Due Process

Due Process

Clermont County Board of DD (CBDD) shall provide written notice at least 15 calendar days in advance of any action that involves a reduction, suspension or termination of a service or item that is being provided. A written notice will also be provided when a request for a service or item is denied at the time of the denial. In cases where a home and community-based waiver is involved, advance notice will also be provided when a service is being approved.

An individual, parent of a minor, or guardian may appeal a termination, reduction, approval or a change in service provided by CBDD. When a timely appeal is requested, the current service in question shall continue to be provided pending final resolution. 

To appeal a decision, there is a grievance procedure and/or formal appeal process. The process in which an individual, parent of a minor, or guardian follows depends on whether or not the issue is related to a waiver service or not. At the individual’s request, an advocate who may speak on behalf of the individual can give assistance during either of these processes. Any written notice provided by CBDD that addresses an approval, denial, reduction, suspension or termination will include detailed instructions on how to appeal the action.

A representative of CBDD will assist the individual with the grievance or formal appeal process. Timelines may be extended if mutually agreeable to all involved parties. Individuals shall be given the toll-free number for the Ohio Department of Developmental Disabilities and Disability Rights Ohio. 

An individual, parent of a minor or guardian will be given written notice of the appeal rights when an individual is deemed ineligible.

Appeal of an Adverse Action or Resolution of Complaint (non-waiver issue)

1. Within 90 days of a denial or proposed action, the individual, parent of a minor or guardian will notify CBDD of their request to formally appeal.
2. The request to appeal can occur by mailing the notice that was received to Clermont County Board of Developmental Disabilities, 2040 US Highway 50, Batavia, Ohio 45103.
3. The Director that receives the appeal request shall conduct an investigation of the appeal, which shall include meeting with the individual or person who filed the appeal.
4. Within 15 calendar days of receipt of the appeal request, the appropriate agency director shall provide and be available to discuss a written report and decision. If the individual, parents of a minor or guardian has difficulty in reading or writing, an oral report is accepted and documented by the director receiving the report.
5. Services will not be reduced, suspended, or terminated until the appeal process is completed when the request is received on or before the effective date of the proposed action.
6. If the individual or person filing the appeal request is not satisfied with the decision made by the appropriate agency director, an appeal with the superintendent can be requested within 10 calendar days.
7. Upon receipt of a request of appeal, the Superintendent/designee, within 10 calendar days, will meet with the party initiating the request and conduct an administrative review.
8. Within 15 calendar days of the appeal request, the Superintendent’s decision is made known, in writing, to the individual or his/her representative and includes a rationale for such decision and a description of the next step in the process.
9. If the individual or his/her representative is not satisfied with the decision of the Superintendent, a written appeal may be filed with the Board of CBDD within 10 calendar days of the receipt of the Superintendent’s decision. 
10. Upon receipt of a written request to appeal, the Board conducts a hearing no later than 20 calendar days. The hearing will be scheduled at a time and place convenient to all parties. 
11. Within 15 calendar days of the conclusion of the board hearing, written notification of the Board’s decision is sent by certified mail to the individual or his/her representative and will include a rationale for the Board’s decision. 
12. If an individual or representative is not satisfied with the decision of the Board, a written appeal is filed with the Director of the Ohio Department of Developmental Disabilities within 15 calendar days of receipt of the Board’s decision.
13. The Director or his/her designee reviews the appeal within 45 calendar days of receipt of the county board hearing transcript, exhibits and decision. 
14. Within 14 calendar days following the Department-level review, the Director’s decision is made known in writing to all affected parties, and includes a rationale for the decision.

Medicaid Due Process (waiver issue)

1. Within 90 days of a denial or proposed action, the individual, parent of a minor or guardian will notify the Ohio Department of Job and Family Services (ODJFS) of their request to formally appeal.
2. The request to appeal can occur by mailing the notice that was received by CBDD to the Ohio Department of Job and Family Services, Bureau of State Hearings, P.O. Box 182825, Columbus, Ohio 43218-2825 or by emailing the notice to bsh@jfs.ohio.gov.
3. Services will not be reduced, suspended, or terminated until the appeal process is completed when the request is received on or before the effective date of the proposed action.
4. In order to attempt to resolve the issue prior to a hearing, a county conference can be requested with CBDD before or after a hearing has been formally requested with ODJFS.