(a) Staff of the Continuous Quality Improvement (CQI) unit conduct an administrative inquiry to assess the validity of allegations of a contractor’s non-compliance with the terms of the contract.
(b) An administrative inquiry is authorized by the administrator of CQI or designee in response to a complaint filed by any interested party which represents a potentially serious breach of the contract by a provider of Child Welfare (CW) services. The administrator of CQI or designee is authorized to conduct a screening to assess the potential validity of a complaint. Parties filing a complaint may remain anonymous; however, this may be a consideration in screening of a complaint’s validity.
(c) An administrative inquiry is typically limited to the scope of a complaint. The inquiry may be expanded beyond the scope of the initial complaint when determined appropriate by staff conducting the inquiry.
(d) Administrative inquiries are prioritized as:
- (1) Priority A. Referrals involve potential risk, other than abuse or neglect, to individuals and are assessed within one week of the complaint;
- (2) Priority B. Referrals involve allegations of contract violation involving agency claims or other funding irregularities and are assessed within one month of a complaint; or
- (3) Priority C. Referrals involve other allegations of contract violation and are assessed within two months of a complaint.
(e) The Department is not required to provide advance notice of an administrative inquiry but may do so when it is determined that such notice will aid rather than impede an inquiry.
(f) Procedures for the presentation of findings and provider requests for the Division of Children and Family Services (DCFS) administrative review replicate those appearing at OAC 340:75-18-8.
(g) Providers submit notice of proposed resolution dates for any findings of non-compliance within two weeks of receipt of the Summary of Findings, as described at OAC 340:75-18-8(n).
(h) Follow-up occurs as described at OAC 340:75-18-8(o).
(i) Sanctions may be imposed as described at OAC 340:75-18-8(p) in the event of chronic or gross violation of the contract.