2014-08-29 due process summary - oacbdd.org

Franklin J. Hickman Janet L. Lowder David A. Myers

Elena A. Lidrbauch Mary B. McKee

Andrea Aycinena

Judith C. Saltzman of counsel

Penton Building 1300 East Ninth Street

Suite 1020 Cleveland, OH 44114

Telephone (216) 861-0360 Fax (216) 861-3113

5062 Waterford Dr.

Sheffield Village, OH 44035 Telephone (440) 323-1111

Fax (440)323-4284

This is a summary only and is not intended to provide legal advice. For individual issues, you should consult your attorney.

SUMMARY OF DUE PROCESS REQUIREMENTS

for

Appeals involving Medicaid HCBS services Complaints/Appeals for Non-Medicaid Services

Franklin J. Hickman Lori Stanfa, OACB

September, 2014

Due Process Table of Contents September, 2014 Page i

TABLE OF CONTENTS

APPEALS FOR HCBS WAIVERS ................................................................................................ 1WHEN NOTICE REQUIRED ........................................................................................................ 1MEDICAID APPEAL PROCEDURE ............................................................................................ 4NOTICE OF DENIAL (applies to all DD waivers)........................................................................ 5

Timing ......................................................................................................................................... 5Content of Notice ........................................................................................................................ 5

NOTICE OF CHANGE, REDUCTION OR TERMINATION ...................................................... 5General ........................................................................................................................................ 5Procedures for change, reduction or termination for TDD waivers ............................................ 6Timing ......................................................................................................................................... 7Content of Notice ........................................................................................................................ 7

STAY PUT...................................................................................................................................... 7HEARING PROCEDURE .............................................................................................................. 7APPEALS ....................................................................................................................................... 9SUMMARY OF COMPLAINT/APPEAL PROCESS UNDER O.A.C. § 5123:2-1-12 .............. 10I. General Principles ................................................................................................................. 10

A. Basis for Review ............................................................................................................ 10B. Who Can File ................................................................................................................. 10C. Non-Medicaid Supported Living ................................................................................... 10D. Rule Does Not Apply to the Following Complaint/Appeals: ........................................ 10E. General Procedures for Complaint/Appeals ................................................................... 11F. Review Proceedings Required before Filing Court Action ............................................... 11

II. Giving Information on Complaint/Appeal Procedures ......................................................... 11III. Notices of Adverse Action ................................................................................................. 11

A. Definition of Adverse Action ......................................................................................... 11B. Notice of Adverse Action (non-emergency) .................................................................. 11C. Notice of Adverse Action in Emergency ....................................................................... 12D. When Notice is deemed to have been served ................................................................. 13

IV. Informal Process for Complaints and Appeals .................................................................. 14V. Formal Process for Complaints and Appeals ........................................................................ 15NOTICE OF NON-MEDICAID ACTIONS ................................................................................ 15

Due Process Table of Contents September, 2014 Page ii

STEP ONE: REVIEW BY SUPERVISOR/MANAGER ............................................................. 15STEP TWO: REVIEW BY SUPERINTENDENT ....................................................................... 16STEP THREE: REVIEW BY DD BOARD ................................................................................. 16STEP FOUR: REVIEW BY DIRECTOR OF DODD .................................................................. 18OTHER REMEDIES .................................................................................................................... 18

HCBS Due Process September, 2014 Page 1

APPEALS FOR HCBS WAIVERS

WHEN NOTICE REQUIRED Situation SSA Activities Forms or

Resources

Resp. Reference

General principles: - Notice MUST be given even if the individual agrees to the change in service. - ONLY the SSA can give the notice, not the provider! - SSA should err on the side of giving due process every time a plan is reviewed and revised, PERIOD. - When in doubt CHECK with your supervisor, SSA director or DODD for guidance

1. Someone asks for a waiver service or services that are similar to a waiver (ex. HPC and Day Array) and CBDD does not have a slot available.

Starts process to put individual on wait list. Explain to family that this a waiver funded service and that SSA will place name on wait list.

ODJFS 7334 (denial)

SSA ORC1 5126.055 ORC 5126.042 OAC 5123:2-1-08(J)(4) OAC 5123:2-1-11(H)(2)

2. Individual is on waiver or in process of enrolling on waiver, individual/guardian requests services that pushes funding outside range.

