405 Ind. Admin. Code 5-21.6-19

Current through October 31, 2024

Section 405 IAC 5-21.6-19 - Complaints and grievances

Authority: IC 12-8-6.5-5; IC 12-15

Affected: IC 12-13-7-3; IC 12-29; IC 25-23.6-10.5; IC 25-27.5-5

Sec. 19.

(a) Any of the following shall have the right to file a written complaint or a written grievance with the state or the office:

(1) An applicant.

(2) A member.

(3) A duly authorized representative or representatives of an applicant or a member.

(b) A complaint or grievance regarding an AMHH provider agency or a provider shall be accepted by the following means:

(1) The family/consumer section on the DMHA website.

(2) The consumer service line (800-901-1133).

(3) In-person via a DMHA staff member.

(4) A written complaint or e-mail submitted to the DMHA.

(c) Upon receipt of a complaint or a grievance, the office shall:

(1) log the complaint or grievance; and

(2) initiate an investigation.

(d) After the investigation is complete, the office shall notify the individual or the member filing the complaint or grievance of the office's findings.

(e) The office decision with regard to a complaint or a grievance:

(1) may not be appealed; and

(2) does not grant any appeal rights to the individual or the member filing a complaint or grievance.

(f) The filing of a complaint or grievance is not a prerequisite to filing an appeal under section 18 of this rule.

(g) If the office sends a letter to a provider agency under this section stating its findings regarding a complaint or a grievance of an applicant or a member, the following shall apply:

(1) The office may require the provider agency to correct an identified deficiency within a timeline established by the office.

(2) A provider agency's failure to correct the deficiency within the established timeline may result in sanctions up to, and including, decertification of the provider agency.

405 IAC 5-21.6-19

Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-19; filed Dec 16, 2013, 9:11 a.m.: 20140115-IR-405130183FRA

Filed 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRA

Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA

Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA