NC Register Volume 21 Issue 09 - Office of Administrative Hearings
NC Register Volume 21 Issue 09 - Office of Administrative Hearings
NC Register Volume 21 Issue 09 - Office of Administrative Hearings
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CONTESTED CASE DECISIONS<br />
STATE OF NORTH CAROLINA<br />
IN THE OFFICE OF<br />
ADMINISTRATIVE HEARINGS<br />
COUNTY OF BU<strong>NC</strong>OMBE 06 DHR 0033<br />
JOSHUA B. WORLEY, by and through his )<br />
Guardian ad Litem, BERTHA GAIL LEVI, )<br />
Petitioner, )<br />
)<br />
vs. ) DECISION<br />
)<br />
N.C. DEPT. OF HEALTH & HUMAN )<br />
SERVICE, Division <strong>of</strong> Medical Assistance, )<br />
)<br />
Respondent. )<br />
______________________________________)<br />
This contested case was heard before Julian Mann, III, Chief <strong>Administrative</strong> Law Judge, on July 5, 2006, in Asheville, N.C.<br />
APPEARA<strong>NC</strong>ES<br />
Attorney for Petitioner:<br />
Attorney for Respondent:<br />
Curtis B. Venable<br />
Diane M. Pomper<br />
Pisgah Legal Services<br />
Assistant Attorney General<br />
P.O. Box 2276<br />
P.O. Box 629<br />
Asheville, N.C. 28802<br />
Raleigh, N.C. 27602-0629<br />
JURISDICTION<br />
As Stipulated by the parties:<br />
This matter is in the appropriate forum and venue. This matter was filed in a timely and appropriate fashion. All parties necessary<br />
were joined.<br />
ISSUE<br />
As Stipulated by the parties:<br />
Is there adequate justification as to why the relative is the provider <strong>of</strong> care?<br />
BURDEN OF PROOF<br />
As Stipulated by the parties:<br />
Petitioner has the burden <strong>of</strong> pro<strong>of</strong> in this matter.<br />
DOCUMENTARY MATERIALS & EVIDE<strong>NC</strong>E<br />
As Stipulated by the parties:<br />
Legal Authority:<br />
• 1915(c) Waiver Application, dated September, 30, 2004.<br />
• Centers for Medicare/Medicaid Services, Approval letter, dated June 30, 2005.<br />
• Centers for Medicare/Medicaid Services, State Medicaid Manual, Section 4442.3B.<br />
• 10A N.C.A.C. 27G .0104(14), parapr<strong>of</strong>essional definition.<br />
Interpretative Manual/Guidelines:<br />
• Community Alternatives Program MR/DD Manual<br />
• Division <strong>of</strong> Mental Health, Developmental Disabilities & Substance Abuse Services, Person-Centered Planning<br />
Guidelines, date March, 2005.<br />
As Stipulated by the parties as to the authenticity, relevancy and admissibility:<br />
• Petitioner’s Annual Plan <strong>of</strong> Care, dated 4/5/05, Respondent’s Ex. 1<br />
• Plan Update/Revision, dated 9/1/05, Respondent’s Ex. 2<br />
• Plan Update/Revision, dated 9/12/05, Petitioner’s Ex. 1<br />
• Plan Update/Revision, dated 11/1/05, Petitioner’s Ex. 2, Respondent’s Ex. 3<br />
• Plan Update/Revision, dated 12/1/05, Respondent’s Ex. 4<br />
<strong>21</strong>:<strong>09</strong> NORTH CAROLINA REGISTER NOVEMBER 1, 2006<br />
854