SSA offers opportunity for prior authorization (individual has the right to request PA for the process to then proceed – note that a provider cannot initiate a request for PA). If person declines PA, give ODJFS 7334 denying the service.

PA request form from DODD or ODJFS 7334 (denial)

SSA ORC 5126.055 OAC 5123:2-9-07; OAC 5160-41-12 (PA for IO) OAC 5123:2-1-11(F)(2)(l) OAC 5123:2-9-06 PA Request form: https://doddportal.dodd.ohio.gov/forms/Documents/PA%20Request%20form.pdf

1 ORC refers to the Ohio Revised Code; OAC refers to the Ohio Administrative Code.


Situation SSA Activities Forms or Resources

Resp. Reference

3. Individual on waiver, individual/guardian request waiver service, but SSA feels that assessments do not indicate a need.

SSA reviews assessments to determine if service is needed, SSA shares results with individual/family. Explain why the service is being denied.

ODJFS 7334 (denial)

SSA ORC 5126.055 OAC 5123:2-1-11(F)(2)(l) OAC 5123:2-9-01(K) OAC 5123:2-9-06

4. Individual is on waiver and currently receiving services. Assessment update indicates a need for reduction of services (HPC, Day Array) through a reduction in units, hours, frequency/duration.

SSA completes process of formal and informal assessments. SSA shares results with individual/family and proposes change in level of service. If an individual’s service needs result in a funding level that may exceed the ODDP designated funding range, offer PA

ODJFS 4065 (reduction) or PA request form from DODD

SSA ORC 5126.055 OAC 5123:2-1-11(F)(2)(l) OAC 5123:2-9-06 OAC 5123:2-9-30 (HPC) OAC 5123:2-9-07 (PA for IO) PA Request form: https://doddportal.dodd.ohio.gov/forms/Documents/PA%20Request%20form.pdf

6. Annual ISP mailed to individual/guardian. SSA mails ISP and 4074 (approval) ODJFS 4074 (approval)

SSA ORC 5126.055 OAC 5123:2-1-11(F)(2)(l)

7. Individual/guardian complains that they were not given adequate choice of provider

SSA must ensure free choice of provider

ODJFS 4065 (change)

SSA ORC 5126.046 ORC 5126.055(A)(2) OAC 5123:2-1-11(F)(2)(l) (i)(c) OAC 5123:2-9-11 OAC 5123:2-9-50(E) OAC 5160-41-08


Situation SSA Activities Forms or Resources

Resp. Reference

8. Individual enrolled on waiver fails to or refuses to utilize waiver services.

SSA conducts monitoring of services. SSA completes assessments to establish that no waiver services are needed. Discuss current assessed needs with individual/guardian, if no waiver services are needed, recommend that individual is disenrolled from waiver.

ODJFS 4065 (termination)

SSA ORC 5126.055 OAC 5123:2-9-01

9. Individual enrolled on waiver fails to cooperate with LOC redetermination process.

SSA makes multiple attempts at contact.

SSA sends NICS Form to DODD DODD gives notice of disenrollment

SSA DoDD

ORC 5126.055 NICS form https://doddportal.dodd.ohio.gov/forms/Documents/NICS Disenrollment Form Part IIa.pdf


MEDICAID APPEAL PROCEDURE

Event Deadlines Reference

General References to Waiver Requirements – sections of these rules may be required to be included in notice. NOTE THAT THERE ARE CROSS REFERENCES TO OTHER RULES WHICH MAY BE RELEVANT OAC 5160-1-01 Medical Necessity OAC 5160-40-01 (IO) OAC 5160-41-18 (IO Payments) OAC 5160-41-17 (SELF) OAC 5160-41-20 (SELF Payments) OAC 5160-42-01(Level 1) OAC 5160 -41-19 (Level 1 Payments) OAC 5160-41-21 (TDD) OAC 5160-41-22 (TDD Payments) OAC 5160-41-22 Appendix A – fee schedule maximums for TDD services OAC 5123:2-9-50 DODD administration of TDD waiver OAC Chap.5123:2-9 (waiver service requirements); Commonly used sections of this Chapter include:

2-1-08 waiting lists 2-9-04 MLAA 2-9-06 Waiver documentation and payment(all ODDP related sections) 2-9-10 enrollment/disenrollment 2-9-25 specialized medical equipment and supplies denials



NOTICE OF DENIAL (applies to all DD waivers)

Timing prompt 5101:6-2-03(A)

Content of Notice Notice of denial must contain or do all of the following:

- a clear and understandable statement of the action the agency has taken

- the reasons for it, - cite the applicable regulations, - explain the individual's right to and the method of obtaining a

county conference and a state hearing, - contain a telephone number to call about free legal services.

