The Columbiana County Mental Health and Recovery Services Board provides for the following:
The quick and objective resolution of concerns and complaints about services;
The provision of services in a non-discriminatory manner with respect for personal dignity, autonomy, and privacy;
Compliance with applicable rules in the Ohio Revised Code that pertain to client rights and grievance procedures, and the investigation of allegations of abuse or neglect.
Promotion of client rights through monitoring patterns and trends of client complaints and grievances via the system wide CQI process, and conducting system improvement activities based on these patterns and trends.
The Board and all providers that comply with Ohio law and requirements of the Ohio Department of Mental Health and Addiction Services are required to have policies and procedures that address client rights and grievances. Providers are required to have a Client Rights Officer available to assist consumers or their advocates in understanding their rights and to resolve concerns or grievances at the agency.
The Board has a Client Rights Officer (CRO) and back up officer available to assist consumers or family members in understanding their rights and resolving their concerns or grievances. A Client Rights Officer is available every working day.
This policy and related procedures apply to the delivery of services to all clients regardless of their living arrangements, including those living in licensed residential facilities and adult care facilities.
A written copy of the Board’s Client Rights and Grievance Guidelines is available upon request.
Client rights and grievance activities are tracked at the Board and reported through the Quality Improvement process.
Providers are required to submit a summary of all grievances and their outcomes quarterly and at the end of each Fiscal Year.
CLIENT GRIEVANCE PROCEDURES:
Providing Assistance in Resolving a Complaint or Grievance:
Any individual contacting the Board requesting assistance in resolving a complaint or filing a grievance, is to be referred to Kathie Chaffee, Client Rights Officer. Whenever possible, the person is to speak to Kathie immediately. If that is not possible, the person is told that Kathie, or the backup CRO will contact him or her within one business day. If Pat Wagner, the backup Client Rights Officer, initiates an investigation, she may turn over responsibility to Kathie or complete the investigation herself, based on her judgment.
The CRO is responsible for arranging for backup client rights coverage if she will be unavailable for more than one business day and to inform staff who field calls, greet individuals, and monitor the CRO's e-mail, who will be responsible for client rights issues and concerns in her absence.
Anyone assisting an individual in resolving a complaint or filing a grievance must collect the following information during the first contact with the person:
Date the complaint was communicated
Individual contacting the Board
Client or clients who are the subject of the complaint or grievance
Relationship of individual contacting the Board to the client or clients who are subjects of the complaint or grievance
Contact information for all involved parties
Contract provider(s) programs or staff involved
Indication of whether the inquiry is a complaint or a grievance.
Who else (if anyone) the complainant has contacted about the matter
All information is kept electronically and is secured following the Board's HIPAA Policies and Procedures.
If an individual other than the client or clients involved contacts the Board, the Client Rights Officer will seek permission from that individual to involve the client or clients who are the subject of the report in all steps involved in the resolution of the concern.
All reports of client abuse, client neglect, and unethical behavior will be considered grievances and will be investigated according to the Board's investigation of abuse or neglect procedures. The Client Rights Officer may handle all other matters as either complaints or grievances. The determination is made in consultation with the complainant. Differentiation between a complaint and a grievance is included in this policy.
The Board Client Rights Officer is responsible to investigate the grievance, including accessing provider information, and review with other Board staff as needed.
In cases in which the person has contacted multiple entities regarding the concern, the CRO will notify the individual of his or her right to ask multiple entities to investigate simultaneously; however, the CRO will recommend that the complainant determine one entity to take the lead in the investigation. The CRO will consult with the individual to determine the most appropriate lead entity to take the lead in the investigation.
The entity that is perceived by the individual as the one that can best maintain objectivity while conducting a thorough and timely investigation will be recommended.
If the individual requests the Board to take the lead, the Board CRO will conduct an investigation by interviewing all parties who can provide information necessary for the resolution of the grievance. The CRO may require that written information be provided and will review the client record at the involved organization(s) as a routine part of any investigation in which information in the client record may be helpful in the resolution of the grievance.
