Filing a Grievance

By Gracie Davis – Deputy Executive Assistant at West Virginia Senior Legal Aid, Inc.

In West Virginia, individuals who receive services from a provider agency funded by the West Virginia Bureau of Senior Services have the right to file a grievance if they are dissatisfied with the services they receive or if an adverse action is taken against them. Applicants who are denied eligibility for any Bureau-funded service also have the right to file a grievance. In both situations, the grievance must be filed within 15 days of receiving written notice of the adverse action or denial. Grievance forms are available upon request from agency staff.

Level One: Provider Agency Review

After receiving the completed Grievance Form, the provider agency must schedule and conduct a meeting within 7 business days. This meeting may take place in person or by telephone. It must include the applicant or service recipient and may also include a legal representative. The meeting will be conducted by the agency director or someone appointed to act on their behalf. Following the meeting, the provider agency must issue a written response within 7 business days. A copy of this response must be sent to the applicant or service recipient, the agency’s board of directors, and the Area Agency on Aging serving the region. If the applicant or service recipient is not satisfied with the Level One decision, they may request that the grievance move forward for review by the provider agency’s board of directors.

Level Two: Review by the Provider Agency’s Board of Directors

To proceed to Level Two, the applicant or service recipient must submit a written request for board review within 7 business days of receiving the Level One decision. The provider agency’s board of directors must then hold a meeting within 7 business days of receiving the request. This meeting may be held in person or by telephone and must include the applicant or service recipient and their legal representative, if applicable, as well as the agency director or designee. The board of directors must issue a written decision within 7 business days of the meeting. A copy must be sent to the applicant or service recipient, the Executive Director of the provider agency, and the Area Agency on Aging. If the applicant or service recipient is dissatisfied with the Level Two decision, they may request further review by the Bureau of Senior Services. The provider agency’s board of directors is responsible for forwarding the Grievance Form and any supporting documentation to the Bureau for Level Three review.

Level Three: State-Level Review by the Bureau of Senior Services

If the applicant or service recipient remains dissatisfied after Level Two, they may file a request for Level Three review. The request must be submitted to the Bureau of Senior Services within 7 business days of receiving the Level Two decision. The Level Three review team will include the AAA Director from the applicant’s region, the Bureau’s Program Manager, and the Commissioner of the Bureau or someone appointed to act on the Commissioner’s behalf. Within 7 business days of receiving the Level Three grievance, the review team must hold a meeting with the applicant or service recipient and their legal representative, if applicable. This meeting may be conducted in person or by phone. The purpose of this meeting is to review the decisions made at Level One and Level Two. Following the meeting, the review team will issue a final written decision within 7 business days. Copies of the decision must be sent to the applicant or service recipient, the provider agency’s board of directors, the Executive Director, and the Area Agency on Aging. This decision is final and cannot be appealed.

For further assistance, please contact a licensed attorney. West Virginia Senior Legal Aid is dedicated to defending seniors’ rights.