Complaint and Grievance Procedure

As a customer of the Aging & Disability Resource 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 Organization 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 process 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 informal 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 ordinarily communicate.

Once the grievance is received, the ADRC Supervisor will have 10 business days to resolve it. This may include a face-to-face meeting 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 conclusion 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 process is the recommended next step in the process.

Step 2: Formal Internal Grievance

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

To file an informal or formal internal grievance 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

What do you do if you are unhappy with your experience in your long-term care program? Click here to read more. 

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 (link sends an e-mail)

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 (link sends an e-mail)

Complaints Relating to IRIS

Complaints relating to a service provider, an Independent Consultant or the Financial Services Agency shall be made to the Independent 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 (link sends an e-mail)

Step 4: State Fair Hearing Process

ADRC customers have the right to a state appeal, if filed within 45 days, after receipt of a notice of a decision or failure to act regarding the following types of grievances: Determination of ineligibility for long-term care benefits; Determination of cost sharing for long-term care benefits; Determination that the person is eligible for, but not entitled to, the Family 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 maintenance 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 organizations that may be available to help you file an appeal. It will be provided upon request.

Complaints Regarding Nursing Homes or Assisted Living Facilities

The Ombudsman Program through The Board on Aging & Long-Term Care can help individuals and their families should they have concern about the facility they are living in. An Ombudsman can advocate and ensure that the individual's rights are being protected. You can reach them by calling 1-800-815-0015 or go to their website by clicking here.

Disability Rights Wisconsin

Disability Rights Wisconsin (DRW) works with individuals who are age 60 and under to help protect rights of individuals with disabilities. Their toll-free number is 1-800-928-8778 or go to their website by clicking here.

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Hours

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

Appointments outside of regular business hours can be made upon request.

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