California Department of Social Services - State Hearings Division
Notes from the Training Bureau - July 29, 1998

The delegation document authorizes a judge to write final decisions on behalf of the California Department of Social Services and the California Department of Health Services. The delegation document also lists issues in which judges are not authorized to write final decisions. Those issues include In Home Medical Care, Medi-Cal Managed Care, Denti-Cal orthodontic cases and others.

Judges MUST write a PROPOSED decision in any case in which they are not delegated final decision authority. Welfare and Institutions Code (W&IC) Section 10966 makes clear that the Department may not determine whether a decision is a proposed or a final decision based on the outcome of the case. Judges must therefore write proposed decisions in cases such as Medi-Cal Managed Care or orthodontia regardless of whether the decision is a grant, denial or dismissal.

Presiding Judges and Specialists have a delegation document giving them the authority to act on Proposed decisions in certain cases. However, that delegation document also lists issues in which the Presiding Judge or Specialist does not have the authority to adopt the proposed decision. The categories of cases that may not be adopted by a Presiding Judge or a Specialist include essentially the same Medi-Cal issues in which judges have no final decision authority such as In Home Medical Care, Medi-Cal Managed Care and orthodontia.

When the Presiding Judge or Specialist receives a proposed decision in one of these cases, he/she must fax or send the proposed decision to the appropriate Medi-Cal branch. The Medi-Cal branch contact will then notify the Presiding Judge or Specialist whether to adopt the proposed decision or to prepare an alternate decision. In a Medi-Cal SCOPE of benefits case, the Presiding Judge or Specialist must also fax the CDHS position statement and denied TAR with the decision. In Mental Health cases, the Presiding Judge or Specialist must send the entire case file as well as the proposed decision.

The following are the list of telephone numbers, fax numbers and addresses for Medi-Cal contacts that will be reviewing proposed decisions:

Medi-Cal Scope of Benefits
Contact: Jim Cicconetti
Phone: (916) 657-0564 (Calnet 8-437-0564)
Fax: (916) 657-0957 (Calnet 8-437-0957)
714 P Street, Room 1640
Sacramento, CA 95814

Denti-Cal
Contact: Mary La Franco
Phone: (916) 229-3111 (Calnet 8-424-3111)
Fax: (916) 229-3122 (Calnet 8-424-3122)

Mental Health
Contact: Teri Barthels
Phone: (916) 654-1615 (Calnet 8-464-1615)
1600 9th Street, Room 120
Sacramento, CA 95814

Judges are reminded that proposed decisions should be submitted well in advance of the adopt date so that the Presiding Judge, Specialist or Medi-Cal branch contact may review the decision. Proposed decisions that may be adopted by the Presiding Judge such as decisions contrary to policy or decisions that invalidate a state regulation should be submitted to the Presiding Judge (or Specialist if the Presiding Judge is unavailable) at least five days prior to the adopt date. Where the Presiding Judge or Specialist has no authority to adopt the proposed decision, Judges should submit the proposed decision at least ten days prior to the adopt date.