DMHAS Client Grievance Procedure

(Go to Spanish version)

William Pierce, Clients Rights and Grievance Specialist
(860) 418-6933, william.pierce@ct.gov

 

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
  1. 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
  2. The Commissioner of DMHAS may determine a provider contracted by DMHAS can be exempt from the Grievance Procedure and Fair Hearing Regulations if the Commissioner issues a written finding that (a) DMHAS funding to the provider does not exceed 20% of its budget and (b) the provider has an adequate procedure for the redress of grievances.
GRIEVANCE DEFINITION
Grievances 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:
  1. Violated a right of the client provided by statute, regulation, or directive of DMHAS
  2. Treated the client in an arbitrary or unreasonable manner
  3. Failed to provide services authorized by a treatment plan
  4. Engaged in coercion to improperly limit a client’s choice
  5. 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
  6. Failed to treat the client in a humane and dignified manner
GRIEVANCE PROCEDURE
  1. 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
  2. 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.
  3. A client may withdraw their grievance at anytime unless it was submitted on their behalf by their conservator or guardian.
    • 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.
  4. Once a grievance is received by the Client Rights Officer the provider has twenty-one (21)calendar days to address the complaint unless the provider’s Executive Official or designee issues written notice to the client authorizing additional fifteen (15) calendar days for good cause or the grievance is an “Accelerated Grievance” as stipulated by Fair Hearing Regulations.
PROCEDURE AFTER A GRIEVANCE IS RECEIVED
  1. 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
  2. If at any time during an inquiry into a grievance the Client Rights Officer has reason to believe that DMHAS staff abused, neglected or exploited a DMHAS client or other protected class or there was a violation of a DMHAS work rule (for DMHAS facilities), agency personnel policy or a criminal statute the CRO will immediately notify the provider’s Executive Official or designee and as provided by policy/procedure initiate a referral to the appropriate authority.
    • 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.
  3. Except when a referral has been made to an outside authority, the Client Rights Officer addresses the grievance by:
    • 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
  4. A Client Rights Officer who believes a resolution to a grievance is possible will submit a written proposed resolution to the client which summarizes the nature of the grievance and recommended resolution.
    • The proposed resolution will not contain information that violates the confidentiality rights of other persons.
  5. Once the proposed resolution is issued, the Client Rights Officer will inform the client:
    • 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
  6. If the Client Rights Officer believes a resolution to a grievance is not possible or it the client rejects the proposed resolution the Client Rights Officer will:
    • 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
  7. Once the Executive Official or designee receives the CRO’s report, the official will conduct a separate review of the grievance including additional material provided by the client in writing or information gathered during a meeting with the client.
    • 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.
  8. The Executive Official or designee issues a Formal Decision which includes a statement of any actions to be taken and notice the client has the right to request in writing a Commissioner’s Review.
ACCELERATED GRIEVANCE
  1. 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.
  2. The Accelerated Grievance is submitted in writing to the provider within five (5) business days of being notified of the reduction or termination.
  3. The provider has five (5) business days to issue a written Formal Decision.
  4. A client may submit a written request for a Commissioner’s Review of the grievance upon receiving the provider’s Formal Decision.
COMMISSIONER’S REVIEW
  1. 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.
  2. 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
  3. Upon receiving the request the Commissioner’s designee (designee) conducts such an inquiry the designee deems necessary to have a thorough understanding of the grievance and provider’s response which may include:
    • 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
  4. The designee issues a Final Determination of the grievance to the client and provider’s Executive Official (or designee) within twenty-one calendar days after receiving the request for a Commissioner’s review and/or no later than fifteen (15) calendar days from the date of the conference if one is held.
  5. The Final Determination serves as the Department’s final administrative decision in the Grievance Procedure.
  6. If the grievance concerns a denial, involuntary reduction or involuntary termination of services, the client may request a Fair Hearing by submitting the request in writing to the Commissioner of DMHAS by mail within thirty (30) calendar days from the date the Final Determination was mailed.
    • The request will identify the services that have been denied, involuntarily reduced, or terminated
  7. In response to the request for a Fair Hearing the client will be provided information on the scheduling of a Fair Hearing as stipulated by Fair Hearing Regulations
REQUEST FOR CONTINUATION OF SERVICES
  1. 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.
  2. A client who does not receive notice of modified services when involuntarily discharged from a DMHAS service, program or DMHAS contracted provider may submit a written request to the Commissioner of the DMHAS within five (5) calendar days of being notified of the involuntary termination
    • 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.
  3. The Commissioner’s designee will review the request and issue a response after considering safety and clinical concerns of the client and others who may be affected. The response may:
    • 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
  4. Decisions made in response to a Request for Continuation of Services may be modified or terminated at anytime by the Commissioner or designee but they are meant to continue in effect until the client’s grievance is resolved either by the provider, Commissioner’s Review or Fair Hearing.
NOTICES
  1. 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.
  2. 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.
  3. DMHAS Office of the Commissioner will provide notices which can be posted in English and Spanish as well as alternative formats upon request.
DATA COLLECTION
  1. 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.
  2. The DMHAS Office of the Commissioner will provide training, technical support, and oversight, to ensure compliance with this policy.