04.04.01 - Appeals

Effective Date: 09/04/02

Revised 01/01/13; 6/10/13; 7/16/15, 07/01/16, 10/01/19, 11/1/19
Reference: 89 Ill. Adm. Code, Chapter IV, §50.110

Policy Statement:

Persons receiving child care services as a family or a child care center provider can request hearings, as provided at 89 Ill. Adm. Code 14, Subpart A, as appropriate, on issues concerning the appropriateness of, denial of, prompt issuance of, or intended actions to discontinue, terminate, suspend, or reduce child care assistance. Child care home providers have the right to file a grievance as stated in Article X of the SEIU contract.

Assistance under this Part will not be continued at the previous level pending a hearing.

Procedures:

Clients
1. All applicants for or recipients of child care assistance have the right to appeal unfavorable decisions made about their child care case by CCR&R staff or Site Administered providers. Issues that can be appealed include, but are not limited to, the denial or cancellation of benefits, the copayment amount, the payment amount or non-payment of a child care subsidy, or any other unfavorable decision.
2. Appeals must be filed within 60 days. The 60-day period begins the day after the unfavorable notice is signed and mailed. If the sixtieth day falls on a non-workday, the parent has until the end of the next workday to request a hearing. Failure to notify the CCR&R, Site Administered Child Care Provider, or the Department before the end of the sixtieth day constitutes a waiver of the individual's right to a hearing.
3. The client may file an appeal:
  1. through the ABE portal at https://abe.illinois.gov/abe/access/appeals
    1. Clients can file an appeal, withdraw an appeal, make changes to information, such as address or phone number, request continuances, and upload exhibits by setting up an account in the portal.
  2. by calling the Department's toll-free number (800) 435-0774)
  3. by sending a written appeal either by fax, mail, or in person to
    1. IDHS local office serving the client
    2. CCR&R serving the client;
    3. IDHS Bureau of Subsidy Management for cases managed by Site Administered Child Care Providers;
    4. IDHS Bureau of Assistance Hearings (BAH),
      Telephone: (800) 435-0774
      
