COP 216759 (03/20/2025)
No right to appeal denial of funding in Children’s Community Options Program

Preliminary Recitals

Pursuant to a petition filed on January 24, 2025, under Wis. Stat. § 46.27(7m), Wis. Stat. § 227.42 and Wis. Admin. Code § HA 3.03(1), to review a decision by the Eau Claire County Department of Human Services regarding Medical Assistance (MA), a hearing was held on March 19, 2025, by telephone.

The issue for determination is whether DHA has jurisdiction over this appeal.

There appeared at that time the following persons:

PARTIES IN INTEREST:

Petitioner:
—

Respondent:
Department of Health Services
1 West Wilson Street, Room 651
Madison, WI 53703
By: P. Dutter
Eau Claire County Department of Human Services
721 Oxford Avenue
PO Box 840
Eau Claire, WI 54702-0840

ADMINISTRATIVE LAW JUDGE:
John Tedesco
Division of Hearings and Appeals

Findings of Fact

1. Petitioner (CARES # —) is a resident of Eau Claire County.
2. Petitioner is enrolled in the Children’s Long-Term Supports (CLTS) waiver program.
3. The CLTS program funds dance classes for petitioner.
4. The Children’s Community Options Program funded four pairs of dance shoes and one dance uniform for petitioner.
5. Petitioner sought funding for more uniforms/costumes and a sewing kit that the county has denied.
6. The agency denied the requests by notice dated 12/27/24.
7. Petitioner filed an appeal of the denials.

Discussion

The Division of Hearings and Appeals (DHA) can only hear cases on the merits if there is jurisdiction to do so. The petitioner appeals decisions by the county under the Children’s Community Options Program. The hearing right is prescribed by statute for actions under this program:

Right to hearing. A child who is denied eligibility for services or whose services are reduced or terminated under this section may request a hearing from the department under s. 227.44, except that lack of adequate funding may not serve as the basis for a request under this subsection.

In this case, petitioner disputes the county’s denial of funding for dance uniforms and a sewing kit. The appeal is not a denial of eligibility or a reduction or termination of services. Petitioner seeks funding for specific goods which have been denied on the county’s stated basis of inadequate funding. On the record made at hearing, this dispute does not meet the limited appeal right set forth by statute. DHA cannot claim jurisdiction over this appeal on its merits.

Following hearing, petitioner sent a written argument asserting that jurisdiction exists for this appeal. The petitioner argues that the denial the uniforms and sewing kit should be seen as a denial of eligibility for services. I disagree. It reasonably appears that DHA’s jurisdiction is granted for fundamental questions such as a termination from the program, or a case of error in determining program eligibility. It is understandable that a fair hearing right does not attach to every decision about every specific item requested and denied. After all, the record reflects that even the single county of Eau Claire has more than 600 members in the program. DHA does not manage the program, nor is DHA a reviewer of the program’s customer service.

Furthermore, petitioner argues that DHA should find jurisdiction in the appeal rights language included with the denial notices. But, DHA obtains jurisdiction only by statutory authority. The appeal rights in this case are limited by express language in the statute and I cannot create jurisdiction where not legally exists.

Conclusions of Law

DHA cannot claim jurisdiction over the merits of this appeal.

THEREFORE, it is

Ordered

That this appeal is dismissed.

[Request for a rehearing and appeal to court instructions omitted.]