12 CCR 2510-1-10.500 - COMPLAINTS, APPEALS AND HEARINGS [Rev. eff. 12/1/10]

A. All service providers, including Area Agencies on Aging (AAA), contractors, and sub-contractors receiving Older Americans Act (OAA) funds to provide services to older adults shall develop policies and procedures for the resolution of complaints and appeals as described at Section 10.205, G.

B. A complaint, in the context of this rule, is an expression of dissatisfaction by:

1. An older adult receiving services under the Older Americans Act (OAA) or State Funding for Senior Services (SFSS), or his/her representative or caregiver;

2. An applicant for services under the OAA or SFSS, or his/her representative or caregiver; or,

3. A service provider.

C. Older adults receiving services, applicants for services, or their representatives or caregivers may file a complaint related to the following:

1. Any action or failure to act which impacts the older adult's experience with programs and services funded by the OAA or SFSS;

2. Dissatisfaction with services including issues related to quality and quantity of services;

3. Dissatisfaction with service providers; or,

4. Other issues related to OAA or SFSS programs raised by the older adult or his/her representative or caregiver.

D. Consumer complaints may initially be verbal or written.

1. If a verbal complaint is made in person, the agency staff or volunteer receiving the complaint shall assist the older adult in recording the complaint.

a. The narrative of the complaint shall be read back to the older adult to ensure that the older adult's complaint is accurately documented and the older adult shall be asked to sign the complaint. The staff member shall sign and date the document to verify this step.

b. The older adult shall not be required to sign the complaint if he/she refuses or is unable to sign.

2. Complaints received by phone shall be documented by the agency staff/volunteer receiving the complaint.

3. Complaints shall be forwarded to the appropriate agency for follow-up and resolution.

E. Service providers may file written complaints for issues related to:

1. Reimbursement;

2. Matters pertaining to an executed contract between the service provider and the contracting agency; or,

3. The conduct of the grant process, limited to issues of compliance with the procedural requirements of applicable laws, regulations, and policies.

F. Service provider complaints shall not include issues related to withdrawal of designation as an AAA, or PSA modification as found in Section 10.506.

G. Complaint procedures for enrollees in the Senior Community Service Employment Program are located at Section 10.422.623.

Notes

12 CCR 2510-1-10.500

39 CR 01, January 10, 2016, effective 2/1/2016