      Fax: (312) 793-3387
      
      Email: DHS.BAH@illinois.gov
    Mail: Bureau of Hearings
    69 W Washington, 4th Floor
    Chicago IL 6060
4. If a client wishes to file an appeal:
  1. Either the Child Care Assistance Program Specialist or their CCAP Supervisor must explain how the decision (eligibility determination) was made.
  2. Explain the appeal process, and
  3. Send the client an Appeal Request Form (IL444-0103 - Notice of Appeal (Cash Assistance, Medical Assistance, SNAP, Child Care) (English Version) (Spanish Version) for additional instructions for filing the appeal
5. Notification of Scheduled Hearing - The Bureau of Assistance Hearing will give reasonable notice in writing that an appeal has been filed to the client, and the Bureau of Subsidy Management Appeals Coordinator. The Notice of Scheduled Hearing Letter will include information regarding the date of the notice, as well as the day, date and time of the scheduled hearing. Details will also include the BAH assigned Appeal number, the entity managing the client's CCAP case.
  1. BAH will notify the Bureau of Subsidy Management Appeals Coordinator of each scheduled hearing by sending a Notice of Scheduled Hearing (also referred to as a Docket). Bureau of Subsidy Management will notify the managing CCR&R Agency or the Site Administered Provider of any assigned hearings.
  2. When an appeal is scheduled, staff must attempt to resolve the issue locally by conducting a pre-hearing meeting. This pre-hearing meeting should be scheduled ten (10) calendar days (except agency observed holidays) after BAH has notified the client that an appeal has been scheduled. The pre-hearing meeting will include the Bureau of Subsidy Management Appeals Coordinator most of the times.
  3. The CCR&R or Site Administered Child Care Provider must complete the Statement of Facts Form IL444-0102 (R-09-15) and work with the Bureau of Subsidy Management Appeals Coordinator to review case notes along with all relevant documentation. The Statement of Facts Form becomes part of CCMS case documentation. The Appeals Coordinator must have access to
    1. The completed Appeal Request Form (IL444-0103 (R-03-16)),
    2. The original Application, related Redetermination (if applicable),
    3. Legible copies of all material which will be reviewed at the hearing. This must include the case record for the last twelve (12) months. Do not send the entire case record. Search the CCMS Document History page to identify which documents are available in CCMS.
    4. Documentation not found in the CCMS Document History page can be electronically sent via e-mail, or mailed through U.S. Postal Service. If documentation is mailed, all material must be compiled in chronological order and addressed to:
      IDHS Bureau of Subsidy Management
      ATTN: CCAP Appeals Coordinator
      100 South Grand Avenue East, 2nd floor
      Springfield, IL 62762-0002
    DHS.CC-APPEALS@Illinois.gov
6. Pre- Hearing Meeting Outcome: If the issue is resolved prior to the day of a scheduled hearing:
  1. Pre-hearing meetings held prior to the day of a scheduled hearing whereby all parties are successful in resolving the issues of an appeal the appellant must consent to withdraw the appeal. The Bureau of Subsidy Management Appeals Coordinator will send the client a Statement of Facts Form IL444-0102, and a Withdrawal Agreement Form IL444-0065. Upon receipt of the signed Withdrawal, the Bureau of Subsidy Management Appeals Coordinator will submit a copy to the BAH for removal of the scheduled hearing from the calendar.
  2. If the pre-hearing meeting does not include the Bureau of Subsidy Management Appeals Coordinator, the CCR&R or Site Administered Child Care Provider must notify the Appeals Coordinator at the following email address: DHS.CC-APPEALS@illinois.gov or telephone number: (217) 557-1325. The CCR&R or Site Administered Child Care Provider must send the client the Statement of Facts Form IL444-0102, and an Appeal Withdrawal Agreement (IL444-0065 (R-03-16)) to complete. Upon receipt of a completed and signed Appeal Withdrawal Agreement from the client, associate the document with the case through CCMS upload or Work Item. (Sites without access to CCMS must contact the Appeals Coordinator). The CCR&R or Site Administered Child Care Provider must inform the Bureau of Subsidy Management Appeals Coordinator upon receipt of the completed documentation. The BCCD Appeals Coordinator will submit documentation to the BA
  3. If the issue is not resolved prior to the day of a scheduled hearing, the Bureau of Subsidy Management Appeals Coordinator should ensure that the Statement of Facts Form is mailed to client so that it is received at least two (2) days prior to the scheduled hearing date. The Appeals Coordinator must have access to:
    1. The completed Appeal Request Form (IL444-0103 (R-03-16))
    2. The original Application, related Redetermination (if applicable),
    3. Legible copies of all material which will be reviewed at the hearing. This must include the case record for the last twelve (12) months. It is not necessary to include the entire case record. Determine and identify which documents are available in CCMS, an
    4. All relevant documentation must be compiled in chronological order if sending by mail to:
      IDHS Bureau of Subsidy Management
      ATTN: CCAP Appeals Coordinator
      100 South Grand Avenue East, 2nd floor
      Springfield, IL 62762-000
7. Following the Conduct of Hearings
  Following all telephonic hearings any additional documentation considered during the hearing (referred to as exhibits) must be submitted within 48 hours. Documents can be submitted to the Hearing Officer or the Bureau of Subsidy Management Appeals Coordinator
8. Final Administrative Decision
  Following the resolution of the appeal, the Department is responsible for implementing the decision of the Final Administrative Decision immediately.
  1. When the Department has jurisdiction, the Final Hearing Decision will either uphold or not uphold the Department's action based only on the information available at the time the action was taken. The Final Administrative Decision often does not use the words "upheld" or "not upheld". Read the decision carefully and follow the directions in the Decision.
    1. The Department shall issue and implement a Final Administrative Decision within 90 days after receipt of a notice of appeal and request for a hearing, unless additional time is required and allowed by the program's rules for a proper disposition of the appeal. This time period shall be extended by any delay in the hearing process caused by the appellant
    2. A Final Administrative Decision, released by the Department, is reviewable only through the Circuit Courts of the State of Illinois. After a Final Administrative Decision is released, no petition for rehearing or reconsideration is allowed. Neither the filing of any such motion, or correspondence in the nature of such a motion, nor any response by the Department to such correspondence or motion will delay the time for filing of a complaint in the Circuit Court.
      1. When implementing any decision, take into account applicable changes in the case that have happened since the original action was taken
      2. Put the hearing decision into effect within 10 calendar days after the date the decision is received
