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Complaint Format: People who feel they have been discriminated against may file a written or verbal complaint. Anyone contacted about a complaint should make every effort to obtain the following information from the complainant: Name, address, telephone number or other means of contacting the complainant Name and location of office where the alleged discrimination took place Nature of the incident that led to the complaint Protected status (i.e., age, race, ethnicity, sex, disability, religious creed, national origin, marital status, veteran status, primary language, or political beliefs) that the complainant believes was violated Names and contact information of the individuals who have knowledge of the discriminatory action Date of the alleged discriminatory action. 1440.20.05 THE DFR AND DISCRIMINATION COMPLAINTS The DFR's and OMPP’s responsibilities related to handling complaints of discrimination are listed below. Civil Rights complaints are to be forwarded to the appropriate Regional Manager (RM) who will initiate the investigation. Complaints may be forwarded to the RM via telephone or the regional mailbox (email). The RM will notify the Medicaid Civil Rights inbox (MedicaidCivilRights@fssa.IN.gov) so that tracking of the complaint may begin. Tracking will include, at a minimum, date complaint was received by the RM; nature of complaint; disposition of complaint; date final response provided to the client. The tracking of civil rights complaints will be managed by the Medicaid Policy section. Any conflicts of interest will be reported and resolved before the investigation moves forward. The RM will designate a manager in their region to address the complaint. This will include at a minimum: contacting client; reviewing case information or other documentation; rectifying any errors in case processing, etc.; completing a report for DFR records; completing a letter that summarizes the findings and responds to the client’s complaint. The RM will maintain oversight of this process.