Individual Consumer/ Organization Grievance
Consumers who believe they have not been provided services they are eligible for, have been denied funding and/ or services, or have concerns about conflict of interest may follow this procedure to address their complaint. The following Grievance procedure is also available to organizations that have been denied funding or have not been afforded the same opportunity to provide services as other participating agencies.
NEI3A strives to promote an environment that is open and encourages problem resolution in a timely process. Utilization of the grievance procedure will not directly impact services or participation eligibility. Individuals and organizations my use this process without concern of retribution.
Northeast Iowa Area Agency on Aging encourages resolving complaints at the lowest level possible. Therefore, the grievances will be forwarded to the appropriate level unless specially requested by the complainant. The complainant has the right to withdraw at anytime during the grievance procedure.
Primary Contact Person
a. We encourage persons or organizations that have a grievance to resolve it with the person the complainant is directly working with to solve the problem. This activity is documented as necessary by Northeast Iowa Area Agency on Aging staff in Consumer Case Notes for Case Managers, Incident Reports if Senior Services Coordinator or other staff. NEI3A employees must keep direct supervisor informed of situations that may require further action.
a. If the complainant does not feel that the complaint or problem has been resolved, and the complainant wishes to have the complaint reviewed by a supervisor, the Case Manager, Center Coordinator, or staff employee provides the Consumer or organization with contact information for their supervisor. The complainant must submit a written complaint* within 30 days including the following information: date complaint submitted, complainant’s name, address, telephone number, the basis of the complaint, and the date of incident, if applicable. The supervisor must respond to the complaint within 15 days of receiving the complaint.
a. Upon receipt of an unresolved written complaint, the supervisor has 15 working days upon receipt of the complaint to attempt to resolve the issue. If the problem is resolved the supervisor documents the outcome in Consumer file, Incident Report, Case Notes or other appropriate organization file and notifies the complainant in writing.
b. If resolution is not reached, the supervisor documents the outcome in Consumer Case Notes, Incident Report, or Consumer file or other appropriate file. If the complainant does not feel that the complaint or problem as been resolved, and the complainant wishes to have the complaint reviewed by the Management Services Coordinator, the supervisor informs the complainant of the contact information of the Management Services Coordinator.
Management Services Coordinator Level
a. Upon receipt of the complaint the Management Services Coordinator has 15 working days to resolve the complaint.
b If the complaint is resolved the complainant will be notified in writing and will be documented in the Consumer file, Incident Report, or other appropriate file.
c. If the Management Services Coordinator is unable to resolve the issue, the complainant is given the contact information of the Executive Director.
Executive Director Level
a. Upon receipt of an unresolved complaint the Executive Director has 15 working days to investigate and attempt to resolve the issue.
b. If resolution is achieved, Executive Director will notify the complainant of the resolution by letter and document in the Consumer file, Incident Report, or other appropriate file.
c. If the matter is not resolved, and the complainant wishes to have the complaint reviewed by the NEI3A Executive Committee of the Board of Directors, the Executive Director provides the complainant the contact information for the President of the Board of Directors.
a. Upon receipt of an unresolved complaint the Executive Committee has 15 working days to investigate and attempt to resolve the issue.
b. If resolution is achieved, Board President will notify the complainant of the resolution by letter and document in Consumer file.
c. If the matter is not resolved, and the complainant wishes to have the complaint reviewed by the Department on Aging, the President of the Board of Directors provides the complainant with contact at the contact information for the Department on Aging: Department on Aging, Jessie M. Parker Building, 510 E 12th Street, Suite 2, Des Moines, IA 50319-9025.
Note: Northeast Iowa Area Agency on Aging, as a HIPAA covered entity may require authorization from the Consumer or personal representative to share personal health information outside NEI3A.
Concerns regarding Consumer’s Civil Rights are referred directly to the Management Services Coordinator at 2101 Kimball Avenue, Suite 320, Waterloo, IA 50702.
Phone 319-272-2244 Or 800-779-8707
The Iowa Civil Rights Commission
Grimes State Office Building
400 E. 14th Street
Des Moines, IA 50319
Phone: 515-281-4121 Or -800-457-4416
*Accommodations will be made for those unable to provide a statement in writing due to disability or English language proficiency.
I have read this form, or it has been read and explained to me and I understand its content.
Individual Consumer/Organization Grievance to be updated annually. A copy of this form will be provided to the consumer.