Applicants and program participants and their designated personal representatives have the right to file grievances and appeals.
- The Brain Injury Alliance of Colorado (BIAC) accepts oral and written grievances and appeals. Oral grievances and appeals are documented in writing by BIAC staff.
- Upon request, BIAC provides applicants and program participants and their designated personal representatives reasonable assistance in filing a grievance or appeal and completing procedural steps in the grievance or appeal process.
- BIAC ensures that the individuals who make decisions on grievances and appeals are individuals who are not a subject of the grievance or appeal and who were not involved in any previous level of review or decision-making regarding the grievance or decision under appeal.
- Applicants and program participants and their designated personal representatives filing a grievance or an appeal are provided a reasonable opportunity to present information, in person as well as in writing.
Grievance Process
A “grievance” is an oral or written complaint or expression of dissatisfaction about any matter other than a decision that may be appealed. A grievance may address issues such as the quality of services provided, the person providing services, the timeliness of services, the accessibility of service locations, or the availability of staff.
- Applicants and program participants and their designated personal representatives have ninety (90) calendar days from the date of the incident to file a grievance expressing a complaint or dissatisfaction with any matter other than a decision that may be appealed.
- BIAC will resolve each grievance and provide written notice within thirty (30) calendar days from the date the grievance is received. The notice will include BIAC’s proposed resolution to the grievance, the individual’s right to further grieve the proposed resolution to the Colorado Traumatic Brain Injury Board or its designee, and information on how to contact the Board or its designee.
- Applicants and program participants and their designated personal representatives have ninety (90) calendar days from the date of the BIAC’s notice to submit their grievance to the Colorado Traumatic Brain Injury Board or its designee.
- The grievance process is an informational dispute resolution process. The decision of the Colorado Traumatic Brain Injury Board or its designee is considered final.
Appeal Process
An “appeal” is a request to review a decision by the service provider to deny or revoke program eligibility or to deny, reduce, suspend or terminate the delivery of program services.
- Applicants and program participants and their designated personal representatives receive written notice of decisions adversely impacting eligibility and program services. The notice includes the decision made, the reasons for the decision, the individual’s right to appeal the decision, and appeal procedures.
- Applicants and program participants and their designated personal representatives have ninety (90) calendar days to file an appeal from the date of BIAC’s notice.
- BIAC will resolve each appeal and provide written notice within thirty (30) calendar days from the date the appeal is received. The notice includes the decision regarding the appeal, the individual’s right to a second level appeal to the Colorado Department of Human Services, Office of Appeals, and information on how to contact the Office of Appeals.
- Applicants and program participants and their designated personal representatives have ninety (90) calendar days from the date of the BIAC’s notice to file a second-level appeal with the Department of Human Services, Office of Appeals.
- The Office of Appeals has the right to additional information and may request oral argument or a hearing if it deems necessary.
- The applicant, program participant or designated personal representative may represent himself/herself or use legal counsel or other spokesperson at a hearing.
- The decision of the Office of Appeals shall constitute final agency action.
- BIAC will participate in the appeals process, provide any documentation required, and implement any decision made by the Office of Appeals.
- The appeal process is conducted pursuant to Section 24-4-105 and 106, C.R.S.
