Section 22-A306. MH PROVIDER GRIEVANCE PROCEDURE

 

306.1Consumers with grievances concerning a MH provider from whom they are receiving services shall file the grievances with their provider. Consumers with grievances concerning rules, policies, or actions of employees that are the sole responsibility of DMH may file them with their MH provider but are not required to do so.

 

306.2Each MH Provider Grievance Procedure shall incorporate, at a minimum, the following elements:

 

(a)Consumers shall have the opportunity to file a grievance at any time during the MH provider's normal hours of operation;

 

(b)Consumers shall be protected against having to file or present a grievance to the person complained about in the grievance;

 

(c)Consumers shall have access to peer advocates and shall have the right to representation during each stage of the grievance procedure by a peer advocate or personal representative;

 

(d)The consumer or his or her designee shall receive written acknowledgment of a filed grievance;

 

(e)Time limits shall be set the completion of each step of the Procedure, consistent with § 306.5;

 

(f)Prompt steps shall be specified to insure the immediate physical safety of a consumer if the circumstances surrounding a grievance raise a reasonable belief that the consumer's safety is threatened;

 

(g)If informal attempts to resolve a grievance are unsuccessful, the chief executive officer of the MH provider shall review the grievance and write a decision in response. The written decision shall be transmitted, with oral explanation, to the consumer or his or her designee along with a reminder of the consumer's right to appeal the grievance to DMH for external review.

 

306.3Each MH provider shall establish a permanent group composed of equal numbers of consumers and staff members who shall be responsible for responding to inquiries regarding the grievance process, for attempting to resolve grievances consensually, and for assisting the chief executive officer of the MH provider in providing a response to grievances.

 

(a)The group or individual group members may look into individual grievances and work with the consumer filing the grievance and other parties to resolve the grievance consensually, using mediation or other dispute resolution techniques.

 

(b)If the grievance cannot be resolved informally, the group or individual group members may fact-find or make advisory recommendations to the chief executive officer of the MH provider.

 

(c)Grievances containing allegations of physical or sexual abuse may be forwarded directly to the chief executive officer of the MH provider without action by the group.

 

306.4Each MH Provider shall demonstrate that consumers have played a meaningful role in the final design of the Grievance Procedure, and that consumers will be meaningfully consulted in future efforts to monitor and evaluate its effectiveness and decide upon needed modifications. The consumer/staff group required by § 306.3 may be utilized for these functions, or the MH Provider may use other means.

 

306.5The chief executive officer of each MH provider shall review, investigate, and provide a substantive response to grievances within the following time frames:

 

(a)Within five (5) business days of the date the grievance is filed if it alleges abuse or neglect of a consumer or a denial of service to a consumer; or

 

(b)Within ten (10) business days of the date the grievance is filed for all other grievances. The chief executive officer of a MH provider may request an extension of the time set by paragraph (b) above for a specific number of days. The consumer filing the grievance shall have the option to grant or deny such a request.

 

306.6If a consumer is dissatisfied with the response to a grievance by the chief executive officer of the MH provider or his or her designee, the consumer shall have ten (10) business days from the date of verbal notification and explanation of the response within which to appeal the grievance to DMH for external review in accordance with §§ 308 and 309.

 

306.7Each MH provider shall submit a copy of each grievance to DMH on the day it is filed and shall submit a copy of any subsequent action concerning the grievance within 24 hours of the action's occurrence. Providers shall submit the information in a manner to be specified by DMH.

 

306.8Each MH provider shall ensure that every staff person, including administrative, clerical, and support staff, has a clearly understood responsibility to immediately advise any consumer or other person who is articulating a grievance on behalf of a consumer, of the right to file a grievance and of the means of contacting the peer advocate program.

 

306.9Each MH provider may accomplish its responsibilities with regard to implementing the MH Provider Grievance Procedure through utilization of its own staff or board members, as appropriate, or through agreement with outside staff, agencies, or organizations. The utilization of outside persons in the MH Provider Grievance Procedure shall be clearly explained to each consumer filing a grievance and to other parties filing a grievance on behalf of a consumer.

 

source

Final Rulemaking published at 50 DCR 8480 (October 10, 2003).