Submitted: August 1, 2018
Appellant Debro Abdul-Akbar's Appeal of Delaware
Department of Health and Social Services Fair Hearing
Decision. APPEAL DISMISSED.
Abdul-Akbar, Wilmington, Delaware, Appellant, pro se
Geoffrey G. Grivner, Esquire, Buchanan, Ingersoll &
Rooney, P.C., Wilmington, Delaware, Attorney for Appellee,
Richard R. Cooch, R.J.
the Court is Appellant Debro Abdul-Akbar's Appeal of the
Decision of the Fair Hearing Officer ("FHO") on
behalf of the Delaware Department of Health and Social
Services ("DHSS"). The FHO upheld a denial of
Appellant's request of 60 hours per week of Self-Directed
Attendant Care ("SDAC"). Highmark Health Options
("Health Options/Appellee") is the contracted
provider and servicer of DHSS's Medicaid
program. Health Options originally set
Appellant's SDAC needs at 28 hours per week. On July 25,
2017, Health Options denied Appellant's request to
increase SDAC to 60 hours per week. Appellant's appeal stems
from this initial denial.
threshold issue at this stage is whether Appellant has met
his burden under 31 Del. C. §520 to establish
that his appeal to this Court was timely filed. The Court finds
that Appellant's appeal was not timely. The appeal is
FACTS AND PROCEDURAL HISTORY
record indicates that Appellant is a 58-year-old man
diagnosed with several medical conditions including diabetes,
hypertension, heart disease, asthma, cyclical vomiting
syndrome, Hepatitis C, celiac disease, and liver disease.
Despite numerous medical conditions, Appellant is
occasionally able to function on his own,  but often
requires assistance with daily activities such as bathing,
cooking, cleaning, and laundry. Appellant's wife handles
much of his care when he is unable to function solely on his
own. Appellant also receives care under the SDAC program, a
DHSS Medicaid program intended to assist disabled patients
with ambulation, assistive devices, wound dressing, bathing,
July 2017, Appellant received 28 hours per week of SDAC.
Appellant apparently believed more hours should be ordered to
help him with numerous daily activities. Through his
physician Dr. Karlo Magat, Appellant requested an increase in
SDAC to 60 hours per week; a 32-hour increase. On July 25,
2017, Health Options denied Appellant's request as
"not medically necessary." ("July Denial")
Appellant requested an appeal of the July Denial on July 31,
2017. Health Options held an internal appeal on August 23,
2017 which upheld the July Denial. Appellant requested a
State Fair Hearing on September 12, 2017. The Fair Hearing
began on October 12, 2017. On January 8, 2018, after a
continuance to gather more medical records, the FHO upheld
the July Denial. Appellant filed the present appeal on
February 12, 2018.
Appellant Mr. Abdul-Akbar 's Contentions
first contends he has "suffered gross negligence"
from the "hearings parties thus
far[.]" Second, Appellant asserts Health Options
committed "gross medical malpractice" by permitting
a nurse to "essentially prescribe
treatment." Lastly, Appellant contends the FHO ignored
claims of discrimination. Appellant asserts the July Denial
"was made due to racial and ...