SECTION 340:2-5-76. Hearing decision

(a)   The Appeals Committee.

(1)   The Appeals Committee makes the hearing decision.

(2)   No member of the Appeals Committee may obtain information about the case from outside the hearing record.

(b)   Legal and factual basis of the decision.

(1)   The factual basis of the decision is the information available to the Oklahoma Department of Human Services (DHS) on the date of the decision and, if DHS failed to follow its own rules regarding the gathering of information, the information that would have been available to DHS at the time of the decision had the rules been followed. This information is obtained through:

(A)   hearing testimony;

(B)   exhibits introduced at the hearing; and

(C)   facts or law of which the AHO has taken judicial notice.

(2)   The law applied to the case is described in (A) - (C) of this paragraph.

(A)   The relevant Sections of the Oklahoma Administrative Code (OAC) are applied.

(B)   Where the OAC is ambiguous or silent on a point critical to the decision, reference to other sources, including state and federal statues, federal regulations, sub-regulatory material, and case law is appropriate.

(C)   No Section of the OAC is declared invalid. However, if the validity of any Section of the OAC is raised as an issue, the AHO permits arguments concerning the issue so that it is preserved for subsequent review.

(c)   Making the decision.

(1)   Following the hearing, the AHO reviews the evidence and applicable law.

(2)   If the AHO concludes DHS acted correctly, the AHO issues a written decision on behalf of the Appeals Committee.

(3)   If the AHO concludes DHS acted incorrectly, the AHO refers the case to the other members of the Appeals Committee.

(A)   The AHO prepares a vote sheet containing the AHO's vote and the reasoning supporting the vote.

(B)   The AHO sends the vote sheet and Appeals Unit file to the member of the Appeals Committee from the affected division, who reviews the summary and Appeals Unit file prior to voting.

(C)   If the vote from the division member is:

(i)   favorable to the client, the file is returned to the AHO to issue a decision; or

(ii)   unfavorable to the client, the file is sent to the Appeals Unit supervisor to review and vote.

(D)   Following the vote by the Appeals Unit supervisor, the file is returned to the AHO to issue a decision in accord with the majority vote of the Appeals Committee.

(d)   The Appeals Committee may make a decision:

(1)   completely favorable to the client;

(2)   partially favorable to the client;

(3)   completely unfavorable to the client;

(4)   dismissing the hearing request because of client withdrawal or abandonment;

(5)   dismissing the hearing request because the hearing request does not relate to an appealable issue;

(6)   to hold a supplemental hearing; or

(7)   direct one, or both parties to obtain and submit additional information.

(e)   The Appeals Committee decision must contain:

(1)   a sufficient explanation of the issues, evidence, findings of fact, and law sufficient to inform the parties of the basis for the decision; and

(2)   appeal rights, the action required to appeal, and the time within which such action must be taken.

(f)   The Appeals Committee decision is sent to:

(1)   the client;

(2)   the authorized representative, if any;

(3)   the local office;

(4)   the DHS State Office programs manager of the program most affected by the decision;

(5)   other DHS components necessary for implementation of the decision; and

(6)   other DHS components the AHO or Appeals Unit supervisor chooses to notify.

[Source: Added at 19 Ok Reg 2199, eff 6-27-02; Amended at 31 Ok Reg 1820, eff 9-15-14]