DMHAS Client Grievance Procedure(Go to Spanish version)
William Pierce, Clients Rights and Grievance Specialist
(860) 418-6933, firstname.lastname@example.org
The Connecticut Department of Mental Health and Addiction Services (DMHAS) Client Grievance Procedure is a non-adversarial method for resolving client grievances at the lowest possible level. The DMHAS Client Grievance Procedure (Grievance Procedure) was established with input from people receiving DMHAS services family members, advocates and DMHAS staff to encourage clients and providers in working together to resolve grievances.
The Grievance Procedure complies with Regulations of Connecticut State Agencies (Section 17a-451(t)(1) et seq.) concerning Fair Hearings (Fair Hearing Regulations) which provides clients the opportunity to request a fair hearing when complaints that services were denied, involuntarily reduced or terminated by DMHAS or DMHAS contracted provider are unresolved.
The Grievance Procedure is the DMHAS complaint resolution procedure for addressing client complaints regarding services, programs and activities under the Americans with Disabilities Act (ADA). Furthermore, staff of DMHAS facilities and staff of DMHAS contracted providers are prohibited from retaliating against clients for submitting grievances.
COVERED SERVICES AND PROVIDERS
- All DMHAS facilities and agencies contracted by DMHAS that provide direct mental health and substance use disorder services (providers) make available the Grievance Procedure to persons receiving services, have received services or are seeking services along with their authorized representatives (clients).
- Matters under the exclusive jurisdiction of the Psychiatric Security Review Board are exempt from the Grievance Procedure
GRIEVANCE DEFINITIONGrievances under the DMHAS Client Grievance Procedure are written complaints submitted by a client that the provider: denied, involuntarily reduced or terminated services or that the client believes the provider or staff:
- Violated a right of the client provided by statute, regulation, or directive of DMHAS
- Treated the client in an arbitrary or unreasonable manner
- Failed to provide services authorized by a treatment plan
- Engaged in coercion to improperly limit a client’s choice
- Unreasonably failed to intervene to protect the client when their rights were jeopardized by the actions of another client in a setting controlled by the Provider
- Failed to treat the client in a humane and dignified manner
- Grievances are submitted in writing to the provider’s designated Client Rights Officer (CRO) within forty-five (45) calendar days of when the action complained of occurred unless good cause is shown to the Client Rights Officer for a late filing or the grievance is an Accelerated Grievance as stipulated by Fair Hearing Regulations
- If the client cannot submit a grievance on their own, their authorized representative may do so on their behalf.
- A client may authorize in writing a representative of their choice to advocate on their behalf in pursuing a grievance unless as stipulated by Fair Hearing Regulations the client’s choice is someone who receives services from the same provider and the provider determines the choice is clinically detrimental to the client.
- The client’s authorized representative may appear with the client and advocate on behalf of the client at any proceeding under the Grievance Procedure.
- The client can request access to relevant records necessary to resolve the grievance and can provide written permission to the provider for their authorized representative to access records relevant to the grievance.
- All records regarding a grievance are confidential unless disclosure is authorized, in writing, by the client or the Office of the Commissioner of DMHAS in accordance with applicable law and policy.
- A conservator or guardian cannot withdraw a grievance submitted by the client
- If a grievance is withdrawn, it will not affect action begun to investigate alleged abuse, neglect, exploitation of a client as well as work rule and agency personnel policies.
PROCEDURE AFTER A GRIEVANCE IS RECEIVED
- Upon receiving a grievance the Client Rights Officer will:
- Issue an acknowledgement to the client within seven (7) calendar days that includes information on contacting state-wide advocacy organizations
- Interview the client as soon as possible (along with their authorized representative if the client has one) and determine what resolutions would the client consider
- Interview other parties as necessary, review relevant records and take other action necessary to have a thorough understanding of the grievance
- The CRO will assist in any investigation, as requested, and will report to the client of the status of such an investigation without violating confidentiality rights of any individual.
