NC Register Volume 21 Issue 09 - Office of Administrative Hearings

CONTESTED CASE DECISIONS
STATE OF NORTH CAROLINA
IN THE OFFICE OF
ADMINISTRATIVE HEARINGS
COUNTY OF BUNCOMBE 06 DHR 0033
JOSHUA B. WORLEY, by and through his )
Guardian ad Litem, BERTHA GAIL LEVI, )
Petitioner, )
)
vs. ) DECISION
)
N.C. DEPT. OF HEALTH & HUMAN )
SERVICE, Division of Medical Assistance, )
)
Respondent. )
______________________________________)
This contested case was heard before Julian Mann, III, Chief Administrative Law Judge, on July 5, 2006, in Asheville, N.C.
APPEARANCES
Attorney for Petitioner:
Attorney for Respondent:
Curtis B. Venable
Diane M. Pomper
Pisgah Legal Services
Assistant Attorney General
P.O. Box 2276
P.O. Box 629
Asheville, N.C. 28802
Raleigh, N.C. 27602-0629
JURISDICTION
As Stipulated by the parties:
This matter is in the appropriate forum and venue. This matter was filed in a timely and appropriate fashion. All parties necessary
were joined.
ISSUE
As Stipulated by the parties:
Is there adequate justification as to why the relative is the provider of care?
BURDEN OF PROOF
As Stipulated by the parties:
Petitioner has the burden of proof in this matter.
DOCUMENTARY MATERIALS & EVIDENCE
As Stipulated by the parties:
Legal Authority:
• 1915(c) Waiver Application, dated September, 30, 2004.
• Centers for Medicare/Medicaid Services, Approval letter, dated June 30, 2005.
• Centers for Medicare/Medicaid Services, State Medicaid Manual, Section 4442.3B.
• 10A N.C.A.C. 27G .0104(14), paraprofessional definition.
Interpretative Manual/Guidelines:
• Community Alternatives Program MR/DD Manual
• Division of Mental Health, Developmental Disabilities & Substance Abuse Services, Person-Centered Planning
Guidelines, date March, 2005.
As Stipulated by the parties as to the authenticity, relevancy and admissibility:
• Petitioner’s Annual Plan of Care, dated 4/5/05, Respondent’s Ex. 1
• Plan Update/Revision, dated 9/1/05, Respondent’s Ex. 2
• Plan Update/Revision, dated 9/12/05, Petitioner’s Ex. 1
• Plan Update/Revision, dated 11/1/05, Petitioner’s Ex. 2, Respondent’s Ex. 3
• Plan Update/Revision, dated 12/1/05, Respondent’s Ex. 4
21:09 NORTH CAROLINA REGISTER NOVEMBER 1, 2006
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