Consumer Participation Program - FAQ's

The Consumer Participation Program FAQs

The Consumer Participation Program (CPP) allows the Department to award reasonable advocacy and witness fees to any person or organization that Represents the Interests of Consumers in a Proceeding and makes a Substantial Contribution to the Department in its deliberations regarding that Proceeding. This page provides answers to Frequently Asked Questions (FAQs) about the CPP. Please see the regulation for more information about the CPP process, available here. 

 

How do I seek compensation through the CPP?

Seeking compensation through the CPP for the first time is a two-step process.

First, each applicant seeking compensation must submit a Petition to Participate within the timeframe specified in the regulation. This is a one-time only requirement. That is, once the Department approves the Petition to Participate, as long as the information it contains remains true and correct, you will not be required to submit future Petitions to Participate.

Then, after you have an approved Petition to Participate, if you would like to apply for an award, you must submit an Application for an Advocacy Award within the time frame specified in the regulation (28 CCR 1010(d).) An Application for an Advocacy Award is required for each Proceeding for which compensation is sought. The Department will review the Application for an Advocacy Award and, after deliberating and potentially requesting additional information, will issue a decision within 60 days of the Application being posted to the Department’s website.  

The CPP process may be completed online through the CPP Portal or it may be completed by mailing the required information to the DMHC. The mailing address is: The Director, Department of Managed Health Care, 980 9th Street, Suite 500, Sacramento, CA 95814.  If completing the CPP process through regular mail, review the regulation to ensure all information required in the Petition to Participate and/or the Application for an Advocacy Award is being submitted.

What is a Proceeding for which a CPP Award may be sought?

A Proceeding may be an administrative decision-making process relating to legislatively authorized guidance (which is guidance issued by the Department that is exempt from the Administrative Procedure Act), the adoption of a regulation, or the issuance of an order or decision by the Director, or the decision of the Director not to issue an order or decision.

Note that, for purposes of the CPP, an order or decision does not include the resolution of individual grievances, complaints, or cases. 

What is the Petition to Participate?

This is the first step in the CPP process and is a one-time only requirement. It provides general information about the applicant and its representation of the interests of consumers. As long as the information contained in the Petition to Participate remains true and correct, the applicant will be deemed eligible to seek Advocacy Awards in future Proceedings without having to submit a new Petition to Participate.

What is the timing required for the Petition to Participate?

If it is the first time an applicant is submitting a Petition to Participate, and the Petition to Participate is being submitted in connection with a particular Proceeding, it must be submitted either no later than the end of the final public comment period of the rulemaking session or within 10 working days after the legislatively authorized guidance, order, decision, or decision not to issue an order or decision becomes final.

What must be included in the Petition to Participate?

The Petition to Participate must contain the following, as applicable:

  • The name of the person or representative, organization name, mailing address, telephone number, and email address.
  • A showing that the person or organization Represents the Interest of Consumers, including a description of the experience advocating on behalf of consumers in administrative or legislative proceedings.
  • Names and titles of the members of the organization’s governing body.
  • Description of the organization’s general purpose, size, and structure.
  • The statute under which the organization is formed or incorporated, including whether it is a non-profit organization.
  • An identification of the Proceeding in which the person or organization seeks to participate. [This will apply only to a Petition to Participate submitted in connection with a specific Proceeding.]
  • A clear and concise statement of the interest in the Proceeding, explaining why the participation is needed to represent consumers. [This will apply only to a Petition to Participate submitted in connection with a specific Proceeding.]
  • An estimate of the Advocacy and Witness Fees that may be sought. [This will apply only to a Petition to Participate submitted in connection with a specific Proceeding.]
  • A statement that the facts contained are true and correct.

Any material changes to the information contained in the Petition to Participate must be disclosed to the Department as soon as possible.

How quickly will the Department review the Petition to Participate?

The Department’s Designated Hearing Officer will review and rule on whether or not the Petition to Participate will generally be granted within 30 days of its receipt.

What is the Application for an Advocacy Award?

Once the Department has approved a Petition to Participate, a Participant may submit an Application for an Advocacy Award seeking compensation for participation on behalf of consumers in a Proceeding. The Application for an Advocacy Award must contain detailed information about the ways in which a Participant has made a Substantial Contribution to the Proceeding.

