Notice of Complaint/Appeal Process

What is a Complaint/Appeal?

If you are not happy with the service you received at the Aging and Disability Resource Center (ADRC) feel that you were treated unfairly or discriminated against or disagree with decisions made or actions taken you have the right to file a complaint or appeal.

 Who Do I Tell?

• Any staff person at the ADRC can assist you with filing a complaint/appeal.
• A friend, relative, or anyone else can help you in filing and resolving a complaint/appeal.
• The following advocacy agencies are also available to help file your complaint/appeal:

Options to Resolve Complaint/Appeal

1. Informal Internal Complaint. This option is intended to promote understanding, bridge differences and identify and resolve problems on a less formal basis. If you choose this option, any ADRC staff can talk with you on the phone, or meet with you in person, to discuss and try to resolve the problem within ten business days. You may include anyone at this meeting.
2.  Formal Internal Appeal. If you prefer a more formal process, or if you have tried the informal internal appeal process and are still dissatisfied, you can file a formal internal complaint/appeal. If you choose this option, the ADRC Office Manager will arrange to meet with you in person to discuss the problem within 15 business days to work towards a resolution. You may include anyone at this meeting. Following the meeting you will receive a letter that reviews your complaint/appeal and how it was resolved.
3. Formal External Complaint. At any time before, during or after the internal process described above, you can choose to file a formal external appeal with the Department of Health Services. They will acknowledge receiving your appeal within 5 days of its receipt; contact you; and try to make a decision no later than 20 business days after it was received.

ADRC Quality Assurance Specialist
Office for Resource Center Development /Division of Long Term Care
Wisconsin Department of Health Services
PO Box 7851
Madison, WI  53707-7851
Phone:  608-266-2536 Fax: 608-267-3203
E-Mail:  DHSRCT@wisconsin.gov (subject line:  ADRC Complaint)

4. State Fair Hearing.  If your complaint/appeal relates to your application for Family Care or IRIS, you can file directly with the State Fair Hearing. This process is used if you have received a notice of decision, or there has been a failure to act regarding one of the following:

• Determination of ineligibility for Family Care or IRIS;
• Determination of cost sharing for Family Care or IRIS;
• Determination that the person is eligible for but not entitled to Family Care or IRIS;
• Determination in regard to divestment, treatment of trust amounts, and protection of income and resources of a couple for maintenance of the “community spouse”;
• Failure of the Aging and Disability Resource Center to provide timely services/support.

Your complaint/appeal must be filed within 45 days of the receipt of notice or failure to act.

For matters other than those listed above, the formal external appeal process must be used, before using the State Fair Hearing Process.  To apply for a State Fair Hearing, contact:
Family Care Request for Fair Hearing
c/o DOA Division of Hearings & Appeals
PO Box 7875, Madison, WI  53707-7875
Phone: 608-266-3096 / TTY: 608-264-9853 / Fax: 608-264-9885

Download Complaint Form