Complaints & Investigations Overview
Iowa law authorizes the Board to investigate complaints about dentists, dental hygienists, and dental assistants. If the Board finds that the practitioner has violated state law or the Board’s administrative rules, it may take action against the practitioner’s license to practice in Iowa. The Board’s disciplinary procedures are located in 650 Iowa Administrative Code. An overview of the process is below.
Complaints
The Board receives complaints from many different sources, including patients and families, health care professionals, insurance companies, law enforcement, Medicaid, and others. Regardless of how the information is received, the Board identifies each of these as a “complaint.”
How to File a Complaint
The Board office accepts complaints in the form of a letter, e-mail or on-line form. Fill out the online complaint form.You may also print it and fax it, or send it in by regular mail. A complaint may be faxed to 515-281-7969. Please mail complaints to the Iowa Dental Board at 400 SW 8th St, Suite D, Des Moines, IA 50309-4687.
If you write to the Board with your complaint, please include information about:
- Your name, address and telephone number.
- The patient: name, date of birth, address, telephone number, and your relationship to the patient.
- The practitioner(s): name, address, telephone number, when the patient went to the practitioner(s) and why, and why you are making a complaint. Please describe your complaint adequately in your letter.
How Are Complaints Handled?
As soon as a complaint is received, staff assigns a case number and opens an investigative file. New complaints are reviewed and prioritized in order to determine the level of investigation appropriate for each complaint. Some cases are referred to the Board for a decision at the next Board meeting as to whether to investigate further, and some cases are assigned immediately to an investigator.
What Happens in an Investigation?
The purpose of an investigation is to gather sufficient information from the view of the complainant and the licensee so that the Board can determine if the facts support whether wrongdoing occurred. In order to get sufficient information from both vantage points, the investigator may:
- Interview those involved, e.g., complainants, licensees, and others;
- Obtain relevant records, e.g., dental records, X-rays, study models;
- Examine the licensee’s disciplinary history with the Board; and/or
- Contact law enforcement or other regulatory boards.
The investigator gathers information and writes a report to the Board summarizing the information obtained in the course of the investigation. The investigator does not make conclusions or recommendations for the Board. The Board reviews the materials on each case and makes a decision. Some cases are forwarded to an outside expert for further review.
What Kind of Complaints Receive Board Action?
The Board uses its limited resources to focus on complaints that identify a significant danger to patients, including: serious competency concerns, severe patient harm, criminal conduct, substance abuse or other impairment, sexual misconduct, and unprofessional conduct that impacts patient care.
Concerns which the Board considers to be less serious are those that do not involve serious patient harm or that are isolated occurrences, including: billing disputes; a single incident of rude behavior or communication problems; personality conflicts; or poor record keeping practices that are not repeated and do not significantly affect patient care.
While the Board may close a less serious case without taking any formal disciplinary action against the licensee, the Board may re-open the case if similar complaints are received at a later date. When a pattern of wrongdoing begins to emerge, the Board heightens its interest in complaints that may seem less concerning on their own.
The Board’s Options When It Reviews a Case
Each Board member has a copy of the investigator’s report and all of the relevant records related to a case. The Board must determine that there is probable cause to take public disciplinary action. Probable cause means there must be reasonable grounds for determining that the wrongdoing occurred.
After discussing the case, considering the evidence, and the risk to the public, the Board takes one of the following actions:
- Dismisses the complaint and closes the case without action.
- Closes the case and issues a confidential Letter of Education or Letter of Warning to the licensee.
- Continues the investigation by
- Referring the case back to the investigator for further investigation;
- Referring the case to peer reviewers for expert opinion; or
- Ordering the licensee to submit to a confidential evaluation.
- Files a public Statement of Charges and refers the case for prosecution to the Office of the Attorney General.
- Summarily suspends some or all of the licensee’s privileges to practice and order a hearing within 30-45 days. In some instances, the Board may issue an emergency suspension in the most serious cases when continued public harm is likely.
What Makes an Investigation Take So Long?
A case remains under investigation until the Board decides to close the file or order a hearing. The investigative process can take several months, or longer, for some of these following reasons:
- The investigator receives and may work on many cases at the same time.
- A licensee/registrant may not be prompt in supplying records or a report.
- A licensee/registrant may have to get a confidential evaluation that takes several weeks or months to schedule.
