An Administrative Disqualification Hearing ADH) is a formal, impartial review by a Human Services Judge for the purposes of rendering a decision as to whether or not an individual committed an intentional program violation (IPV).
An IPV is any action by an individual or provider which is a willful or intentional false statement, a concealment of a fact, or misrepresentation, whether or not it did or could have resulted in receipt of additional benefits. For more information about the methods for establishing an IPV, see Chapter 14.12.3 (Disqualification for Fraud – Families) and Chapter 14.12.6 (Disqualification for Fraud – Providers).
Misrepresentation or a failure to report on a timely basis does not necessarily constitute an IPV. The criteria for establishing the IPV requires an intentional act of deception, or one taken with an appreciation or understanding or its consequences or wrongfulness, and must be proven by a preponderance of evidence. To establish an IPV in an ADH, there must be a finding of intentional concealment or misrepresentation of a material fact by the legal standard of “preponderance of evidence”. Preponderance of evidence requires less evidence than “clear and convincing proof” or “proof beyond a reasonable doubt.” Legally, preponderance of evidence means that when the evidence is considered, it is more likely than not that fraud occurred.
An ADH must be initiated for individuals accused of committing an IPV when criminal charges are not being pursued. ADH procedures and requirements, EXCEPT for the notice of hearing as explained below, are the same as for administrative appeal hearings. See Chapter 15 (Appeals).
Resolve cases of suspected IPVs through either the criminal or ADH process, not both. Do not make concurrent referrals for prosecution and ADH. The practice of resolving an IPV first through the ADH process and then referring the same IPV for prosecution is prohibited.
If a case is dismissed in court, an ADH may be pursued because the burden of proof in establishing an IPV in an ADH action is the lower “preponderance of evidence” test as opposed to the “any reasonable doubt” standard required in a criminal prosecution.
Upon identifying an IPV and determining that the ADH process will be pursued, the accused individual or provider must be offered the opportunity to waive the appearance before a Human Services Judge and simply agree to the prescribed disqualification penalties.
Initiate the ADH process by completing the Notice of Intentional Program Violation –Waiver of Administrative Disqualification Hearing (DHS-3131) for families, or the Provider Notice of Intentional Program Violation – Waiver of Administrative Disqualification Hearing (DHS-3131A) for providers, whichever is appropriate. Prepare a narrative summary of the allegations, investigative findings, and the evidence to support the findings. Someone other than the assigned case worker must also review and sign the form and find that the case facts, if proven, would justify a finding of fraud. A county contact person must also be listed for the accused person to contact for reviewing the agency’s proof. The back page of the ADH waiver form has instructions to accused person as to how to waive the hearing, or request an ADH hearing. The waiver allows the accused person to admit to the facts or not, with the understanding that the disqualification penalty will be imposed in either case. Present or mail the ADH Waiver to the accused person. In either case, allow the person up to 10 days to return the form.
When the ADH involves a provider, complete one ADH Waiver for each individual or business that you propose to disqualify from receiving CCAP payments. Only the person or entity named on the ADH Wavier will be disqualified as a provider due to the ADH process. If you have questions about whether to bring an ADH against an individual provider, the provider’s business or both, consult with your county attorney’s office for guidance or contact the Office of Inspector General at the Department of Human Services (DHS). The provider must have received a copy of the Child Care Provider Responsibilities and Rights (DHS-4079) which includes the Penalty warning, before the ADH can be successful.
Waivers should not be offered when there is only a suspicion of guilt but the evidence is not convincing. If a county agency determines that it has sufficient evidence to hold a hearing and has offered the individual an opportunity to waive the hearing, the agency must then schedule a hearing if the individual requests a hearing or does not sign the wavier. Do not offer an ADH waiver if the case is being referred for prosecution nor should prosecution be suggested as a threat if the waiver is not signed. If an ADH waiver is offered it should be because the county has already determined that an ADH is appropriate and is merely offering the individual the opportunity to opt out of the actual hearing
If the accused person waives their right to a hearing, disqualify the person. See Chapter 14.12.3 (Disqualification for Fraud - Families), Chapter 14.12.6 (Disqualification for Fraud - Providers).
People have the right to revoke a signed waiver and to request that an ADH be held. This revocation must be in writing and be received by the county agency prior to the effective date of the proposed disqualification or within 30 days of the date the waiver was signed, whichever is earlier.
If the accused person refuses to sign the waiver, requests to have a hearing, or fails to return the waiver, refer the case for an ADH. Complete the Request for Administrative Disqualification Hearing (DHS-3132), for families, or the Request for Provider Administrative Disqualification Hearing (DHS-3132A), for providers, whichever is appropriate, and send to:
Minnesota Department of Human Services
P.O. Box 64941
St. Paul, MN 55164-0941
Upon receipt of the Request for Administrative Disqualification Hearing (DHS-3132), the State Appeals Office will either accept or deny the request. If denied, the county agency will receive a notice indicating the reason for the denial. Denied requests may be resubmitted to the State Appeals Office for reevaluation. ADH requests may be withdrawn any time before the scheduled hearing date with written notice to both the accused person and the State Appeals Office.
If the State Appeals Office accepts a request it will schedule a hearing date and send accused person and county agency a notice of hearing. The notice will include a copy of the summary prepared by the county agency. Federal regulations require the State Appeals Office to give notice of an ADH hearing at least 30 days in advance (unless the accused person waives the hearing), rather than the 5-day notice for a regular fair hearing.
A Human Services Judge may combine a fair hearing and ADH into a single hearing if the factual issues arise out of the same or related circumstances. The accused person must receive 30 days advance notice (unless waived) that the hearings will be combined.
Within 90 days of client notification of an ADH or a combined hearing, the State Appeals Office must conduct the hearing, reach a decision, and notify the accused person and county agency of the decision.
People found guilty of fraud by an ADH determination are subject to the disqualification procedures in Chapter 14.12.6 (Disqualification for Fraud - Providers), Chapter 14.12.3 (Disqualification for Fraud - Families).
Subpoena authority is available to county agencies to gather information relevant to the investigation of a potential IPV that will be pursued through the ADH process. Consider using an investigative subpoena when a third party refuses to provide information. Complete the Request for Investigative Subpoena (DHS-3436) and send to the DHS Appeals and Regulations Division. Include a description of the information being requested and the relevance of the information to establishing the IPV.
These subpoenas are not self-enforcing meaning that a first refusal to obey will not result in a contempt citation. However, these subpoenas are enforceable by appealing to district court for their enforcement by issue of a district court subpoena.
County attorneys can also use the Disqualification Consent Agreement (DCA) (DHS-3429) for families, or the CCAP Disqualification Consent Agreement (DCA) (DHS-3429A) for providers, whichever is appropriate, as an option for establishing an IPV and allowing an accused person to voluntarily agree to a disqualification and repayment of program benefits. Use of the DCA form is limited to the discretion of and execution by the county attorney’s office. The DCA’s intended use is for those IPV cases that the county attorney chooses to adjudicate without formal charging and prosecution outcomes.
Minnesota Statutes 119B
Minnesota Statutes 256.046
Minnesota Statutes 256.98
Minnesota Rules 3400.0183
Minnesota Rules 3400.0230