5101:6-2-03(A)(1)

Form: JFS 07334 (rev. 10/2007), or the ODJFS computer-generated denial notice is required

5101:6-2-03(A)(2)

NOTICE OF CHANGE, REDUCTION OR TERMINATION (see additional procedures for TDD below)

General



- MUST be given even if the individual agrees to the change in service.

- ONLY the SSA can give the notice, not the provider! - SSA should err on the side of giving due process every time a

plan is reviewed and revised, PERIOD. - When in doubt CHECK with your supervisor, SSA director or

DODD for guidance.

Form: JFS 4065 is required for notice of change, reduction or termination

5101:6-2-04(C)

Procedures for change, reduction or termination for TDD waivers

If SSA proposes budget in new TDD case, and DODD authorizes, SSA issues notice. If appeal is filed, SSA completes appeal summary and presents case at appeal hearing, if any.

5123:2-9-50(H) 5160-41-21(C)(2)

If SSA proposes reduction in existing TDD case, the SSA updates cost calculator and sends to DODD. If DODD agrees, then SSA sends notice. If appeal is filed, SSA completes appeal summary and presents case at appeal hearing, if any.

5101:6-2-04 5123:2-9-50(H)

5160-41-21(C)(2)

If SSA submits budget and DODD denies or only partially approves, DODD issues notice. If there is an appeal, DODD completes appeal summary and presents case at appeal hearing, if any

5101:6-2-04 5123:2-9-50(H)

5160-41-21(C)(2)



Timing 15 calendar days prior to date of proposed action

5101:6-2-04(A)

Content of Notice

The notice shall contain all of the following: - a clear and understandable statement of the proposed action - the reasons for it, cite the applicable regulations, explain the

assistance group's right to and the method of obtaining a county conference and a state hearing,

- explain the circumstances under which a timely hearing request will result in continued benefits, and

- a telephone number to call about free legal services.

5101:6-2-04(B)

STAY PUT

When a request for a state hearing is received by the state or DD Board within the fifteen day prior notice period, benefits shall not be reduced, suspended, or terminated until a state hearing decision is rendered except under specified circumstances.

Within 15 days after notice

5101:6-4-01(A)

HEARING PROCEDURE Chapter 5101:6

Hearings are held by Bureau of State Hearings (BSH); hearings are typically conducted at the local JFS office; hearing officer typically participates by phone.



DD Board must prepare appeal summary which includes summary of all facts and documents relevant to issue under appeal. Exception to this requirement is Reduction or termination of TDD services which are contrary to recommendation of SSA. In such cases, the DODD prepares appeal summary.

Must file with BSH at least three business days prior to hearing and make available to individual filing appeal prior to hearing in manner prescribed by BSH.

5101:6-5-01(B)

Form for Appeal Summary: ODJFS 04067 5101:6-5-01(B)

DD Board must provide opportunity for county conference; county conference is not mandatory. Procedures are at 5101:6-5-01(C)

5101:6-5-01(C)(1)

Postponement of hearing: The local agency may request one postponement not later than seven days prior to the hearing. No postponement will be granted if it will prevent the bureau of state hearings from issuing the decision within applicable time limits. Individual requesting hearing has broader rights for postponement.

Not later than 7 days prior to hearing

5101:6-5-02(E)

Telephone hearings: Hearings are often held with the hearing officer participating by phone. Documents from DD Board and individual must be provided to BSH in advance. If all relevant documents are not available, they may be submitted at the hearing or the record can be held open until all documents are received.

5101:6-6-04

All hearings are recorded electronically 5101:6-6-03

DD Board has the burden of proof – this means that it is the DD Board’s responsibility to show, by a preponderance of the evidence, that its action or inaction was in accordance with ODJFS rules of the Administrative Code.

5101:6-7-01(C)(1)(c)



The DD Board shall - explain the reasons for the agency's action, - cite the regulations upon which the action was based, - provide relevant case information and documents, and - answer relevant questions from the individual and the hearing

officer.