- While the separate investigation is pending, the CRO will defer further action unless a portion of the grievance is resolvable without interfering with any other investigation.
- Meeting the client to discuss the grievance and consider resolutions
- Acting as mediator between parties if the CRO determines such a meeting could resolve the grievance
- Maintaining documents concerning a grievance and their confidentiality
- Authorizing if necessary another staff to assist in addressing a grievance while retaining responsibility for its response
- The proposed resolution will not contain information that violates the confidentiality rights of other persons.
- The client has ten (10) business days to review the proposed resolution and either sign an acceptance which will resolve the grievance and terminate the Grievance Procedure or to notify the CRO in writing they do not agree with the resolution
- The grievance will be considered withdrawn if the client does not respond within ten (10) business days
- The ten (10) business days will not count towards the twenty-one (21) calendar days the provider has to resolve the grievance
- Prepare a written report summarizing the grievance and efforts to reach a resolution for the provider’s Executive Official or designee and client along with the client’s authorized representative
- Notify the client and their authorized representative they can present additional material to and may upon request meet the Executive Official or designee who will conduct a separate review of the grievance
- The Executive Official or designee may issue written notice to the client that an additional fifteen (15) calendar days has been added for good cause.
- A client or their authorized representative may submit an Accelerated Grievance to a provider when that provider involuntarily reduces or terminates Opioid Substitution therapy or terminates inpatient treatment scheduled for thirty (30) days or less.
- The Accelerated Grievance is submitted in writing to the provider within five (5) business days of being notified of the reduction or termination.
- The provider has five (5) business days to issue a written Formal Decision.
- A client may submit a written request for a Commissioner’s Review of the grievance upon receiving the provider’s Formal Decision.
- A client who does not agree with the provider’s Formal Decision may submit a written request for a Commissioner’s Review within fifteen (15) business days of receiving the Formal Decision to a designee of the DMHAS Commissioner unless the designee extends the time for good cause.
- A client may also request a Commissioner’s Review when:
- The provider’s written response to a grievance is more than seven (7) calendar day past the twenty-one (21) calendar days the provider had to address the grievance, unless the grievance was an Accelerated Grievance or the provider notified the client of an extension
- The provider failed to implement a resolution agreed to by the client and CRO
- The provider issued a denial that a complaint was a grievance covered by the Grievance Procedure
- Requesting and reviewing additional information from the client parties.
- Interviewing the client and other parties
- Convening an informal conference of the parties involved in the grievance
- The request will identify the services that have been denied, involuntarily reduced, or terminated
REQUEST FOR CONTINUATION OF SERVICES
- As stipulated by Fair Hearing Regulations a provider notifies a client of an involuntary reduction or involuntary termination including:
- Of the action and reason for the action
- The right to submit a grievance under the DMHAS Client Grievance Procedure
- The right to request a continuation of services if the provider fails to notify the client of modified services.
- The request includes the service being terminated, the reason why the client wants the service continued and that the client has submitted a grievance to the provider.
- Direct the provider to continue providing services that were involuntarily terminated.
- Direct the provider to offer the client modified services
- Support the decision of the provider
- DMHAS facilities and providers contracted by DMHAS provide notices to clients and people applying to services which describe the Grievance Procedure and information on state-wide advocacy programs in a method the person understands.
- A summary version of this policy which includes the name and telephone number of the relevant Client Rights Officer(s) shall be posted prominently in a form provided by the commissioner in every unit, ward, program location and client lounge operated by DMHAS or DMHAS contracted provider.
- DMHAS Office of the Commissioner will provide notices which can be posted in English and Spanish as well as alternative formats upon request.
- DMHAS facilities and DMHAS contracted providers will provide information to the Commissioner’s office about the nature of grievances filed, their numbers and resolutions as the Commissioner or Commissioner’s designee directs.
- The DMHAS Office of the Commissioner will provide training, technical support, and oversight, to ensure compliance with this policy.