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.
(3)
Mediation. An applicant
or eligible individual who is dissatisfied with the findings of an
administrative review or has elected to bypass the administrative review
process may request mediation by submitting a letter to the
program
administrator This letter must be received within seven days of the date of
determination of the administrative review, if an administrative review has
been conducted.
a. The program administrator
shall acknowledge receipt of the request for mediation and shall make
arrangements for mediation to occur within 30 days of the request to initiate
the dispute resolution process. The date, time, and place shall be mutually
agreeable to all parties. The applicant or eligible individual shall be
notified in writing of the right to submit evidence or information to support
the applicant's or eligible individual's position and to obtain representation
to be present during the mediation sessions. 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. All
mediation sessions shall be held in a timely manner and shall be concluded
within 45 days of the date that the applicant or eligible individual initiated
the dispute resolution process, unless an extension of this time is agreed upon
by all parties. The department will pay costs for the mediator and, when
appropriate, transportation, meals and lodging expenses for the applicant or
eligible individual which are directly associated with the mediation process.
The program administrator will determine who will represent the department
during mediation sessions.
b. The
department in conjunction with the Iowa department of education, division of
vocational rehabilitation services, will maintain a list of individuals who are
impartial, qualified mediators and knowledgeable in laws (including
regulations) relating to the provision of vocational rehabilitation and
independent living rehabilitation services. Potential mediators will be
identified by the division of vocational rehabilitation services utilizing
three primary sources: mediators used by the department of education, the Iowa
peace institute, and the Iowa extension services. The department and the
division of vocational rehabilitation services will train potential mediators
in the laws and regulations governing vocational rehabilitation and independent
living rehabilitation services.
c.
A mediator will be selected at random or by agreement of the director and the
applicant or eligible individual or, as appropriate, the applicant's or
eligible individual's representative from the list described in paragraph
11.9(3)"b. "
d.
Discussions which occur during the mediation process shall be confidential and
shall not be used as evidence in any subsequent due process hearing or civil
proceeding.
e. All agreements
reached by the parties to the dispute and the mediation process shall be set
forth in a written mediation agreement. This agreement shall be prepared by the
mediator and mailed within seven days to all parties.
f. Either party to the dispute may request a
formal hearing. This request must be in writing and must be submitted to the
director within seven days of the date of the written mediation
agreement.
(4)
Formal hearing. An applicant or eligible individual who is
dissatisfied with any determinations made concerning the furnishing or denial
of independent living rehabilitation
services or the findings of an
administrative review or mediation if an administrative review or mediation
took place may request a formal hearing by submitting a letter to the
director
a. The director shall acknowledge receipt of
the request and make arrangements for a formal hearing to be held within 60
days of the request of the applicant or eligible individual to initiate the
dispute resolution process at a date, time and place mutually agreeable to both
parties. The applicant or eligible individual shall be notified of the right to
have a representative present at the formal hearing and to seek assistance
through the Iowa client assistance program. Reasonable time extensions shall be
granted for good cause shown at the request of a party or at the request of
both parties.
b. The impartial
hearing officer shall be an individual who is not an employee of a public
agency other than an administrative law judge, hearing examiner, or employee of
an institution of higher education. (An individual is not an employee of a
public agency solely because the individual is paid by that agency to serve as
a hearing officer.) The impartial hearing officer (1) is not a member of the
commission for the blind; (2) has not been involved in previous decisions
regarding the independent living rehabilitation services of the applicant or
eligible individual; (3) has knowledge of the delivery of independent living
rehabilitation services, the state plan, and the federal regulations and state
rules governing the provision of services; (4) has received training with
respect to the performance of official duties; and (5) has no personal,
professional, or financial interest that would be in conflict with the hearing
officer's objectivity. The director may also request that other designated
department personnel be present at the formal hearing. At the request of the
applicant or eligible individual, a representative of the applicant or eligible
individual and a representative of the Iowa client assistance program may also
be present. Any of these persons shall have the opportunity to present relevant
evidence.
c. An impartial hearing
officer must be selected on a random basis or by agreement between the director
and the applicant or eligible individual or, as appropriate, the applicant's or
eligible individual's representative from a pool of persons qualified to be an
impartial hearing officer
d. The
impartial hearing officer shall inform those present of the confidentiality of
matters discussed. The proceedings shall be recorded.
e. Within 30 days of the completion of the
formal hearing, the decision of the impartial hearing officer shall be mailed
to the applicant or eligible individual or, if appropriate, the applicant's or
eligible individual's representative and the
director A representative of the
Iowa client assistance program who has attended the formal hearing shall also
receive a copy of the decision. The applicant or eligible individual may
receive a copy of the tape-recorded transcript of the hearing upon written
request to the
director
The decision of the impartial hearing officer shall be based
upon the provisions of the approved state plan for independent living, the
federal Rehabilitation Act, and state rules and policies.
f. The decision of the impartial hearing
officer is final.
(5)
Documents provided. Transcripts, notices, responses and other
documents which are an integral part of the dispute resolution process shall be
provided to involved parties in standard print format. An applicant or eligible
individual, or representative of an applicant or eligible individual, or other
involved party, may request provision of documents in alternative media.
Documents in alternative media shall be provided in a timely
manner