5101:6-6-02(A)

During the hearing, each party may present and cross-examine witnesses.

5101:6-6-02(A)

DODD carries out functions of DD Board at hearings when there is Reduction or termination of TDD services which are contrary to recommendation of SSA.

APPEALS

The DD Board has no right to appeal an adverse decision by the hearing officer.

5101:6-8-01(A)

Non-Medicaid Complaints/Appeals September, 2014 Page 10

SUMMARY OF COMPLAINT/APPEAL PROCESS UNDER O.A.C. § 5123:2-1-12

I. General Principles

A. Basis for Review

The Rule is intended to provide a process for: (a) Resolution of complaints involving the programs, services, policies, or

administrative practices of a DD Board or an entity under contract with a DD Board.

(b) Appeal of adverse actions proposed or initiated by a DD Board. 5123:2-1-12(A) (Hereinafter Rule(-)). An Adverse action includes any denial, reduction, suspension, or termination of a non-Medicaid services or denial of eligibility. Rule (C)(1).

B. Who Can File

1. A complaint may be filed by either an individual or person. Rule (B)(1).

2. An appeal can only be filed by an individual. Rule (B)(1).

3. Definitions

(a) The rule defines “individual” as any of the following:

i. a person with a developmental disability who is eligible, or purports to be eligible, for services pursuant to Chapters 5123. and 5126. of the Revised Code

ii. a parent of a minor child, iii. an individual's guardian, or iv. an adult authorized in writing by the individual pursuant to section 5126.043 of

the Revised Code to make a decision regarding receipt of a service or participation in a program. Rule (C)(8).

(b) The Rule defines “person” as including "an individual, corporation, business

trust, estate, trust, partnership, and association.” Rule (C)((11); R.C. 1.59 (C).

C. Non-Medicaid Supported Living

For Complaint/Appeals involving non-Medicaid supported living services, the individual must follow the Provider’s contract terms before filing an Complaint/Appeal under this rule. Rule (B)(4).

D. Rule Does Not Apply to the Following Complaint/Appeals:

1. When DD Board is subcontractor or vendor

2. Issues arising from special education or early intervention services

3. Medicaid appeals, including appeals involving HCBS services

4. Delegated nursing decisions


5. Services provided by an ICF/IID. Rule (B)(2).

If a Complaint/Appeal is not covered by 5123:2-1-12, the DD Board must provide information on how an appropriate Complaint/Appeal can be filed, including the name and telephone number, if available, of the appropriate entity with which to file the complaint or appeal of adverse action. Rule (B)(3).

E. General Procedures for Complaint/Appeals

1. Complaints and Appeals must be in writing. When an individual/person expresses dissatisfaction with outcome that is subject to complaint/appeal under the rule, the DD Board must assist the individual/person in filing the Complaint/Appeal. Rule (D)(1).

2. All Complaint/Appeal proceedings are confidential unless the individual specifically consents to disclosure in writing. Rule (D)(2).

3. An advocate may assist the individual at all times throughout the process. Rule (D)(3).

4. Time lines can be extended by mutual agreement of all parties in writing. Rule (D)(5).

5. Parties can resolve a dispute informally at any stage of the process if all parties agree in writing. Rule (D)(6).

F. Review Proceedings Required before Filing Court Action

A civil action or appeal can only be filed after exhausting the administrative remedies required by this rule. Rule (B)(1), (H); R.C. 5126.06. This rule is not intended to provide any right or cause of action that does not exist absent this rule. Rule (H).

II. Giving Information on Complaint/Appeal Procedures

A DD Board shall provide a copy of the attached form which summarizes Complaint/Appeal procedures:

1. At time of initial request for services

2. At least annually to all individuals receiving non-Medicaid services

3. At least annually to all individuals on a waiting list for non-Medicaid services

4. Upon receipt of a complaint under the Rule

5. When the DD Board proposes an adverse action. Rule (E)(1).

III. Notices of Adverse Action

A. Definition of Adverse Action

An Adverse action includes any denial, reduction, suspension, or termination of a non-Medicaid services or denial of eligibility. Rule (C)(1).

B. Notice of Adverse Action (non-emergency)

1. DD Board must give written notice at least 15 calendar days before proposed action, except when necessary to protect health and safety of the individual or others.


2. Notice must include all of the following (Rule E(2)(a)). The DD Board must retain documentation of receipt as defined above. Rule E(2)(b).