- Competency cases may require peer review before the Board can rule.
- The Board typically only reviews cases at its quarterly meetings.
What Is Public Information and What Is Not?
An investigation is confidential. It cannot be shared with the public, the complainant or the licensee involved. The public may know only when the Board files charges against a licensee. Only then is the investigative file shared with the licensee who is charged. The investigative file is never open for view of the complainant or the public. The Board is careful to follow Iowa law in regards to what records may be made public, or shared with certain individuals or agencies.
Prosecutions
Statement of Charges
The Board may file a Statement of Charges if it finds probable cause that a licensee violated Iowa law or other regulations. The Statement of Charges notifies the public that legal action has been initiated against the licensee/registrant and the licensee/registrant will be given an opportunity to due process. The licensee/registrant is served with several legal documents that include charges and an order for a hearing. This is the beginning of what is called a 'contested' case, which allows the licensee/registrant to defend himself or herself before the Board, with opportunity for several levels of appeal.
Once the Board files charges, the case is referred to the Office of the Attorney General and an Assistant Attorney General is assigned to prosecute the case on behalf of the “State,” meaning the public interest of Iowans. Licensees/registrants may hire a private attorney to assist them through this legal process and to assure their interests are protected.
Settlement or Hearing?
The Board office schedules a hearing in order to allow both sides, the licensee/registrant and the State, to have an opportunity to present evidence related to the charges filed by the Board. State law encourages the Board to enter into informal settlement negotiations prior to the initiation of a hearing. In most circumstances the State makes a settlement offer. If no settlement is attempted or reached, the case proceeds to hearing. The members of the Board hear the case.
Whether a Hearing Is Open or Closed to the Public
The Board office notifies the public when a hearing is scheduled. Iowa law allows the licensee/registrant to choose whether to hold the hearing in open or closed session. While a hearing may be open to the public at the discretion of the licensee involved, most licensees choose to hold the hearing in closed session. The decision to close the hearing to the public is often made at the beginning of the hearing.
Administrative Law Judge
An administrative law judge (ALJ) from the Iowa Department of Inspections and Appeals presides over Board hearings. The ALJ rules on matters of law and assists the Board in preparing the Findings of Fact, Conclusions of Law, and Decision and Order of the Board based on the evidence presented during the hearing.
Disposition of Cases
The Board has a range of actions that it is authorized to take following a hearing, or as part of a settlement. The Board may impose any combination of the following which it finds appropriate:
- Dismiss the charges and close the case without formal action;
- Dismiss the case and close it without action;
- Issue the licensee/registrant a formal Citation and Warning;
- Place a licensee/registrant on probation subject to monitoring or conditions;
- Restrict a license/registration;
- Suspend or revoke a license/registration to practice;
- Accept a voluntary surrender of a license/registration; and/or
- Issue a civil penalty not to exceed $10,000.
Appeals
Board actions are considered public documents and are posted on the Board’s website. Board actions are also reported to the National Practitioner Data Bank. All parties to a contested case have the right to appeal the final decision of the Board within the time frame established by law. When all administrative remedies are exhausted with the Board, the parties to the case may appeal the Board’s decision to the State’s courts. While the decision of an appeal is pending, the sanctions imposed by the Board are enforced.
Confidentiality
All Board investigative materials are privileged and confidential. They are not subject to discovery, subpoena, or other means of legal compulsion for their release except to the licensee/registrant and the Board. The Board may only release investigative materials to a licensee/registrant in cases where formal charges against the licensee/registrant have been filed.
Investigative information may, however, be released to the applicable licensing authority in another state in which the licensee/registrant is licensed or has applied for a license/registration. Additionally, if the Board’s investigative materials indicate that a crime has been committed, information may be shared with the appropriate law enforcement agency.
Civil Immunities
Members of the Board, its staff and peer review committee members are protected by Iowa law from civil liability. Board members and staff are immune from suit for their role in any act, omission, or decision of the Board, as long as they act in good faith. A person who files a report or a complaint is also immune from civil liability if the reporter acts without malice.
Mandatory Reporting of Peers
State law requires licensees/registrants to report a peer who may have violated the law or other regulations by omission or wrongdoing. A person licensed by the dental Board is required to report someone else licensed by the Iowa Dental Board, but not other health practitioners. Any licensee/registrant who fails to comply with mandatory reporting may be subject to Board discipline.