Resolutions of Complaints Procedure

1. 1. Purpose:

      To outline the process for individuals/guardians to follow when they feel an adverse action has been taken by the County Board which affects the individual being served or the individual requesting services.

       

      1. This process can include but is not limited to following:
         1. Eligibility
         2. Any action regarding waiting list
         3. Denial, reduction, suspension or termination of County Board funded service(s) (non- Medicaid Services).

       

      2. The following entities/situations are not applicable to resolution of complaints:
         1. Education services arranged by the Local Education Agency (LEA).
         2. If the County Board is a vendor or subcontractor for service
         3. The administration of prescribed medication, tube feedings and performance of health- related activities by county board See OAC 5123:2-17-01 for these situations.
         4. Services provided to an individual residing @ an ICF/IID.

       

      3. The SSA shall give the “Complaint or Appeal of Adverse Action Explanation Form” contained in the appendix of  OAC 5123:2-1-12 (see attachment A) along with the MCBDD resolution flow chart (see attachment B), to an individual or persons:
         1. At the time of the individual's initial request for
         2. At least annually to each individual receiving or on a waiting list for non-Medicaid
         3. At the time a complaint or when the county board proposes an adverse

       

      4. At any point the individual/guardian requests to file a complaint, the complaint must be submitted in writing within 30 days of the denial or proposed The Community Services Director is to be notified of receipt of complaint. If/when necessary, the SSA can assist the individual or person filing the complaint.

       

      5. All appeals and adverse actions shall follow the MCBDD resolution flow chart (Attachment).
      
      

Rev. 5/15/2018

---

Complaint Resolutions Process

(Informal)

1. Complaint by individual

   ↓

   Brought to Program Administrator

   ↓

   Informal remedy - Within thirty (30) days of notification

   --------------------------------------------------

   Step one

   Filing of formal complaint in writing within 30 days of denial or proposed action

   ↓

   Investigation by Program Administrator – Includes meeting w/individual or person who filed complaint/appeal

   ↓

   Report submitted - Within fifteen (15) calendar days of receiving report

   ↓

   Appeal options explained

   --------------------------------------------------

   Step two

   Appeal to Superintendent – Within ten (10) calendar days (if no decision was rendered within 15 calendars days by the Supervisor/Manager, the complaint or appeal may be filed with Superintendent within twenty-five (25) calendar days)

   ↓

   Meet with Superintendent - Within ten (10) calendar days

   ↓

   Superintendent decision - Within fifteen (15) calendar days

   --------------------------------------------------

   Step three

   Appeal to President of the County Board - Within ten (10) calendar days

   ↓

   Hearing conducted - Within twenty (20) calendar days

   ↓

   Committee of Hearing Office – Issues report and recommendation to the County Board within ten (10) days

   ↓

   President of County Board submits decision report - Within five (5) calendar days

   --------------------------------------------------

   Step four

   Appeal to Director of Ohio Department of Developmental Disabilities - Within fifteen (15) Calendar Days

   ↓

   Decision of Director - Within forty-five (45) Days of Review

   ↓

   Civil Action

    

Resolution of Complaints 1-16-2018 rjm