(a) An explanation of the county board's policy and/or authority for taking the adverse action;

(b) A description of the specific adverse action being proposed or initiated by the county board;

(c) The effective date for the adverse action;

(d) A clear statement of the reasons for the adverse action including a description of the specific assessments and/or documents that are the basis for the adverse action;

(e) An explanation of the individual's right to appeal the adverse action;

(f) An explanation of the steps the individual must take to appeal the adverse action;

(g) A statement that the individual has ninety calendar days to appeal the adverse action;

(h) A statement that the individual must file his or her appeal prior to the effective date for the adverse action to keep his or her services in place during the appeal process;

(i) The name and contact information for the staff member of the county board who can assist the individual with his or her appeal; and

(j) The "Complaint or Appeal of Adverse Action Explanation Form" contained in the appendix to the Rule.

C. Notice of Adverse Action in Emergency

1. This notice section applies when it is necessary to suspend an individual's services without delay to ensure the health and safety of the individual or other individuals. Rule (E)(3). The DD Board must retain documentation of date of service of notice in accordance with requirements summarized in section D.

2. The following steps are required for notice in emergency:

(a) Determine what immediate steps are necessary to ensure the health and safety of the individual and other individuals; and

(b) Provide written notice to the affected individual immediately. The notice shall include:

(i) An explanation of the county board's policy and/or authority for suspending the individual's services;


(ii) A description of the specific services being suspended;

(iii) The effective date for the suspension of services;

(iv) A clear statement of the reasons for the suspension of services including a description of the specific circumstances that jeopardize the health and safety of the individual or other individuals;

(v) An explanation that the county board shall arrange for appropriate alternative

services and a description of the specific alternative services available to the individual;

(vi) An explanation of the steps the county board shall take in accordance with

paragraphs (E)(3)(c) and (E)(3)(d) of the rule;

(vii) The name and contact information for the staff member of the county board who can answer questions about the suspension of services; and

(viii) The "Complaint or Appeal of Adverse Action Explanation Form"

contained in the appendix to the Rule.

3. The DD Board shall convene a team within 5 calendar days of service of notice. The team must consider ways to eliminate the identified risk to health and safety.

4. Five calendar days after the team meeting, the DD Board must do any one of the following:

(a) With consent of the individual, eliminate risk to individual or others and restore services; or

(b) With consent of the individual, arrange for appropriate alternative services; or

(c) Provide written notice of termination of services that includes the components described in section III.B.2 of this summary. The notice must be served at least fifteen calendar days prior to the effective date of such action. If the individual files an appeal prior to the effective date of the termination of services, the county board shall keep the individual's alternative services in place until the appeal process is completed.

D. When Notice is deemed to have been served

The following criteria are used to determine whether notice has been properly served and when the time requirements for further action begin (Rule (C)(10)):

1. For an individual who has selected email as his or her preferred method of communication, electronic confirmation that the individual has read the email;

2. Personal delivery to an individual; or

3. The date of certified mailing to an individual unless:


(a) The original certified mailing is refused, in which case notice is deemed to have occurred on the date the notice is resent by ordinary mail to the individual; or

(b) The original certified mailing is unclaimed, in which case notice is deemed to have occurred on the date the notice is resent by ordinary mail to the individual unless within thirty days after the date the notice is resent, the resent notice is returned for failure of delivery.

IV. Informal Process for Complaints and Appeals

DD Boards may adopt a policy which allows an individual or person to engage in informal dispute resolution, providing that the informal process does not take longer than 30 days. Use of the informal process will delay the time required for filing an appeal. Rule (F); (G)(1)(b).


V. Formal Process for Complaints and Appeals

Event Days 5123:2-1-12

NOTICE OF NON-MEDICAID ACTIONS

Notice (non-emergency) Content of notice at Summary section III.B.2

15 calendar days prior to effective date of proposed action

E.2.a

Notice (emergency) Content of emergency notice at Summary section III.C.2(b) above. If emergency notice issued, there are Mandatory DD Board meetings at Summary sections III.C.3, 4 above.

Immediately E.3.a.ii

Filing complaint with supervisor or manager of DD Board

Within 90 Calendar days of becoming aware of the program, service, policy, or administrative practice that is the subject of the complaint.

