Current through Register Vol. 47, No. 6, September 18, 2024
(1)
Denial, reduction or termination of services.
a. When a contractor denies, reduces or
terminates services funded by the HOPES-HFI grant against the wishes of a
participant, the contractor shall notify the participant of the following:
(1) The action taken;
(2) The reason for the action; and
(3) The participant's right to
appeal.
b. If a
participant files an appeal, the contractor shall provide services to the
participant throughout the appeals process, unless the contractor receives a
waiver from the department pending the outcome of the appeal.
(2)
Local appeals
process.
a. All contractors shall
have a written local procedure to hear appeals. The local procedure shall, at a
minimum, include:
(1) The method of
notification of the right to appeal;
(2) The procedure for conducting the
appeal;
(3) Time limits for each
step; and
(4) The method of
notification of the outcome of the local appeal and notification of the
participant's right to appeal to the state. Notifications of the outcome of the
local appeal shall include the facts used to reach the decision and the
conclusions drawn from the facts to support the contractor's
decision.
b. The written
appeals procedure and the record of appeals filed (including the record and
disposition of each) shall be available for inspection by authorized
representatives of the Iowa department of public health.
(3)
Appeal to department.
a.
Procedure for appeal. If
a participant is dissatisfied with the decision of the local appeal, the
participant may appeal to the state. The appeal shall be made in writing by
certified mail, return receipt requested, to the Division Director, Division of
Health Promotion and Chronic Disease Prevention, Iowa Department of Public
Health, Lucas State Office Building, Des Moines, Iowa 50319-0075, within 15
days of receipt of the local contractor's appeal decision.
b.
Department review. The
department shall evaluate the appeal based upon the merits of the local appeal
documentation. A department decision affirming, reserving, or modifying the
local appeal decision shall be issued within 30 days of the receipt of all
local appeal documentation. The department decision shall be in writing and
shall be sent by certified mail, return receipt requested, to the participant
and the contractor
(4)
Further appeal. The participant may appeal the department's
decision by submitting an appeal, within 10 days of receipt of the department's
decision, to the Division Director, Division of Health Promotion and Chronic
Disease Prevention, Iowa Department of Public Health, Lucas State Office
Building, Des Moines, Iowa 50319-0075. Upon receipt of an appeal that meets
contested case status, the department shall forward the appeal within 5 working
days to the department of inspections and appeals pursuant to the rules adopted
by the department of inspections and appeals regarding the transmission of
contested cases. The continued process for appeals shall be governed by
641-Chapter 173, Iowa Administrative Code.
