Ala. Admin. Code r. 825-X-2-.04

Current through Register Vol. 43, No. 1, October 31, 2024
Section 825-X-2-.04 - Complaint Process

Introduction

1. Statutory Authority - In accordance with Section 22-10B-3(b) of the Code of Ala. 1975, the procedures in this section are intended to address complaints regarding service and management of statewide programs and address any other discrepancies brought to the attention of the Alabama Sickle Cell Oversight and Regulatory Commission ("ASCORC").
2. Exemption - Anyone providing direct medical care and/or functioning as a licensed physician is exempt from the procedures set forth in this section. Complaints concerning medical care and/or licensed physicians should be directed to the Alabama Board of Medical Examiners and Medical Licensure Commission.
3. Definitions
a. Complainee: any individual or entity against whom a Complaint is submitted. This individual or entity must be regulated by the ASCORC pursuant to 825-X-2-.01(3) for these procedures to apply.
b. Complainant: individual/entity submitting the Complaint.
c. Services provided: any services performed as enumerated in Title 22-10B-5.1 See 825-X-2-.03 for further discussion of these services.

Complaint Procedures

I.Part One
1. To file a Complaint that a Complainee has failed to provide services pursuant to Title 22-10B-5, Complainants shall follow the Complainee' s established complaint procedures. Complaints must be submitted within ninety (90) days of the alleged occurrence.

1 The sickle cell services shall include all of the following:-

1. Public and professional health education which shall be provided by persons specially trained for the task.

2. Screening of all newborns within a designated area for sickle cell disease by accurate laboratory techniques.

3. Genetic counseling and decision-making counseling which shall be offered to all parents of infants who are affected with Sickle Cell Disease and to those parents and patients at risk of having other children affected with this disease.

4. Medical referral and follow-up which shall consist of a prompt definitive diagnosis of patients found to have medically significant hemoglobin and the medical management of painful episodes, infections, and other complications which shall be provided by physicians and other medical professionals.

5. Psychosocial support services which shall be provided to help patients affected with Sickle Cell Disease to live a happy and successful life.

2. If the Complainee does not have established complaint procedures, then the Complainant shall submit a written (signed) or videoed complaint to the Complainee alleging that the Complainee has failed to provide services in accordance with Title 22-10B-5. Complaints must be submitted within ninety (90) days of the alleged occurrence.
3. The Complainee shall investigate and make a final determination concerning the Complaint. The Complainee's final decision must be in writing and provided to the Complainant.
4. A copy of the Complaint and Complaninee's decision must be kept by the Complainee.
5. If the Complainant disagrees with the Complainee's determination, then the Complainant shall proceed to Part Two.
II.Part Two
1. Upon (a) receipt of a written (signed) or videoed Complaint to the ASCORC alleging that a community-based organization or any individual operating within the community-based organization regulated by ASCORC pursuant to 825-X-2-.01(3) has failed to provide services in accordance with Title 22-10B-5, and (b) verification that the Complaint has been presented to the Complainee and action was taken, the Executive Director of the ASCORC shall perform a preliminary review to determine if there is merit and sufficient evidence to warrant formal proceedings. Complaints must be submitted to ASCORC within thirty (30) days after the Complainee's final decision.
2. If the Executive Director and the ASCORC legal counsel determine that the Complaint may be meritorious and that sufficient evidence exists to warrant proceedings, the Complaint will be given to the investigative committee for further action. The investigative committee shall be formed pursuant to 825-X-1-.04 and will consist of one (1) ASCORC member, one (1) ASCORC counsel, and the Executive Director.
a. When ASCORC receives a Complaint against a Complainee, ASCORC or its designee shall provide the Complainee with the allegations. The Complainee may submit to the Executive Director a written or videoed response and any supporting documentation.
b. The investigative committee shall review the Complaint and other information submitted to determine if further investigation is warranted.
3. If further investigation is warranted, an investigator may be retained. The investigator shall work under the direction of the Executive Director to conduct further investigation.
4. At the conclusion of the investigation, the investigator shall submit an investigative report to be reviewed by the investigative committee, which has the authority to act on the report.
a. The investigative committee shall send written notification to the Complainant and Complainee of any action it decides to take in response to the investigative report.
b. If the investigative committee determines that the Complaint does not present a violation or is meritless, the Complaint shall be brought to ASCORC for dismissal without any further action.
c. The Executive Director shall notify the Complainant and the Complainee that the investigation has been closed.
5. Following the investigation, if the Complaint requires further action, ASCORC or its authorized designee shall have the power to act on the report of the investigation as follows:
a. Resolve the issue without a formal hearing (settlement),
b. Institute a corrective plan of action, or
c. Commence formal disciplinary proceedings with a hearing.
6. If the program remains noncompliant, ASCORC reserves the right to recommend reallocation of funding consistent with legislative intent pursuant to Section 22-10B-4 of the C ode of Ala. 1975.

Ala. Admin. Code r. 825-X-2-.04

Adopted by Alabama Administrative Monthly Volume XLI, Issue No. 10, July 31, 2023, eff. 9/14/2023.

Author: Sara Rogan, Assistant Attorney General

Statutory Authority:Code of Ala. 1975, § 22-10B-3.