The Board requires each contract provider to have a client rights policy and procedure which requires them to investigate grievances or to assist in the investigation of grievances of their clients. Additionally, providers must submit Major Unusual Incident reports to the Board whenever allegations of client abuse or neglect occur. Contract providers submit quarterly summaries of grievance activities as part of the system wide CQI process. If information concerning client abuse or neglect appears on any MUI or quarterly grievance summary, the CQI Coordinator follows up with the provider organization to ensure that an investigation was conducted.
A written response to the grievance will be provided within 21 calendar days of receipt of the grievance. The written response will include the date the grievance was received, nature of the grievance, summary of the investigatory process, proposed resolution, right to further appeal, and a copy of the appeals procedures. A copy of this response will be provided to the Board's Quality Improvement Coordinator. The investigative process is outlined in the section of the procedure entitled Grievance Investigation Procedures.
The time frame for a resolution may be extended with permission of the complainant. The only circumstances in which the CRO may request additional time is when information necessary to appropriately investigate is not available during the 21-day time frame. An example is a key individual at the provider agency's lack of availability due to leave during the 21-day time frame.
In cases in which the CRO determines that abuse, neglect, or professional misconduct is substantiated, the CRO will notify all relevant entities as required by law, (for example, professional licensing organizations).
The CRO will document each interview and maintain copies of all documents relevant to the resolution of the grievance.
Records of client grievances will be maintained for at least two years and will include documentation as to how the grievance was resolved, a copy of the grievance, documentation as to how the grievance was resolved, and a copy of the letter to the grievant reflecting resolution of the grievance.
Client grievance information will be kept confidential, unless the client has authorized disclosure or release of information. All aspects of the grievance procedure will comply with federal and state confidentiality regulations.
Aggregate data regarding grievances will be tracked and reported quarterly and annually through the Board's Continuous Quality Improvement system. Patterns and trends are reviewed by the CQI Committee to identify and implement needed service improvements. Plans for corrective action or training are implemented with providers as needed.
The CRO submits information on grievances to the ODMHMAS.
Differentiating Between a Complaint and a Grievance:
A complaint is handled more informally than a grievance. It may involve a concern that does not clearly violate a designated right. The individual seeking assistance does not have to submit a formal statement, and the Client Rights Officer is not required to provide a written report summarizing the results of the inquiry. The individual seeking assistance provides verbal permission to the Client Rights Officer to facilitate a resolution to his concern as quickly as possible. Concerns that are most effectively handled as complaints are those that can potentially be resolved by facilitating clear and quick communication between the client and the service provider(s). Examples include:
The complainant perceives that a service provider has not been responsive to his expressed concerns.
The complainant has questions concerning his service plan that have not been addressed adequately.
The complainant wants an appointment with a service provider more quickly than it has been offered.
If an individual agrees to have his concern handled as a complaint, he does not relinquish his right to file a grievance if the complaint resolution procedure does not end in a satisfactory result.
If the individual chooses to have his concern handled as a complaint, the Client Rights Officer and the complainant agree on a course of action. The Client Rights Officer contacts the involved service provider(s), determines who needs to be involved in the resolution of the concern, and facilitates communication and problem solving among the parties. The Client Rights Officer communicates verbally with the complainant to determine his satisfaction with the resolution. If the complainant is not satisfied with the resolution, the CRO reviews all other options for getting the concern addressed, including filing a grievance.
A grievance is a formal process in which the Client Rights Officer conducts, or ensures that another appropriate entity conducts, a formal investigation of an allegation which constitutes a violation of one or more of the client's rights enumerated in this policy. The complainant must provide a formal statement. Allegations of unethical behavior, abuse, or neglect are always handled as grievances. The CRO determines whether the complaint is substantiated and provides a written response to the complainant at the conclusion of the investigation.
The following organizations may also be accessed for assistance in the resolution of a grievance.