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Consumer Participation Program - FAQ's

The Consumer Participation Program is a program that awards reasonable advocacy and witness fees to any person or organization that represents the interests of consumers and has made a substantial contribution on behalf of consumers to the adoption of any regulation or to a Director's order or Director's decision, which affects a substantial number of consumers.  

Which law made this program possible?

The Consumer Participation Program is made possible by section 1348.9 of the Knox-Keene Act. The statute is clarified at Title 28, Article 2, Section 1010 of the California Code of Regulations.

How many forms must I complete in order to receive an award of fees?

There are 3 forms. The first form, the Finding of Eligibility to Participate and Seek Compensation form, is to see if you substantially advocate on behalf of health care consumers. The second form, Petition to Participate in a Proceeding Form, approves you to participate in a specific proceeding and seek an award of fees. The third form, the Application for an Award of Advocacy and Witness Fees, is the actual request for fees.

What would make an applicant eligible to seek compensation?

  • The applicant represents consumers including a description of the applicant's experience in advocating on behalf of health care consumers in administrative or legislative proceedings.
  • The applicant is not employed by a health care service plan or specialized health care service plan.
  • The proceeding is not regarding resolution of individual grievances, complaints or, cases.

How long does the Department have to make a decision on if I may seek compensation?

The Department has 30 days, after the receipt of a completed application, to decide if you are eligible.

How long is an applicant eligible if they complete the Finding of Eligibility to Participate and Seek Compensation Form and are approved?

The finding of eligibility is valid for 2 years so long as the Applicant continues to represent the interests of consumers.

What is the Petition to Participate in a Proceeding Form?

Approval of this form identifies you as eligible for a specific proceeding. A person desiring to participate in a proceeding and seek an award of fees may submit a Petition to Participate in a Proceeding Form. Periodically, the Director may identify regulatory proceedings in which he or she believes consumer participation would be helpful and anticipates that fees may be awarded. This doesn't limit compensation only to those proceedings on the Director's list.

Is there a time limit on how long a Petition to Participate in a Proceeding Form may be submitted?

The Petition to Participate in a Proceeding Form will be submitted no later than the end of the public comment period or the date of the first of public hearing in the proceeding in which the proposed Applicant seeks to become involved, whichever is later. For orders or decisions, the request will be submitted within 10 working days after the order or decision becomes final.

How long does the Department have to approve or deny my Petition to Participate in a Proceeding Form?

The Department has 30 days, after the receipt of a completed application, to approve or deny the Petition to Participate in a Proceeding Form.

I have been approved for Petition to Participate in a Proceeding, what is my next step?

If you have made a substantial contribution to the proceeding, you must complete and submit the Application for an Award of Advocacy and Witness Fees within 60 days of the regulation, Director's order, or Director's decision.

How will I be notified if I am to receive an award of fees?

You will receive an approval letter via email.

What if I have participated in a proceeding and object to an application regarding the same proceeding?

Once an Application for an Award of Advocacy and Witness Fees has been received, it is posted on our website. You may use the "objection form" to object to that application. The Application for an Award of Advocacy and Witness Fees will be posted for 30 days. During that time, you may submit your objection form, objections will not be accepted after the 30th day.

What are the criteria to receive an award of compensation?

  • Applicant must have made a substantial contribution in representing consumers in an administrative proceeding, regulation, order, or decision. This must be supported by specific citations to the record, Applicant's testimony, cross-examination, arguments, briefs, letters, motions, discovery, or any other appropriate evidence.
  • Applicant must have completed the Finding of Eligibility to Participate and Seek Compensation Form and received approval or completed the Petition to Participate in a Proceeding Form and received approval.
  • A detailed, itemized description of the advocacy and witness services for which the Applicant seeks compensation.
  • Legible time and/or billing records created contemporaneously when the work was performed, which show the date and the exact amount of time spent on each specific task.

Will I receive the entire amount I applied for?

The hearing officer will determine the amount of compensation to be paid, which may be all or part of the amount claimed.

Can I appeal the hearing officer's decision?

Within 30 days of the hearing officer's decision, you may appeal to the Director for a review of the decision. The notice of appeal should state the relief that the Applicant is seeking and the reasons why the decision by the hearing officer should be modified or changed.

Can I appeal the Director's decision?

The Director's decision is final and there is no further administrative remedy.

Once I apply, is my information kept confidential?

All of the applications are subject to public disclosure under the California Public Records Act.

How much is the Department able to award during the year?

The Department may award up to a total of $350,000 for each fiscal year.

 

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Need Help with Your Health Plan?

Call the DMHC Help Center

1-888-466-2219

or submit an Independent Medical Review/Complaint Form