In order to meet the state mandated due process needs of applicants and recipients of the Affordable Care Act/Covered California (ACA), and the additional responsibilities pertaining to Relative Assessment hearings and Administrative Disqualification hearings, the Employment and Human Services Department is requesting to add one (1) Social Services Appeals Officer position. The additional responsibilities have greatly impacted the Appeals Officers workload. Recent ACA regulatory changes provide strict guidelines on whether a case will be heard or not, and will require Appeals Officer to conduct for each family member a separate Medi-Cal hearing; previous regulation allowed for the review of the family's circumstances as one budget unit. In addition, the Harris vs Wagner lawsuit settlement requires the Appeals Officers to represent the department at state-level hearings related to Children Family Services Relative Assessment hearings. The California Department of Social Services (CDSS) requires the Appeals Officer to present the county’s case at the pre-hearing conference, and the follow-up hearing. The Relative Assessment hearings require that the Appeals Officers have an in-depth knowledge of the regulations, due process rights and the ability to interpret the Department of Justice criminal records. In addition, in accordance to CDSS, all counties are mandated to commence Administrative Disqualification Hearings as soon as reasonably possible. The Appeals Officers will be responsible for Administrative Disqualification Hearings. The Appeals Unit also has experienced an increase in the number of Civil Rights complaints and investigations, including the recently assigned civil rights issues for programs funded by the Metropolitan Transportation Commission (MTC) for CalWORKs recipients.

If the SS Appeals Officer position is not added there will be insufficient staff to assume the additional caseload and adhere to the mandated regulatory changes required by the Affordable Care Act/Covered California, as well as investigate civil rights issues filed by CalWORKS recipients. The County and Department will run the risk of violating client's due process rights.

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