      3. The Appeals Coordinator must complete an Implementation of Appeal Decision (Form IL444-1456) when the Final Administrative Decision directs an action. Form IL444-1456 must show all steps taken and the dates actions were taken. NOTE: Do not complete Form IL444-1456 if all directions on the Final Administrative Decision uphold the Department's action without ordering a new determination and/or dismiss for want of jurisdiction, an
      4. Send original Form IL444-1456 to Bureau of Assistance Hearings with required attachments. Scan a copy of the completed and signed Form IL444-1456 into the CCMS case record.
Licensed and license-exempt child care Centers Providers
1. Center based providers can only appeal decisions made about child care payments. Providers must file first-level appeals on decisions about child care payments directly with the IDHS Office of Early Childhood Bureau of Subsidy Management's Policy Unit within 60 calendar days of the payment or overpayment they are disputing. If the decision is not about a payment issue, the CCR&R /Site Administered provider will explain to the provider that the client must initiate the appeal process. If the provider is dissatisfied with the results of the first-level appeal, they can then file a second-level appeal through the DHS Bureau of Hearings.
2. If a center wants to file an appeal, or has issues with their payment:
  1. CCR&R staff must explain that center can only appeal decisions made about actual payments. Examples of the payment issues that can be appealed by providers include, but are not limited to:
    1. Dispute the number of days paid;
    2. Claiming payment for full time days instead of part time or school age days;
    3. Overpayments
    4. Requesting a higher rate not supported by a Rate Certification Form.
  2. CCR&R staff are to take the following steps within 10 business days of receiving the center's inquiry:
    1. Review the Certificate Report, HSCCMS payment details and case information to determine if the payment was processed correctly;
    2. Explain why the payment they want to appeal was made in the way it was;
    3. Review any supporting documents submitted by the center;
    4. Address any issues that the CCR&R determines were not processed properly within 10 working days of the determination;
    5. Explain the center's right to appeal and the appeal process.
  3. If the center is not satisfied with the explanation, and the CCR&R cannot resolve the issue per CCAP policies and procedures, inform the provider that they may file a first-level appeal with IDHS Bureau of Subsidy Management.
  4. Send the center an Appeal Request Form IL444-0104 - Notice of Appeal (Providers) for additional instructions on filing the appeal.
  5. The center may file an appeal by calling the Office of Early Childhood, Bureau of Subsidy Management at 217-557-1325 or sending a written appeal either by email, fax, mail, or in person to:
    IDHS Bureau of Subsidy Management
    100 South Grand Ave East 2nd Floor
    Springfield, Il 62762-0002
    Fax: (217) 785-9147
    Email: DHS.CC-APPEALS@Illinois.gov
3. The Bureau of Subsidy Management will contact the CCR&R when a center files an appeal and inform them of the first-level hearing date.
  1. The CCR&R must conduct a pre-appeal meeting with the center at least 2 days prior
    to the scheduled hearing to determine if the issue has been or can be resolved under CCAP policies and procedures. If so, issue an Appeals Withdraw form toe the center to complete and return to the CCR&R, who will send a copy to the Subsidy Management Appeals Coordinator.
  2. If there is no resolution from the pre-appeal meeting, Subsidy Management Appeals Coordinator will ensure that the Statement of Facts Form is mailed to the center so that it is received at least two (2) days prior to the scheduled hearing date. The appeals coordinator must have access to:
    1. The completed Appeal Request Form (IL444-0103A (R-03-16))
      conduct the first-level hearing as scheduled;
    2. The original Overpayment paperwork decision;
    3. Legible copies of all material which will be reviewed at the hearing. This must include the case record for the disputed time period. It is not necessary to include the entire case record. Determine and identify which documents are available in CCMS, and;
    4. All relevant documentation must be compiled in chronological order if sending by mail to: IDHS Bureau of Subsidy Management ATTN: CCAP Appeals Coordinator 100 South Grand Avenue East, 2nd floor Springfield, IL 62762-0002.
4. Following the conduct of all telephonic hearings any additional documentation considered during the hearing (referred to as exhibits) must be submitted within 48 hours. Documents can be submitted to the Hearing Officer or the Bureau of Subsidy Management Appeals Coordinator.
5. Final Administrative Decision Following the resolution of the appeal, the Department is responsible for implementing the decision of the Final Administrative Decision immediately.
  1. When the Department has jurisdiction, the Final Hearing Decision will either uphold or not uphold the Department's action based only on the information available at the time the action was taken. The Final Administrative Decision often does not use the words "upheld" or "not upheld". Read the decision carefully and follow the directions in the Decision.
  2. The Department shall issue and implement a Final Administrative Decision within 30 days after receipt of a notice of appeal and request for a hearing, unless additional time is required.
  3. Subsidy Management will issue a written decision to the CCR&R and the provider based on the hearing within 30 days of the first-level hearing. CCR&R staff are to ensure that all actions associated with the decision are completed within 10 business days of receiving the decision.
6. If the provider is dissatisfied with the results of the first-level appeal, they can then file a second-level appeal through the DHS Bureau of Hearings:
  1. through the ABE portal at https://abe.illinois.gov/abe/access/appeals
    1. Centers can file a second-level appeal, withdraw an appeal, make changes to information, such as address or phone number, request continuances, and upload exhibits by setting up an account in the portal.
    2. calling the Department's toll-free number (800) 435-0774) or
    3. sending a written appeal either by fax, mail, or in person to:
      1. IDHS local office serving the center;
      2. CCR&R serving the client;
      3. IDHS Bureau of Subsidy Management for cases managed by Site Administered Child Care Providers;
      4. IDHS Bureau of Assistance Hearings (BAH),
        Telephone: (800) 435-0774
        
        Fax: (312) 793-3387
        
        Email: DHS.BAH@illinois.gov
      5. Mail: Bureau of Hearings
        69 W Washington, 4th Floor
        Chicago IL 60602
7. Appeals on the results of Fire Marshal inspections should be filed with the State Fire Marshal's office.
8. Providers applying as license-exempt centers would contact IDCFS to appeal decision made concerning their exemption determination.
Licensed and License-exempt Home Provider

All home-based child care providers have the right to file a grievance based on any decision made by the CCAP that directly affects the provider. Home providers should contact their SEIU representative if they wish to file a grievance.