Appeals Policy/Process

Consumers, their families and/or representatives, and providers have the right to appeal certain adverse decisions of the county or its designated agents:

Appealable Issue

1. Claim for financial assistance or services from Polk County has been denied.
2. Application for financial assistance or services from Polk County has not been acted upon with reasonable promptness.
3. Notification that Polk County will suspend, reduce or discontinue services or financial assistance.
4. Failure to take account of the person's choice in assignment to a lead agency or other similar Polk County program.
5. Other situations as determined by the county.

Non-appealable Issue

1. Decisions regarding licenses or certification issues by DHS, DIA, or any other licensing or accrediting body.
2. Competence of an individual provider to engage in the practice of a discipline or profession.
3. Diagnostic decisions.
4. Determinations by an individual provider that the provider cannot meet the needs of the consumer.
5. Discharge decisions of providers.
6. Decision to place a consumer on a waiting list.

Right of Appeal

Consumers, families, consumer representatives or advocates (with the consent of the consumer) and providers may appeal appealable decisions as defined above. When a decision is made by the county to deny service, change the level of service, or to declare a consumer ineligible for service, the consumer must be given notice of the decision. The right to appeal must be spelled out in the notice of decision. Polk County Health Services and access points will provide written forms for appeals and information about the appeal process.

If the consumer wishes to appeal he/she:

1. Must appeal within 90 calendar days of the decision. If the appeal is made within 10 calendar days, services will continue during the appeal process.
2. Must send the County Director, Polk County Community, Family, and Youth Services (General Relief Appeals) or the Executive Director, Polk County Health Services (MH/MR/DD Appeals), an appeal form or a letter containing:
   1. Current address and phone number.
   2. Description and date of disputed decision or action.
   3. Why the applicant thinks the decision was wrong.
   4. Copies of any documents that support the applicant's position.

Appeal to the Director

Upon receipt of the client's letter, the DCFYS Director or the Executive Director of Polk County Health Services notifies the appropriate Program Manager/Case Manager/Service Coordinator, who prepares a case summary. The case summary must be submitted within ten (10) workdays of the receipt of the appeal notice. The Director/Executive Director reviews the case and appeal with appropriate staff and makes a decision within four (4) workdays of the receipt of the case summary. The Program Manager/Case Manager/Service Coordinator prepares a letter signed by the Director/Executive Director notifying him/her of the decision. This letter must be sent within fifteen (15) workdays of the appeal. If the appeal is denied, the client must be informed of his/her right to appeal to the Service Appeal Board. The appeal must be made by letter or phone call within ten (10) workdays of the date of the letter of decision.

Appeal to the Service Appeal Board

Upon notification of the client's desire to appeal to the Service Appeal Board, the hearing will be placed on the earliest possible regular meeting agenda, but no sooner than five (5) workdays after the appeal is taken. At the hearing, the client presents his/her information and the Board members have an opportunity to ask questions. After discussion, the Service Appeal Board votes on the appeal. A letter will be sent to the client within five (5) workdays of the hearing. An appeal to the District Court shall be allowed the applicant of the Service Appeal Board decision within the time, manner, and the procedures established under the Iowa Administrative Procedures Act, Chapter 17A, Code of Iowa. Applicants with state case status may appeal decisions to DHS, following the procedures established in Iowa Administrative Code 441-153.59.