What is the timing required for the Application for an Advocacy Award?

If the Proceeding is ongoing, a request for Interim Compensation may be made by submitting an Application for an Advocacy Award. Another Application for an Advocacy Award may be submitted at the end of the Proceeding, but it is not required. Note that a Participant may only submit one request for Interim Compensation per Proceeding.

If the Proceeding is complete, the Application for an Advocacy Award must be submitted no later than 60 days following the effective date of a regulation or the effective date of an order or decision by the Director, the decision not to issue an order or decision by the Director, or the date of issuance of legislatively authorized guidance.

What must be included in the Application for an Advocacy Award?

The Application for an Advocacy Award must include:

  • A detailed and itemized list description of the Advocacy and Witness Fees for which the Participant seeks compensation.
  • Legible time and/or billing records, created at the time the work was performed, which show the date and time spent on “each specific task” in 30 minute increments. If the submission is for Interim Compensation, the Application for an Advocacy Award shall include the specific time period for which the compensation is sought.
  • The hourly rate of compensation for each witness or advocate; a justification for each hourly rate, which may include previously approved hourly rates; and, each witness or advocate’s resume or curriculum vitae. Note that the hourly rate sought shall not exceed the Market Rate.
  • A description of the ways in which the Participant has made a Substantial Contribution to the Proceeding, supported by citations to specific tasks as necessary.
  • A clear and concise statement of the Participant’s interest in the Proceeding, which explains why participation was needed to represent the interest of consumers.
  • A copy of the Petition to Participate and a statement that the facts contained in the Petition to Participate remain true and correct to the best of the knowledge of the person verifying the information.

What does “each specific task” for purposes of the Application for an Advocacy Award mean?

“Each specific task,” for which detailed time and/or billing records must be maintained in 30 minute increments, includes, but is not limited to, the following activities and level of detail:

  • Telephone calls or meetings/conferences, identifying the parties participating in the telephone call, meeting/conference and the subject matter(s) discussed.
  • Legal pleadings or research, identifying the pleading or research and the subject matter(s).
  • Letters, correspondence, emails, or memoranda, identifying the parties and the subject matter(s).
  • Attendance at hearings, specifying when the hearing occurred, subject matter of the hearing, and the names of the Participant's witnesses or advocates who appeared and provided testimony at the hearing, if any.
  • Written comments submitted during a defined comment period.

What is the Market Rate?

The Market Rate, which the hourly rate used to determine the Advocacy and Witness Fees shall not exceed, is defined as the prevailing rate for comparable services in the private sector in the Los Angeles or the San Francisco Bay Area.

What does it mean for a Participant to have made a Substantial Contribution to a Proceeding?

A Participant has made a Substantial Contribution to a Proceeding if the Participant significantly assisted the Department by presenting relevant issues, evidence, or arguments that were helpful and seriously considered, and the involvement resulted in more relevant, credible, and non-frivolous information being available to the Director.

How quickly will the Department review the Application for an Advocacy Award?

After receiving the Application for an Advocacy Award, the Department will post it to its website within a reasonable amount of time. Within 60 days of posting the Application for an Advocacy Award to the website, the Designated Hearing Officer will issue a written decision stating whether the Participant has made a Substantial Contribution to the Proceeding such that the Application for an Advocacy Award will be granted. The decision will be posted to the Department’s website and sent to all Participants in the Proceeding within a reasonable time.

Note that prior to issuing its decision, the Designated Hearing Officer may request additional documentation or may audit the records or books of the Participant to assist in making his or her decision.

How can someone object to the Application for an Advocacy Award or an actual Award?

Within 30 days of the Application for an Advocacy Award being posted to the Department’s website, any person participating in the Proceeding may submit to the Director an objection to the Application for an Advocacy Award. This objection will be forwarded to the Designated Hearing Officer.

Once an Award has been granted, within 30 days or posting and sending the decision, an unsatisfied Participant may submit to the Director an appeal of the decision. The appeal must state the relief the Participant seeks and the reasons the decision should be modified or changed. The Director or a designee will review the written record and may ask for additional information to determine whether the original decision was an abuse of discretion. The decision rendered by the Director or his or her designee will be final and no additional remedy will be available.

 


 

 

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