Effective January 1, 2014, the Iowa Department of Inspections and Appeals (“department”) must provide an independent reviewer meeting the criteria found in 2013 Iowa Acts, Senate File 394, to hold informal conferences with health care facilities desiring to contest a state citation and assisted living programs desiring to contest the department’s final findings. The independent reviewer must be licensed as an attorney in the state of Iowa, must not be employed or have been employed by the department in the past eight years, and must not have appeared in front of the department on behalf of a health care facility or assisted living program in the past eight years. Preference shall be given to an attorney with background knowledge, experience, or training in long-term care.
Federal law provides a mechanism for informally challenging certain department actions. Federal regulations (42 CFR 488.331) require the department to provide long-term care facilities with one opportunity for Informal Dispute Resolution (IDR) after the facility receives a federal Statement of Deficiencies. Senate File 394 requires the department to hold the Informal Conference (IC) concurrently with any IDR held pursuant to 42 CFR 488.331 for those facilities eligible for IDR.
The independent reviewer is responsible for holding informal conference/informal dispute resolution meetings at the Lucas State Office building in Des Moines, Iowa, typically scheduled to occur on the same day of each week. If the facility requests a telephone conference, the reviewer would not need to report to the Lucas State Office building to conduct the conference, but may conduct it via telephone. At the conclusion of the meeting, the independent reviewer may affirm, modify, or dismiss a state citation or a federal deficiency. The independent reviewer must state in writing the specific reasons for the affirmation, modification or dismissal and transmit copies of the decision to the Department. The independent reviewer shall be allotted no more than a total of three hours to a single case, which includes one hour for the meeting and two hours for preparation and decision.
The independent reviewer shall provide monthly statistics to the department via email by the tenth calendar day of each month, including the number of internal conferences and informal dispute resolutions conducted; the number of regulation violations reviewed; and the number and percentage of regulation violations retained, dismissed, and/or modified. The statistics shall be separated by provider type, including nursing home, residential care facility (RCF), Intermediate Care Facility for the Intellectually Disabled (ICF/ID) and assisted living program.
The federal Centers for Medicare and Medicaid Services (CMS) holds the State accountable for the federal Informal Dispute Resolution process. Since CMS has ultimate oversight of the State’s performance, it may review an IDR decision and make its own binding determination.
The department shall provide the independent reviewer with training related to state and federal regulations, and reference material necessary to conduct reviews.
Compensation shall be $250 per hour, with a maximum of three hours per case. Reimbursement for reasonable and necessary actual mileage is available at 39 cents per mile; note that travel time is not reimbursable. Paid training provided at the Lucas State Office Building.
Description of Submission Requirements
For consideration, submit a cover letter and resume, a legal writing sample, and three professional references to Mindla White, Bureau Chief no later than Monday, July 1, 2019. Mindla may be contacted directly at 515.281.3765 with any questions.
About Iowa Department of Inspections and Appeals
The Department of Inspections and Appeals (DIA) is a multifaceted regulatory agency charged with protecting the health, safety, and well-being of Iowans. The Department was created in 1986 [Iowa Code Chapter 10A] to coordinate and conduct various audits, appeals, hearings, inspections, and investigations related to the operations of the Executive Branch of Iowa State Government. Staff in the Department is responsible for inspecting and licensing or certifying health care providers and suppliers, restaurants and grocery stores, social and charitable gambling operations, hotels and motels, and barber and beauty shops. In addition, DIA staff investigates alleged fraud in the State's public assistance programs and conducts contested case hearings to settle disputes between Iowans and various state government agencies.
DIA is organized into four major operational divisions – the Administration Division, the Administrative Hearings Division, the Health Facilities Division, and the Investigations Division. Each division has its own Code-mandated duties and responsibilities. Also attached to the Department are four semi-autonomous units – the Child Advocacy Board, the Employment Appe...al Board, the Iowa Racing and Gaming Commission, and the Office of the State Public Defender. DIA provides budgeting, program coordination, and related management functions for these attached units.