6 Pa. Code § 3.5 - Informal complaints
(a)
General requirement. Prior to arranging for any formal
hearings on complaints or appeals, the Department will require all parties
appealing under §
3.3 (relating to opportunities for
appeals and fair hearings) to proceed through the informal complaint process
provided for in this section.
(b)
Submission, form and content of informal complaints.
(1) All informal complaints shall be filed in
writing within 30 days following the receipt of the notice of adverse
action.
(2) Parties appealing under
§
3.3(3) and (4)
shall send their informal complaints to the director of the local Area Agency
on Aging.
(3) Parties appealing
under §
3.3(1) and (2)
shall send their informal complaints to the Department's Bureau of Program and
Field Operations.
(4) The complaint
shall contain all of the following information:
(i) Name and address of the
complainant.
(ii) Party against
whom the complaint is made.
(iii) A
copy of the notice of adverse action.
(iv) A statement of all relevant facts and
the grounds upon which the complaint is based.
(v) A statement of all issues
presented.
(vi) The relief or
solution requested by the complainant.
(vii) While not required, the complaint may
be accompanied by supporting papers.
(c)
An informal complaint as an
official request for a hearing. The filing of an informal complaint in
accordance with subsection (b) shall constitute an official request for a
hearing under 45 CFR
1321.51(b) (relating to
confidentiality and disclosure of information).
(d)
Local efforts to resolve informal
complaints filed with Area Agencies on Aging.
(1) Each Area Agency on Aging shall establish
a system for seeking local resolutions to informal complaints filed under
subsection (b)(2).
(2) The Area
Agency on Aging system required under subsection (d)(1) shall, as a minimum,
provide for all of the following:
(i) The Area
Agency on Aging shall confer with all parties directly involved in the adverse
action to determine all pertinent facts, clarify all applicable statutes and
regulations and develop an appropriate recommended resolution.
(ii) The Area Agency on Aging shall notify in
writing the parties to the complaint of its recommended resolution within a
period of not more than 10 working days from the date of its receipt of an
informal complaint.
(iii) Written
notification of a recommended local resolution shall include instructions for
the response of the parties within an additional 10 days.
(iv) The Area Agency on Aging shall utilize
the Domicilary Care Review Team to handle all complaints or appeals from
domiciliary care providers and applicants for or recipients of domiciliary care
services.
(v) The Area Agency on
Aging shall place on file written documentation of all steps taken to resolve a
complaint at the local level, the recommended resolution and the response to
the recommended resolution made by the parties to the complaint.
(vi) If either party to an informal complaint
handled under subsection (d) does not accept the resolution recommended by the
Area Agency on Aging and so notifies the area agency within the required 10
days, the Area Agency on Aging shall forward a copy of the originally filed
complaint to the Department's Bureau of Program and Field Operations within 3
working days of the receipt of the notification of lack of acceptance. The copy
of the complaint submitted to the Department shall be accompanied by a
description of the Area Agency on Aging's efforts to resolve the complaint
locally, including the recommended resolution and the response of the
parties.
(e)
Handling informal complaints filed with the Department.
(1)
Investigation by the
Department. The Department's Bureau of Program and Field Operations
will investigate each informal complaint with a view toward informal
resolution. The investigation will include, but not be limited to, discussions
and negotiations with all parties involved. The investigation will be completed
within 30 days of the Department's receipt of the informal complaint.
(2)
Notification of recommended
resolution. Following the completion of the investigation, the
Department will notify all parties concerned of its recommended resolution of
the complaint.
(3)
Appellate rights.
(i) The
parties to the adverse action shall notify the Department of acceptance or
rejection of the recommended resolution within 30 days following the receipt of
the recommended resolution.
(ii) If
either party rejects the recommended resolution, that party may request a
formal hearing. All requests for a formal hearing must be made within 30 days
following the receipt of the recommended resolution.
(iii) If the Department does not receive any
response to the recommended resolution from a complainant within the specified
time, the complaint will be declared abandoned and the case closed.
(4)
Final report.
A final report on each informal complaint transmitted to the Department through
an Area Agency on Aging shall be sent by the Department to the Area Agency on
Aging at the close of the response period. The report shall include a summary
of the investigation, whether the complaint was resolved or not and its
resolution.
Notes
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