Ky.gov

Commonwealth Office of the Ombudsman

Office of Citizen Services and Policy Integrity - Commonwealth Office of the Ombudsman

​​​​​​​​​​​​​​​​​​​

The Office of Citizen Services and Policy Integrity is responsible for the investigation of any administrative act or inaction of the Cabinet for Health and Family Services without regard to the finality of the administrative act or inaction. It is comprised of two Branches:

1) the Complaint Review Branch and 2) the Quality Advancement Branch.
​
The two branches and specific duties are discussed below.

Complaint Review Branch 

​The Complaint Review Branch reviews and makes recommendations to resolve complaints about the Cabinet for Health and Family Services (CHFS) and services delivered by CHFS employees. The Branch issues recommendations to the CHFS concerning complaint t​​​​rends to improve CHFS's performance and may require corrective action when policy violations are identified.

Frequently Asked ​​Questions

The Commonwealth Office of the Ombudsman is part of the Auditor of Public Accounts, ensuring it remains completely separate for impartial and unbiased investigations of the Cabinet for Health and Family Services. Importantly, the Ombudsman does not represent employees of the Cabinet for Health and Family Services (CHFS).

The Complaint Review Branch receives and investigates complaints about programs administered by (CHFS). This Branch recommends corrective action where appropriate, prompts CHFS staff to resolve customer problems, and advises CHFS’s Secretary of service-delivery problems. The Complaint Review Branch cannot make, change, or set aside law, policy, or administrative decisions of CHFS. However, the Commonwealth Office of the Ombudsman makes recommendations to resolve citizen complaints about CHFS and improve its performance.



You should contact us anytime you have a concern or complaint against the Cabinet for Health and Family Services (CHFS) involving:

  • Any act or inaction by CHFS personnel;

  • The quality, timeliness, or nature of services rendered by CHFS; or

  • Any interaction where you believe CHFS personnel engaged in dishonest, unethical, or illegal conduct or practices.
Whether you have concerns about a policy, are upset over a caseworker’s conduct, frustrated with delays, or you believe your issue wasn’t handled correctly—if it involves CHFS personnel or programs, it belongs here.

Upon receipt of the complaint, a member of the Complaint Review Branch will contact you. Some inquiries and complaints will require the Commonwealth Office of the Ombudsman to conduct an investigation. The Complaint Review Branch will approach every complaint with impartiality and objectivity.​


Quality Advancement Branch 

The Quality Advancement Branch (QA) completes comprehensive reviews of services provided by the Cabinet for Health and Family Services (CHFS) to ensure accountability and delivery of services to Kentuckians.

Per federal regulations, CHFS must provide an administrative hearing process to citizens adversely affected by a CHFS action. QA determines whether the KY Office of the Attorney General’s Office of Administrative Hearings (OAG) can address the issue the citizen wishes to appeal. We assist citizens in understanding CHFS actions and, if possible, in resolving disputed actions without a hearing.

QA assists citizens with the following types of appeals:
  • Department for Community Based Services
    • Protection & Permanency Service Appeals
    • CAPTA Appeals (appeals regarding child abuse and neglect findings)
    • Vulnerable Adult Maltreatment Appeals
    • Childcare Appeals
  • Office of Inspector General
    • Kentucky National Background Check Program Rehabilitation Review Appeals
  • Department for Aging and Independent Living
    • Guardianship Trust Fund Appeals
    • Personal Care Attendant Appeals
    • Homecare Program Appeals
    • Traumatic Brain Injury Trust Fund Appeals
  • Department for Medicaid Services
    • Advanced Premium Tax Credit Appeals
    • Waiver Appeals
      • ​​Home and Community Based Services
      • Michelle P. Waiver
      • Supports for Community Living
      • Acquired Brain Injury Waiver
      • Acquired Brain Injury Long Term Care Waiver
      • Model II Waiver
    • Program of All-Inclusive Care for the Elderly (PACE)
    • Estate Recovery Appeals
    • MCO Member State Fair Hearing Requests
  • Office for Children with Special Health Care Needs
    • General Appeals of Services
    • Early Hearing Detection and Intervention Program
      • ​​Entity Denials or Removals

Frequently Asked ​​Questions

QA completes “hearable” appeal requests within ten (10) working days and “non-hearable” appeal requests within 30 calendar days. We forward hearable appeal requests to the OAG for further consideration. The OAG Hearing Officer must complete a Recommended Order within 60 days of receiving a copy of the official record of the proceeding. The CHFS Secretary’s Office must complete a Final Order within 90 days of receiving the Recommended Order.
After hearing eligibility is established, a letter will be sent to you by QA staff informing you of the status of your appeal and the next steps in the appeal process. If your appeal request is eligible for an administrative hearing, you will then receive a certified letter from the OAG, providing details of your hearing.
QA does not provide legal advice. While it is not necessary to have an attorney to complete the administrative hearing process, it is your right to have one.
You should submit an appeal request as soon as you receive a notice of an appealable action or become aware of an issue you believe may be appealable. Carefully review any appeal rights notice you receive, as it will specify the deadline for filing your appeal. The timeframe is often 30 days from the date of the notice, but some appeals may have different deadlines. Even if you think you may have missed the deadline, we recommend submitting your appeal request anyway. There may be circumstances that affect whether your appeal can still be accepted or considered timely.
Eligibility for an administrative hearing depends on several factors. Most adverse actions taken by CHFS have appeal rights. These actions may include the denial, reduction, suspension, modification, or termination of CHFS services, such as the closure of a Child Protective Services case or the denial of a waiver. Findings of child abuse or neglect, or findings involving vulnerable adult maltreatment (including adult abuse, caretaker neglect, or exploitation), may also be eligible for an administrative hearing. Timeliness is another important factor. Whether your appeal request is submitted within the time limit specified in your notice can affect eligibility. In some cases, related court actions may also determine whether an administrative hearing can proceed.