Grievance System Summaries Sample Clauses

Grievance System Summaries. Information regarding Grievances, Appeals and Denial, Termination, or Reduction (DTR) Notices as required under Article 8.
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Grievance System Summaries. Information regarding Grievances, Appeals and Denial, Termination, or Reduction (DTR) Notices as required under Article 8. Administration and Subcontracting Information. Information relating to MCO administration and subcontracting arrangements, as specified by the STATE and CMS. Reporting Requirement if using an alternative arrangement for Health Care Home. The MCO shall annually provide a description of each comprehensive payment arrangement and its proposed outcome or performance measures, that the MCO uses as an alternative to Health Care Homes payment in a reporting template provided by the STATE. The template shall include the following: Identify each Certified Health Care Home for whom the MCO is paying a comprehensive payment arrangement instead of the standard Health Care Home care coordination fee. Number of Enrollees served under each arrangement; Description of payment arrangements;‌ Scope of the services included in the arrangement (for example, if a total cost of care, whether long term care, Medicare and Medicaid costs and chemical, mental and/or behavioral health services are included, and whether any services are carved out of the arrangement); Describe the MCO’s process for overseeing the entities and evaluating their performance; Describe quality indicators used to measure performance; Describe the benchmarks used to determine whether the Provider entity is within the cost of care expectations. The completed template is due September 1 of the Contract Year. Reporting Requirement for ICSP. The MCO shall annually provide information on ICSPs described in section 7.9 below and ICSP outcome or performance, using formats provided by the STATE. The MCO shall report aggregate ICSP payments and recipients, separated by payment type and project type by September 1 of the Contract Year, as requested by the STATE and using the template provided. The MCO shall cooperate with the STATE to document ICSP case study briefs by September 1 of the Contract Year, as requested by the STATE and using the template provided. The MCO must provide briefs for at least the minimum required number and type of ICSP arrangements, and is encouraged to provide briefs describing all ICSP arrangements. The briefs shall be used for the purpose of identifying innovations due to the program. Third Party Resources. Pursuant to section 10.2, the MCO shall report to the STATE any additional Third Party Resources, including Long Term Care Insurance, except for Medicare. Third Pa...
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Grievance System Summaries. Information regarding Grievances, Appeals and Denial, Termination, or Reduction (DTR) Notices as required under Article 8. Administration and Subcontracting Information. Information relating to MCO administration and subcontracting arrangements, as specified by the STATE and CMS. Health Care Home.
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Related to Grievance System Summaries

  • Grievance Description 80. The Union and the City agree that the following guidelines will be used in the submission of grievances.

  • Grievance Initiation 33. a. A grievance affecting more than one employee shall be filed with the departmental official having authority over all employees affected by the grievance.

  • GRIEVANCE REPORT Attachment I (Grievance Report) will be used in the processing of all grievances.

  • GRIEVANCE REPORT FORM Grievance # School District Distribution of Form 1. Superintendent

  • Grievance Steps Grievances shall be handled in the following manner: Step One: The grievant, advocate and/or Union staff representative shall present a grievance orally to the grievant’s immediate supervisor within fifteen (15) calendar days from the date of the occurrence of the facts or from the date the alleged violation first became known, whichever is later. The supervisor shall respond in writing to the grievance within ten (10) calendar days of the presentation to agree to resolve the grievance or to deny the grievance. The supervisor’s response shall be addressed to both the grievant and the Union. Should the supervisor fail to respond within this time frame, the Union shall have the right to forward the grievance to the next step. Step Two: If no resolution or settlement is reached between the grievant and the supervisor, the grievant or the Union may file a written appeal of the supervisor’s decision rendered in Step One to the appropriate Program Director or his/her designated representative. The grievant or Union shall file this written grievance within fifteen (15) calendar days after his/her receipt of the supervisor’s decision from Step One. A meeting with the appropriate Program Director or his/her representative, the grievant and the advocate or Union staff representative shall be held not later than ten (10) calendar days after receipt of the written grievance. The appropriate Program Director’s response shall be addressed to the grievant and the Union. The appropriate Program Director’s response shall be final and binding on the employee, the Union, and the Employer unless it is timely appealed to arbitration by the Union in accordance with this Article. Grievances concerning discharge or discrimination, or grievances filed by the Union shall be filed initially at Step Two. Group grievances claiming the same alleged conduct involving employees who work under more than one supervisor may be filed initially at Step Two. Multiple individual grievances alleging the same violation that are filed during the same time frame may be combined into a group grievance and commenced at Step Two.

  • Grievance Commissioner System This is to confirm the discussion of the parties during collective bargaining that they are committed to encouraging early discussion and resolution of labour relations issues at the local level and seek to resolve grievances in a timely and cost efficient manner. To that end, this is to confirm that pursuant to Article 8, the parties agree that the Employer and Union at individual nursing homes may agree to utilize the following process in order to resolve a particular grievance through the utilization of a joint mediation-arbitration procedure:

  • Submission of Grievance Information a) Upon appointment of the arbitrator, the appealing party shall within five days after notice of appointment forward to the arbitrator, with a copy to the School Board, the submission of the grievance which shall include the following:

  • Year-End Grievance In the event a grievance is filed at such time that it cannot be processed through all steps in this grievance procedure by the end of the school year and, if left unresolved until the beginning of the following school year, could result in irreparable harm to a party in interest, the time limits set forth herein shall be reduced so that the grievance procedure may be exhausted prior to the end of the school year or within a maximum of 30 days thereafter. Reduction of the time limit shall be with mutual consent.

  • Grievance Investigations Where an employee has asked or is obliged to be represented by the Institute in relation to the presentation of a grievance and an employee acting on behalf of the Institute wishes to discuss the grievance with that employee, the employee and the representative of the employee will, where operational requirements permit, be given reasonable leave with pay for this purpose when the discussion takes place in the headquarters area of such employee and leave without pay when it takes place outside the headquarters area of such employee.

  • Grievances and Complaints 5.1 It is the mutual desire of the parties hereto that grievances and complaints relative to this Agreement or working conditions generally shall be adjusted as quickly as possible.

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