The following information was gathered from "How to Get Assistive Technology Devices and Services Funded", Protection and Advocacy System, Albuquerque, New Mexico, June 1995.

The Protection and Advocacy for Assistive Technology (PAAT) program is a project of the Protection and Advocacy System, a non-profit statewide advocacy and legal rights center for persons with disabilities. It serves persons with disabilities who are, or would be, able to maintain or improve their functioning through the use of assistive technology, but have been denied funding or are otherwise having problems in obtaining these devices or services. Both children and adults are eligible for services.

You may contact the PAAT program at:

Protection and Advocacy System
1720 Louisiana Blvd. N.E. Suite 204
Albuquerque, NM 87110
(505) 256-3100 Voice/TTY
(505) 256-3184 Fax
(800) 432-4682

You have the right to appeal any adverse decision (denial of benefit or prior approval). A decision can be challenged in a "fair hearing." You may request a fair hearing either orally or in writing. However, in order to be considered timely, the reques6 must be received by the New Mexico Human Services Department (HSD) no later than the close of business on the 90th day from the decision. You may file a fair hearing request for reasons including:

1. Your application is denied or not acted upon within 30 days;

2. Your assistance is reduced, terminated, withheld, or the form of payment is changed;

3. You are "aggrieved" (harmed) by any other action affecting your benefits or participation in the program.

You have the right to be advised about the hearing; to receive help in preparing for or participating in the hearing; to have a hearing which fully safeguards your opportunity to present your case; to have prompt notice and implementation of the decision based on the hearing; and to be advised as to the availability of judicial review. You may make your own presentation at the hearing, or an attorney, friend, relative, or other spokesperson may represent you. HSD must give you the documents you need to prepare for the hearing; provide a sign language or other interpreter, if needed; and assist you to submit the hearing request.

At the fair hearing, HSD must explain the reason for the denial. In turn, you must be able to explain why the request should have been approved. You may present written and oral statements and witnesses to support your position. You may also question the HSD's witnesses. Fair hearings are usually informal, and may be held in person, or are conducted by conference call. You should be notified of the date of the hearing at least 10 days before the hearing. HSD has published hearing procedures in HSD Pamphlet No. 2.

Before a hearing, HSD will schedule an optional conference to discuss the issue concerning the hearing. You may be able to resolve the dispute at this conference. You may request a conference to discuss any adverse action you do not agree with. However, unless you make a written withdrawal of the fair hearing request, the fair hearing will still be held.

Following the hearing, a written decision will be issued. The decision may be to reverse the service denial and direct Medicaid to approve your funding request. The decision could also uphold the denial, or send the matter back to the original decision-maker for further information gathering or other review. Should you disagree with the final decision, you have 30 days after the date of the decision to appeal by filing a notice of appeal with the clerk of the Court of Appeals.

Here are some tips to get you started:

• Be sure to get a written denial with the reason(s) for turning down your request. Do not accept merely a verbal explanation of the denial.

• Prepare a statement, which justifies your funding request based on the regulations set forth by Medicaid.

• Be prepared to indicate why HSD's denial of funding is contradictory to the regulations set forth by Medicaid.

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© 2002 UNM CDD Assistive Technology.