereto, and his
      representative, if any, of the availability of judicial review  and  the
      time limitation thereon.
        11. The provisions of subdivisions three and four of section twenty of
      this  chapter  shall  be  applicable  to  state  reimbursement otherwise
      payable to any social services district in the event of the failure of a
      social services official to comply with a  commissioner's  determination
      upon an appeal within the time required by regulations of the department
      or such additional time as the commissioner may allow. In the event that
      the  court  stays  any  such  determination  in a proceeding pursuant to
      article seventy-eight  of  the  civil  practice  law  and  rules,  state
      reimbursement   shall  not  be  withheld  or  denied  pursuant  to  this
      subdivision  for  non-compliance  during  such  stay.  Nothing  in  this
      subdivision shall limit the power of a court in a proceeding pursuant to
      article  seventy-eight  of  the  civil practice law and rules to order a
      social services official to comply with a  commissioner's  determination
      upon an appeal.
        12.  Every  applicant or recipient of public assistance and care shall
      be informed in writing, through the  distribution  of  an  informational
      pamphlet,  at  the  time  of  application  and at the time of any action
      affecting his receipt of assistance or care:
        (a) of his right to an appeal or fair hearing;
        (b) of the method by which he may obtain an appeal or fair hearing;
    
        (c) of his right to representation by legal counsel, or by a relative,
      friend, or other spokesmen, or that he may represent himself;
        (d)  of  the availability of community legal services to assist him in
      the appeal or fair hearings process;
        (e) of the nature of the  precedures  to  be  followed  throughout  an
      appeal or fair hearing;
        (f)  of the types of information he may wish to submit at an appeal or
      fair hearing;
        (g) of any additional information which would clarify the appeals  and
      fair   hearings  procedure  for  applicants  and  recipients  of  public
      assistance and care, and would assist  such  persons  in  more  adequate
      preparation for such hearings.
        13.  Whenever  under  other provisions of this chapter an applicant or
      recipient of public assistance or care may appeal to  the  department  a
      decision  of a social services official, or the failure of such official
      to act on his application within the required period, and may request  a
      fair  hearing  thereon,  if  such  applicant or recipient requires legal
      services in connection with such an appeal and  fair  hearing  and  such
      services  are  not  otherwise  available  to  him,  the  social services
      official shall, upon request, make provision for payment for such  legal
      services if required by federal law or regulations.
        14. To provide an analysis of the outcome of the fair hearings process
      within  the  office  of  temporary and disability assistance to identify
      inadequacies and potential improvements in the functioning of  the  fair
      hearings  system,  such office shall prepare for inclusion in the annual
      report required by subdivision (d) of section seventeen of this  article
      to be filed with the governor and the legislature prior to the fifteenth
      day of December of each year, a report containing with respect to income
      maintenance  programs,  including  the  family  assistance  program, the
      safety net assistance program, the medical assistance  program  and  any
      other  program,  the  number  of  affirmations  and  reversals  by local
      districts and by program including a breakdown by local districts of the
      number of fair hearings requested by program  and  the  number  of  fair
      hearings  held  by  program,  formal  requests  by  local  districts and
      recipients for reconsideration or rehearing of appeals, and a summary of
      court actions on hearing decisions.