Current through Register Vol. 47, No. 6, September 18, 2024
(1)
Program initiation of
discharge. If a program initiates the involuntary discharge of a
participant and the action is not the result of a monitoring, including a
complaint investigation or program-reported incident investigation, by the
department and if the participant or participant's legal representative
contests the discharge, the following procedures shall apply:
a. The program shall notify the participant
or participant's legal representative, in accordance with the contractual
agreement, of the need to discharge the participant and of the reason for the
discharge.
b. If, following the
internal appeal process, the program upholds the discharge decision, the
participant or participant's legal representative may utilize other remedies
authorized by law to contest the discharge.
(2)
Discharge pursuant to results of
monitoring or complaint or program-reported incident investigation by the
department. If one or more participants are identified as exceeding
the admission and retention criteria for participants and need to be discharged
as a result of a monitoring or a complaint or program-reported incident
investigation conducted by the department, the following procedures shall
apply:
a.
Notification of the
program. Within 20 working days of the monitoring or complaint or
program-reported incident investigation, the department shall notify the
program, in writing, of the identification of any participant who exceeds
admission and retention criteria.
b.
Notification of others.
Each identified participant, the participant's legal representative, if
applicable, and other providers of services to the participant shall be
notified of their opportunity to provide responses including: specific input,
written comment, information, and documentation directly addressing any
agreement or disagreement with the identification. All responses shall be
provided to the department within 10 days of receipt of the notice.
c.
Program agreement with the
department's finding. If the program agrees with the department's
finding and the program begins involuntary discharge proceedings, the program's
internal appeal process in subrule 70.24(1) shall be utilized for
appeals.
d.
Program
disagreement with the department's finding. If the program does not
agree with the department's finding that the participant exceeds admission and
retention criteria, the program may collect and submit all responses to the
department, including those from other interested parties. In the program's
response, the program shall identify the participant, list the known responses
from others, and note the program's agreement or disagreement with the
responses from others. The program's response shall be submitted to the
department within 10 working days of the receipt of the notice. Submission of a
response does not eliminate the applicable requirements, including submission
of a plan of correction under 481-subrule 67.10(5). Other persons may also
submit information directly to the department.
(1) Consideration of response. Within 10
working days of receipt of the program's response for each identified
participant, the department shall consider the response and make a final
finding regarding the continued retention of a participant.
(2) Amending the regulatory insufficiency. If
the department's determination is to amend the regulatory insufficiency based
on the response, the department shall modify the report of findings.
(3) Retaining regulatory insufficiency. If
the department retains the regulatory insufficiency, the department shall
review the plan of correction in accordance with this chapter and 481-Chapter
67. The department shall notify the program of the opportunity to appeal the
report findings as they relate to the admission and retention
decision.
(4) Effect of the filing
of an appeal. If an appeal is filed, the participant who exceeds admission and
retention criteria shall be allowed to continue to participate in the program
until all administrative appeals have been exhausted. Appeals filed that relate
to the participant's exceeding admission and retention criteria shall be heard
within 30 days of receipt, and appropriate services to meet the participant's
needs shall be provided during that period of time.
(5) Request for waiver of criteria for
retention of a participant in a program. To allow a participant to continue to
participate in the program, the program may request a waiver of criteria for
retention of a participant pursuant to rule
481-67.7
(231B,231C,231D) from the department within 10 working days of the receipt of
the report.