1. The client, his/her guardian, legally responsible
parent, his/her attorney, designated representative, a representative of state
governmental rights protection or advocacy agency, or other person(s) specifically
aggrieved may make a grievance.
2. Filing a grievance will not result in disciplinary
action, reprisal, loss of privileges, or loss of services to the individual
filing the grievance (heretofore called the �grievant�). The agency employee
and/or contractee receiving the grievance shall
immediately refer the grievant to the Executive Director or designee (as
outlined below), who shall inform the grievant of his/her rights and due
process under the law, and explain the informal and formal grievance procedure
process available.
3. Community Care will encourage the use of informal
resolution procedures for the investigation and resolution of grievances.
Clients will have access to their service provider or designee to share verbal
or written complaints and grievances. The service provider or designee is
responsible for submitting all grievance information to their supervisor or
Program Director for investigation. Documentation of informal grievances will
be added to the case record and submitted to the client and/or legally
responsible parent or guardian.
4. The service provider or designee will advise the
client to first attempt to resolve the issue through discussion with the
involved individual. If the client is unwilling to discuss the complaint, the
individual involved or his/her immediate supervisor will advise the grievant of
Community Care's formal grievance procedure as outlined below.
5. Steps of a formal grievance:
a. The Executive Director, or designee (as outlined
below), shall document the grievance in writing using Community Care's Client
Complaint Form and attempt to resolve the issue to the client�s/guardian�s
satisfaction in a timely manner. Full documentation of this shall appear in the
case record. Any time successful resolution cannot be achieved at the agency
level or if the grievant chooses to bypass the internal resolution, the
grievant will be provided information and assistance, if desired, in filing a
formal grievance with The Department Health and Human Services. At a minimum,
all grievants shall be provided with the DHHS Grievance
Form, which must be completed and submitted to The Department of Health and
Human Services in order to begin the formal grievance resolution process. For a
full and complete explanation of the grievance process for clients receiving
services under the auspices of The Department of Health and Human Services,
please refer to the Rights of Recipients of Mental Health Services Who Are
Children In Need of Treatment and/or Rights of Recipients of Mental Health
Services.
b. Formal grievances using the DHHS Grievance Form are
filed first with the grievant�s service provider or
directly with supervisor or Program Director if the grievance is against the service
provider.
c. A copy of the formal grievance is forwarded to the
Executive Director, who enters it into the Master Complaint File and forwards
the grievance to the DHHS Grievance Coordinator. Once the formal grievance has
been filed, the process for resolution is as outlined in the Rights of
Recipients of Mental Health Services Who Are Children In Need of Treatment and/or
Rights of Recipients of Mental Health Services.
6. Through each step of the grievance procedure, the
grievant has the right to:
a. Be represented by an advocate from the State Office
of Advocacy Service,
b. Review any information obtained in the processing
of the grievance, except that which would violate the confidentiality of
another person,
c. Present evidence or witnesses pertinent to the
grievance, and
d. Receive of complete findings and recommendation(s),
except that which would violate the confidentiality of another person.
7. Community Care will make an electronic or written
record of all formal grievance proceedings and an electronic recording of all
grievance hearings.
8. Community Care bears the burden of proof to show
remedial action taken in compliance with agency or state client rights policies
and procedures in all grievances filed.
9. The final report for all grievances shall include a
determination of Community Care's adherence to agency and/or state client
rights policies and procedures, supporting evidence, and proposed specific
remedial steps to assure policy and procedure compliance.
10. Any time a client and/or legal guardian is not
satisfied with the findings of a formal grievance, they have the right to an
appeal. The appeal process may include review by the Community Care Board of
Directors, Mediation, and/or an Administrative Hearing. The Mediation and
Administrative Hearing process is outlined in Rights of Recipients of Mental
Health Services Who Are Children In Need of Treatment and Rights of Recipients
of Mental Health Services.