Grievances System Sample Clauses

Grievances System a. Contractor shall have written procedures approved in writing by DHS for accepting, processing and responding to all Grievances and Appeals from OHP Members, consistent with the requirements of Exhibit N and OAR 410-141-0260 through 410-141-0266, including Grievances and Appeals related to requests for accommodation in communication or provision of Services for OHP Members with a disability or limited English proficiency. DHS reviews the Contractor’s procedures for compliance with the requirements of Exhibit N and OAR 410-141-0260 through 410-141-0266, as well as any applicable federal requirements, including 42 CFR 438. b. Each time a Covered Service or benefit is denied, terminated, suspended or reduced, or when Contractor authorizes a course of Treatment or Covered Service, but subsequently acts to terminate, discontinue or reduce the course of Treatment or a Covered Service, Contractor shall issue a Notice of Action to the affected OHP Member at least 10 Business Days before the date of the Action, unless there is documentation that the OHP Member had previously agreed to the c. In the event an OHP Member or an OHP Member Representative requests an Administrative Hearing from DHS, Contractor shall comply with the requirements of Exhibit N and OAR 410- 141-0264, Administrative Hearings. d. Contractor shall maintain a log of all OHP Member Grievances and Appeals. The log shall identify the OHP Member, the date of the Grievance, the resolution and the date of resolution. Contractor shall retain Grievance and Appeal logs for 7 (seven) years. This provision shall survive expiration or termination of this Contract. e. Contractor shall submit to DHS a quarterly report summarizing OHP Member Grievances, using the report format in Exhibit N, Attachment 1. f. Contractor and its subcontractors shall cooperate with the DHS’ Client Advisory Services Unit and the AMH Representatives in all of DHS’ activities related to OHP Member Grievances, Appeals, and Administrative Hearings. g. Contractor shall inform OHP Members about the Contractor’s Grievance and Appeal procedures and timeframes, the availability of assistance in the filing process, the toll-free numbers that an OHP Member can use to file a Grievance or Appeal by phone, how to request continuation of benefits (and OHP Member responsibility to pay for the cost of services furnished while an Appeal or Administrative Hearing is pending if the final decision is adverse to the OHP Member), and how to access a Ad...
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Related to Grievances System

  • Group Grievances No more than five (5) grievants will be permitted to attend grievance meetings.

  • Types of Grievances (A) An Individual Grievance is a grievance initiated by the Union on behalf of an individual employee. (B) A Group Grievance is a grievance initiated by the Union on behalf of a group of employees similarly affected by the Employer’s actions. (C) A Policy Grievance is a grievance by the Union which may involve a matter of general policy or general application of the Collective Agreement. (D) A Union Grievance is a grievance which directly affects the Union. (E) An Employer Grievance is a grievance initiated by the Employer.

  • Policy Grievances ‌ Where either party to this agreement disputes the general application, interpretation or alleged violation of an article of this agreement, the dispute shall be discussed initially with the Executive Director or designate or the President of the Union within 14 calendar days of the occurrence. Where no satisfactory agreement is reached, either party, within a further 14 calendar days, may submit the dispute to arbitration.

  • Disciplinary Grievances If the grievance is not resolved at Step 2, the Union may file a request for mediation with the Public Employment Relations Commission (PERC) in accordance with WAC 000-00-000, with a copy to the Office of Financial Management/SHR/Labor Relations Section (OFM/SHR/LRS) and the Human Resources Office within fifteen (15) days of receipt of the Step 2 decision. In addition to all other filing requirements, the request must include a copy of the grievance and all previous responses.

  • Grievances Any Complaint alleging Discrimination or Harassment shall be pursuant to Board Rule 4001.2 and 4001.3 as they existed on July 10, 2021. Any amendments to Board Rule 4001.2 or 4001.3 which occur after July 10, 2021 will be submitted to the Union for approval prior to implementation for employees covered by this Agreement. Any other grievance, complaint, disagreement or difference of opinion between the District, the Union or the employees covered by the Agreement concerning application of the terms of this Agreement will be processed using the following grievance procedure: (A) Any Employee or the Union may present a Grievance. Any Grievance which is not presented within fifteen (15) days following the event giving rise to such a Grievance shall be forfeited and waived by the aggrieved party. The grievance form shall state the name of every employee authorizing the filing of the grievance, and all grievances shall be signed by at least one aggrieved employee. An aggrieved employee shall have the right to a Union Representative appointed by the Union. (B) The grievant shall first take up the Grievance by presenting it in writing to their immediate supervisor or designee. If the Grievance is not satisfactorily adjusted with five (5) days from the meeting with the supervisor, the Employee or the Union representative shall present the grievance in writing to the Chief Financial Officer or his or her designated representative. (C) The Chief Financial Officer or his or her designated representative shall within ten (10) days from the day it was received, make a determination and submit the determination to the aggrieved party in writing. (D) Each party reserves the right to litigate a question presented by the Grievance by bringing an original action in any court of competent jurisdiction in the event such party shall not be satisfied with the resolution of the Grievance. However, no such litigation may be maintained until all available steps under this grievance procedure have been pursued and exhausted. It is understood and agree to between the parties that the role of the Chief Financial Officer or his or her designee in the grievance procedure is not an exercise of a judicial or quasi-judicial function, but solely as a means to allow the parties to resolve disputes informally. (E) Definitions: Days shall mean calendar days.

  • Grievances and Appeals a. If you have questions about any pediatric dental services received, please first discuss the matter with your Dental Provider. However, if you continue to have concerns, please call Delta Dental’s Customer Service Center. You can also email questions by accessing the “Contact Us” section of the dental plan website at xxx.xxxxxxxxxxxxxx.xxx.

  • Processing Grievances The Association Representative involved and the grieving supervisor shall not leave work or disrupt departmental routine to discuss grievances without first requesting permission from his/her immediate superior, which shall not be unreasonably withheld. The Association Representative and the grieving supervisor shall be allowed a reasonable amount of time during working hours while on the Appointing Authority's premises when a grievance is investigated or presented in Steps 1 and 2.

  • Union Grievances 4/8/1 Union officers and grievance representatives who are members of the bargaining unit shall have the right to file and process a grievance when any provision of this Agreement has been violated or when the Employer interpretation of the terms and provisions of this Agreement lead to a controversy with the Union over application of the terms or provisions of this Agreement. Such grievances must be designated as Union grievances at the initial step and must comply with the time limits previously set forth in this Article.

  • Grievance Procedures The AGENCY agrees to establish a formal written grievance process with procedures through which clients and recipients of services may present grievances to the governing authority of the AGENCY regarding services being provided under this Contract. Additionally, the AGENCY agrees to establish fair hearing procedures that ensure all persons will be advised of their rights to a fair hearing to appeal a denial or exclusion from services and/or the failure of staff to take into account the individual’s choice of service. The AGENCY’S internal grievance procedure must document and include, at a minimum, the following: date of grievance, a written response to the applicant sent within thirty (30) days, and the opportunity for the applicant to meet with the AGENCY Executive Director or designee. Upon request by the COUNTY, the AGENCY shall provide a written report as to the grievance outcome within five (5) normal COUNTY working days. The AGENCY will maintain these documents on file for review by the COUNTY.

  • Facilities for Grievances The Employer shall supply the necessary facilities for the grievance meetings.

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