Iowa Administrative Code › Agency 111 - Blind, Department for The › Chapter 11 - Independent Living Rehabilitation Services › Rule 111-11.9 - Dispute Resolution Process

Current through Register Vol. 47, No. 3, July 24, 2024
This rule defines the procedures under which the dispute
				resolution process shall be conducted by the department.
(1)
Definitions.
"Administrative review"
means a procedure by
				which the department may provide an opportunity for an applicant or eligible
				individual to express and seek remedy for dissatisfaction with a decision
				regarding the furnishing or denial of services.
"Formal hearing "
means a procedure whereby an
				applicant or eligible individual who is dissatisfied with the findings of an
				administrative review or mediation concerning the furnishing or denial of
				services may request a timely review of those determinations before an
				impartial hearing officer
While the department encourages the use of the administrative
				review process to resolve grievances, the administrative review process is not
				to be used as a means to delay mediation or a formal hearing before an
				impartial hearing officer unless the parties jointly agree to a delay. An
				applicant or eligible individual may elect to proceed directly either to
				mediation or to the formal hearing process. The department will not suspend,
				reduce, or terminate independent living rehabilitation services to any
				applicant or eligible individual throughout the administrative review,
				mediation or formal hearing process before a final agreement or decision is
				made, unless the applicant or eligible individual or, as appropriate, the
				applicant's or eligible individual's representative so requests, or the
				department has evidence that the services have been obtained through
				misrepresentation, fraud, collusion, or criminal conduct on the part of the
				applicant or eligible individual.
"Mediation"
means an alternative which an
				applicant or eligible individual may choose if the applicant or eligible
				individual is dissatisfied with the findings of an administrative review
				concerning the furnishing or denial of services.
(2)
Administrative review.
An applicant for, or eligible individual of, independent living rehabilitation
			 services may request review of a decision regarding provision or denial of
			 services with which the applicant or eligible individual is dissatisfied by
			 submitting a letter to the program administrator of field operations.
a. The program administrator shall
			 acknowledge receipt of the letter and arrangements shall be made for the
			 administrative review to be held at a mutually convenient date, time and place
			 which shall be within ten days after receipt of the request for review. The
			 applicant or eligible individual shall also be notified of the applicant's or
			 eligible individual's right to obtain assistance through the Iowa client
			 assistance program.
b. The
			 administrative review shall consist of: review of the case file and any other
			 documentation involved in the subject matter of the review; interviews with the
			 service specialist for the blind and any others directly involved with the
			 subject matter of the review; and an interview with the applicant or eligible
			 individual or, as appropriate, a representative of the applicant or eligible
			 individual.
c. The program
			 administrator shall issue a written decision within five days of the review.
			 The decision shall set forth the issue, principle, and relevant facts
			 established during the review; pertinent provisions of law, administrative rule
			 or department policy; and the reasoning upon which the decision is based. The
			 letter transmitting the decision shall advise the applicant or eligible
			 individual that the applicant or eligible individual shall inform the program
			 administrator within seven days that either:
(1) the applicant or eligible individual
			 accepts the decision; or
(2) the
			 applicant or eligible individual does not accept the decision and wishes to
			 proceed either to mediation or to a formal hearing.
d. A record of the decision and any action
			 resulting from the decision shall be sent to the applicant or eligible
			 individual by mail. The decision and a record of any action resulting from the
			 decision shall be entered into the case file.