This SHMTL contains twenty internal forms that are newly created or revised for accuracy and for compatibility with the new Hearings and Appeals Tracking System (HATS X). The effective date of the forms is January 2015, and the forms are being released in conjunction with the launch of HATS X.

JFS 04002 "State Hearing Schedule Notice," effective 09/2002 is obsolete and replaced by JFS 04002 "Notice to Appear for Scheduled Hearing," effective 01/2015. This revised, internal form is created for accuracy and compatibility with the new HATS X system. The notice tells the appellant when the state hearing is scheduled. The notice provides the place, time, and date of the hearing, as well as explains the appellant's rights and responsibilities.

JFS 04003"Administrative Appeal Request," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form A." Use of the form is optional, as customers may still submit a written administrative appeal request by mail, fax, or e-mail. The form allows an appellant to request an administrative appeal and will only accompany a state hearing decision. The request also provides the appellant an opportunity to explain why the appellant believes the state hearing decision is incorrect.

JFS 04004"State Hearing Request Denial Notice," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form H." The notice instructs the appellant a request for a state hearing is denied in accordance with federal and/or state law, providing the specific reason and Ohio Administrative Code authority for the denial.

JFS 04005 "State Hearing Decision," effective 03/2003 is obsolete and replaced by JFS 04005"State Hearing Decision," effective 01/2015. This revised, internal form is created for accuracy and compatibility with the new HATS X system. The form contains template language and is supplemented with information specific to the appellant's issue(s) from the scheduled state hearing. The form provides a summary of the facts of the case, the legal analysis as applied to the facts, and describes exhibits submitted by the agency or appellant.

JFS 04006"Subpoena Notice to Appear," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form R." The notice tells a witness to the hearing the witness is subpoenaed. The notice provides the place, time, and date of the hearing, as well as the rights and responsibilities resulting from the subpoena. The evidence necessary to the hearing and the Ohio Administrative Code authority for the subpoena is also listed on the form.

JFS 04010 "Denial of Good Cause Waiver," effective 01/2008 is obsolete and replaced by JFS 04010"Insufficient Good Cause Notice," effective 01/2015. This revised, internal form is created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form K." The notice tells an appellant the documentation provided is insufficient to establish good cause for rescheduling a hearing. The notice also provides the specific reason and statutory authority for the denial of good cause.

JFS 04013"Administrative Appeal/County Review Decision," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form F." This multipurpose form is used for the decision resulting from an administrative appeal or county review. The administrative appeal decision is issued following an appellant or authorized representative requesting an administrative appeal of a state hearing decision. The county review decision is issued following an agency's request for a county review of a state hearing decision. The county review decision does not alter a state hearing outcome.

JFS 04014"Notice Dismissing a County Review Request," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form J." The notice tells the county its request for a county review is dismissed, providing the specific reason and Ohio Administrative Code authority for the dismissal.

JFS 04015"Notice Dismissing Your Administrative Appeal Request," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form I." The notice tells an appellant the request for an administrative appeal is denied, providing the specific reason and Ohio Administrative Code authority for the dismissal.

JFS 04019"Notice of Abandoned Hearing," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form B." The notice tells the appellant the scheduled state hearing is abandoned for failing to come to the scheduled state hearing and the appeal is dismissed. The form also provides the appellant and authorized representative an opportunity to provide good cause for the absence.

JFS 04020"Notice to Appear for a Mediation Scheduling Conference," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form L." The notice, used only for adoption assistance cases, tells an appellant a mediation conference is scheduled, providing the date, time, and location of the meeting.

JFS 04028"Record Left Open Notice," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form M." The notice tells the appellant the case record is left open to allow the appellant the opportunity to submit additional information. The form also describes the materials that must be submitted and provides a submission deadline.

JFS 04029"Postponement/Reschedule Request Denial Notice," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form N." The notice tells the appellant the request for a reschedule is denied, and the notice provides the specific reason and Ohio Administrative Code authority for the denial.

JFS 04030"Notice of Withdrawal," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form S." The notice tells the appellant the state hearing request, administrative appeal request, or administrative disqualification referral is withdrawn. The appellant retains the right to revoke their withdrawal and have the state hearing request reinstated within 10 days of the withdrawal date.

JFS 04068 "State Hearing Compliance," effective 05/2001 is obsolete and replaced by JFS 04068 "Order of Compliance Notice," effective 01/2015. This revised, internal form is created for accuracy and compatibility with the new HATS X system. The notice tells the agency what actions are required as a result of a state hearing decision and the date by which they must be taken in order to achieve compliance. The form also requires all documentation be submitted indicating the agency's compliance with the decision. This notice will accompany a state hearing decision, an administrative appeal decision, or a judicial review.

JFS 04069 "State Hearing Request," effective 08/2003 is obsolete and replaced by JFS 04069 "State Hearing Request," effective 01/2015. This revised, internal-use only form is created for accuracy and compatibility with the new HATS X system. The form is utilized by state and county staff to complete a verbal request for a state hearing within HATS X. Alternatively, customers still have the ability to submit paper requests by mail or electronic requests by fax or email.

JFS 04071"Notice About Your Request for a Compliance Review," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form C." When an appellant makes a complaint regarding the manner in which compliance is approved, this notice tells the appellant the agency did comply with the state hearing decision and no further action will be taken by the Bureau of State Hearings. Furthermore, the notice describes the rights of the appellant as a result of the compliance ruling. A copy of the form will also be sent to the agency.

JFS 04072"Reschedule Request Not Timely Denial Notice," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form O." The notice tells the appellant the reschedule request is denied because the request is not timely, providing the Ohio Administrative Code authority for the denial.

JFS 04073"Subpoena Request Denial Notice," effective 01/2015 is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form Q." The notice is used after a hearing is scheduled and a valid subpoena, which is requested by a party to the case, is denied. The notice provides the specific reason and Ohio Administrative Code authority behind the denial.

JFS 04075"Compliance Rejection Notice," effective 01/2015, is a new, internal form created for accuracy and compatibility with the new HATS X system and replaces the clearance draft "Form D." The notice tells the agency it did not comply with a state hearing decision, providing the specific reason and Ohio Administrative Code authority for the rejection. A copy of the form will also be sent to the appellant and authorized representative.

SHM Instructions:

This information is also available on the Internet and may be accessed at:

ODJFS Electronic Manuals:http://emanuals.jfs.ohio.gov/

InnerWeb Calendar:http://www.odjfs.state.oh.us/lpc/calendar/staff/

Internet Calendar:http://www.odjfs.state.oh.us/lpc/calendar/