Support Services for Adults with Developmental ... - DHS home

(F) The decision of the SPD Assistant Director is final. Any
further review is pursuant to the provision of ORS 183.484 for
judicial review.
(h) Documentation of complaint. Documentation of each complaint
and its resolution must be filed or noted in the complainant's record.
(2) NOTIFICATION. Upon enrollment and annually thereafter, and when a
complaint is not resolved according to section (1)(b) through (1)(d) of this
rule, the brokerage must inform each individual, or the individual's legal
representative, orally and in writing, using language, format, and methods
of communication appropriate to the individual's needs and abilities, of the
following:
(a) Brokerage grievance policy and procedures, including the right to
an administrative review and the method to obtain an administrative
review; and
(b) The right of a Medicaid recipient to a hearing as pursuant to
section (3) of this rule and the procedure to request a hearing.
(3) DENIAL, TERMINATION, SUSPENSION, OR REDUCTION OF
SERVICES FOR INDIVIDUAL MEDICAID RECIPIENTS.
(a) Each time the brokerage takes an action to deny, terminate,
suspend, or reduce an individual's access to services covered under
Medicaid, the brokerage must notify the individual or the individual's
legal representative of the right to a hearing and the method to
request a hearing. The brokerage must mail the notice by certified
mail, or personally serve the notice to the individual or the individual's
legal representative 10 days or more prior to the effective date of an
action.
(A) The brokerage must use form SDS 0947, Notification of
Planned Action, or a comparable SPD-approved form for such
notification.
(B) This notification requirement does not apply if an action is
part of, or fully consistent with the ISP, and the individual or the
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