G.1.a

Filing appeal after notice of adverse action. Appeal filed with supervisor or manager of DD Board

Within 90 calendar days of notice of the adverse action or within ninety calendar days of conclusion of the informal process set forth in paragraph (F) of this rule.

G.1.b

STEP ONE: REVIEW BY SUPERVISOR/MANAGER

Supervisor or manager shall conduct investigation, including a meeting the individual/person who filed complaint/appeal. Written report required which includes

- rationale for the decision - description of the next step in the review

process Supervisor or manager must be available to discuss written report

Within 15 calendar days of receipt of complaint or appeal.

G.1.c, d



STEP TWO: REVIEW BY SUPERINTENDENT

If process in Step One is not satisfactory, the individual/person can file complaint/appeal with Superintendent

Within 10 calendar days of notice of decision of supervisor/manager If supervisor/manager does not issue decision within required time, 25 calendar days of filing complaint/appeal with supervisor/manager

G.2.a, b

Superintendent or designee shall meet with individual/person and conduct administrative review. Superintendent may ask questions, review circumstances and facts. Individual/Person filing complaint/appeal shall have opportunity to present Superintendent with reasons why decision of supervisor/manage should be reconsidered.

Within 10 calendar days of receipt of complaint/appeal

G.2.c, d

Superintendent shall send decision to individual/person who filed complaint/appeal. Decision shall be sent certified mail, return receipt requested. Decision must include:


process

Within 15 days of receipt of complaint/appeal

G.2.e

STEP THREE: REVIEW BY DD BOARD

If process in Step Two is not satisfactory, the individual/person can file complaint/appeal with president of the DD Board.

Within 10 calendar days of notice of decision of superintendent/designee. If superintendent does not issue decision within required time, 25 calendar days of filing complaint/appeal with superintendent

G.3.a, b



DD Board must conduct hearing on complaint/appeal within 20 calendar days of receipt of complaint/appeal. Board may conduct hearing in one of three ways:

- Full DD Board - Committee of two Board members - Hearing officer who is not an employee or contractor with the DD Board.

G.3.c

Upon request, individual/person has access to all records and materials related to complaint/appeal

Not less than 10 days before hearing

G.3.d

Hearing private unless individual/person requesting hearing chooses to make hearing public

G.3.e

Both parties may present evidence G.3.f

Individual/person has right to be represented by counsel

G.3.g

Individual/person may require attendance of, and question, any official, employee, or agent of the county board who may have evidence upon which the complaint/appeal is based.

G.3.h

DD Board shall record proceedings either with stenographer or recording. Individual/person filing complaint/appeal is entitled to one free copy of transcript.

G.3.i

In making its decision, the county board may request or consider additional information with notice to all affected parties, may request a presentation in writing and/or in person from each party, or take other action necessary to make a determination.

G.3.j

DD Board shall send decision to individual/person, by certified mail, return receipt requested. Decision shall include:


process

Within 15 calendar days of board hearing or Within 15 calendar days of receipt of report/recommendation of committee or hearing officer

G.3.k



STEP FOUR: REVIEW BY DIRECTOR OF DODD

If process in Step Three is not satisfactory, the individual can file complaint/appeal with Director of DODD NOTE THAT ONLY AN INDIVIDUAL AS DEFINED IN SUMMARY SECTION I.A.3(a) CAN FILE AN APPEAL TO DODD

Within 15 calendar days of notice of decision of DD Board. If DD Board does not issue decision within required time, within 55 days of filing complaint with president of DD Board

G.4.a, b

Director shall send copy of complaint/appeal to superintendent and president of DD Board

G.4.c

President of DD Board shall send the director the written transcript of the county board hearing, copies of any exhibits, and a copy of the county board's decision

within 20 calendar days of receiving the copy of the complaint/appeal of adverse action from the director.

G.4.d

The director may request or consider additional information with notice to all affected parties, may request a presentation in writing and/or in person from each party, or take other action necessary to make a determination.

G.4.e

Director shall issue decision with rationale. Decision must be sent certified mail, return receipt requested, to all parties

Within 45 days of receipt of the written transcript of the DD board hearing, copies of any exhibits, and a copy of the county board's decision

G.4.f

Standard of review by director: Whether the decision of the DD Board is in accordance with applicable statute and administrative rule

G.4.f

OTHER REMEDIES

After completion of all procedures, the individual/person may commence a civil action or appeal.

H