How to Request a Hearing
The Division's work and family services unit conducts administrative hearings required by state and federal law for the Department of Health Services (DHS), the Department of Children and Families (DCF) and the Department of Administration (DOA). Hearings are generally held at county social service agencies. Decisions must be issued within either 60 or 90 days, depending on the type of hearing.
The unit handles a wide variety of hearings for Department of Health Services including:
- medical assistance
- foster home
- day care center licensing
- medical care facility licensing
- certification or penalty issues
- Medicaid rate-setting and recoupment matters
Hearings held for Department of Children and Families involve:
- child care
- foster care
The hearings held for the Department of Administration involve the Low Income Energy Assistance program.
How to request a hearing:
Requests for hearing must be made in writing to the
Division of Hearings and Appeals
5005 University Avenue, Suite 201
Madison, WI 53707-5400
Your request should include:
- your name
- your mailing address
- a brief description of the problem
- which county or state agency took the action or denied the service
- your social security number
- your signature
The Request for Fair Hearing form is in Portable Document Format (PDF). This form is also available in Spanish, Burmese, Hmong, Lao, Russian, German, Chinese Mandarin, Arabic, and Somali You will need the Adobe Acrobat reader to view/print this document. If you do not have Adobe Acrobat, you may download it free from http://www.adobe.com.
If you wish to withdraw your request for a hearing, you may use the Voluntary Withdrawal form.
Certification of Administrative Action