Your Rights and The Grievance Procedure

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As a customer of the Aging & Disability Re-source Center (ADRC) of Winnebago County you have the right to be treated with dignity and respect.

As an ADRC customer you have the right to register complaints/grievances and exercise your full due process rights regarding services provided by the ADRC, Managed Care Or-ganization or the self-directed supports waiver program called IRIS; Include, Respect-I Self Direct. There will be no reprisal to you for using the grievance process.

If you wish, the staff of the ADRC are avail-able to assist you at any point during the proc-ess should you request it. To contact the ADRC manager, please call 877-886-2372.

Please Note: You may access step 3 of the appeal process, without having gone through Steps 1 and 2. Accessing Step 4 is subject to specific criteria as listed in the section titled Step 4: State Fair Hearing Process. You are responsible for initiating your griev-ance within 45 days of the event you are grieving.

Step 1: Informal Internal Grievance

Many grievances can be resolved at this level, and you are encouraged to contact an ADRC Information & Assistance Specialist and/or the ADRC manager to register your complaint before initiating the formal process. The in-formal process begins on the date that the ADRC receives it, whether it is in writing on a grievance form, blank sheet of paper or by any other method through which you ordinar-ily communicate.

Once the grievance is received, the ADRC Supervisor will have 10 business days to re-solve it. This may include a face-to-face meet-ing with you and anyone you wish to bring with you. You will be notified in writing of the outcome of your grievance and of the time limits for accessing other steps of the process. You will have 10 business days from the con-clusion of the informal internal grievance process to request a formal internal grievance.

If informal internal method does not resolve your issue, the formal internal grievance proc-ess is the recommended next step in the proc-ess.

Step 2: Formal Internal Grievance

Formal internal grievances should be ad-dressed to the Aging & Disability Resource Center Manager. If the informal internal grievance process is bypassed, the formal in-ternal grievance time limit for filing within 45 days of the event must be followed.

To file an informal or formal internal griev-ance call, write, or e-mail the complaint to:

ADRC of Winnebago County

220 Washington Ave.

PO Box 2187

Oshkosh WI 54903

877-886-2372

adrc@co.winnebago.wi.us

The Aging & Disability Resource Center Manager will work with you to resolve your complaint within 10 business days.

Step 3: Formal External Grievances

The formal external grievance process can be accessed before, during or after the ADRC’s internal process.

Complaints Relating to the Managed Care Organization:

DHS Family Care Grievances

c/o MetaStar, Inc.

2909 Landmark Place

Madison, WI 53713

famcare@wisconsin.gov

Complaints Relating to ADRC

ADRC Quality Assurance Specialist

Office for Resource Center Development

Division of Long Term Care

WI Department of Health Services

PO Box 7851

Madison, WI 53707-7851

Phone: 608-266-2536

Fax: 608-267-3203

DHSRCTeam@wisconsin.gov

Complaints Relating to IRIS

Complaints relating to a service provider, an Independent Consultant or the Financial Ser-vices Agency shall be made to the Independ-ent Consultant Agency by calling 1-888-515-4747 or e-mailing info@wisconsin-iris.com

Complaints Relating to the ICA Independent Consulting Agency

John OKeefe, IRIS Manager

Beth Wroblewski, Director

Bureau of Long Term Support

Department of Health Services

P.O. Box 7851

Madison, WI 53707-7851

608-261-6749 John Okeefe

John.Okeefe@wisconsin.gov

Step 4: State Fair Hearing Process

ADRC customers have the right to a state ap-peal , if filed within 45 days, after receipt of a notice of a decision or failure to act regarding the following types of grievances: Determina-tion of ineligibility for long-term care bene-fits; Determination of cost sharing for long term care benefits; Determination that the per-son is eligible for, but not entitled to, the Fam-ily Care benefits specified in s46.286 (3) Stats.; Determination in regard to divestment, treatment of trust amounts and protection of income and resources of couple for mainte-nance of community spouse; and Failure of a Case Management Organization (Lakeland) to provide timely services and support.

To access the state appeal process call, write, or fax the request to:

Division of Hearings & Appeals

5005 University Avenue, Rm 201

Madison, WI 53703

1-608-266-3096 (voice)

1-608-264-9885 (fax)

For all other matters, the Department’s review process must be utilized prior to using the State Fair Hearing Process.

Advocacy Organizations

The ADRC maintains a list of advocacy or-ganizations that may be available to help you file an appeal. It will be provided upon re-quest.

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Hours

8:00am - 4:30pm, M - F

Oshkosh Office

220 Washington Ave
PO Box 2187
Oshkosh, WI 54903-2187
Toll Free:(877) 886-2372
Fax:(920) 424-7521

Neenah Office

211 N Commercial St
Neenah, WI 54956
Toll Free:(877) 886-2372
Fax:(920) 424-7521

Aging and Disability Resource Center