SECTION 340:2-3-53. Grievances of clients receiving services from the Developmental Disabilities Services (DDS)

(a)   Application. This Section describes processes relating to grievances of clients receiving services from DDS who are not residing in an Oklahoma Department of Human Services- (DHS) operated facility and are not Hissom class members. This Section includes minors and adults in specialized foster care. Subsections (h) through (k) apply to clients who were former residents of NORCE or SORC, upon the Oklahoma Commission for Human Services resolution to close the state operated resource centers November 1, 2012.

(b)   Definitions. The definitions in Oklahoma Administrative Code (OAC) 340:2-3-2 and 340:2-3-45(b) apply to this Section unless the context clearly indicates otherwise.

(c)   Notice of grievance rights. The DDS case manager gives Form 15GR006E, Notice of Grievance Rights - DDS Clients (General), to the service recipient or guardian when applicable, at the initial plan of care meeting and at each annual plan of care meeting thereafter. When the service recipient does not have a DDS case manager, the provider gives Form 15GR006E to the service recipient within 30-calendar days of service initiation and annually thereafter. Form 15GR006E is used to identify the local grievance coordinator and to explain the client's right to grieve. After the client or guardian signs the form, the original is maintained in the client's permanent record.

(d)   Filing and grievance processing. Provider and DHS grievances are filed and processed per OAC 340:2-3-45. When a grievance involves a decision of an individual's team, the first level respondent is the supervisor of the client's case manager unless the case manager participated in making or approved the decision being grieved.

(e)   Time limits on filing grievances. The time limit set forth in OAC 340:2-3-45(g) does not apply to grievances filed by or on behalf of the clients listed in this Section.

(f)   Contested grievances. When a grievant asks to appeal a DHS grievance, the appeal is processed per OAC 340:2-3-46.

(g)   Monitoring grievance programs. In order to avoid unnecessary duplication, the Office of Client Advocacy (OCA), in cooperation with other monitoring entities, monitors provider grievance programs per OAC 340:2-3-45 (d) through (m).

(h)   Provider grievances of DDS clients who were former residents at NORCE or SORC as of November 1, 2012.

(1)   Each residential and vocational provider that contracts with DDS to provide services to DDS clients has a grievance system for resolution of grievances. The provider's written grievance policies, forms, and procedures are in compliance with OAC 340:2-3-45.

(2)   Provider grievances are initiated by the DDS client, the assigned OCA advocate, or a person interested in the welfare of the client by using Form 15GR001P (paper version) or 15GR001E (electronic version) or the provider's grievance form. The completed grievance form is submitted to the provider's grievance coordinator. Upon receipt of a provider grievance by or on behalf of a DDS client by anyone other than the OCA advocate or the client's DDS case manager, the local grievance manager promptly informs the DDS case manager and the advocate assigned to the client by email, fax, or phone. When a DHS employee initiates a grievance on behalf of a client, at the time the grievance is filed the employee sends a copy to the DDS case manager and the OCA advocate assigned to the client.

(3)   When the subject matter of a grievance can be submitted for resolution as a provider grievance or a DHS grievance, the DDS client has the option to file it as a provider grievance, a DHS grievance, or both.

(i)   Contested grievances. When the response to a DHS or provider grievance is contested by a DDS client or a grievant on behalf of a client, the contested grievance is processed per OAC 340:2-3-46 unless otherwise provided in this Section. The DDS director is the state office administrator responsible for responding to DDS client contested grievances.

(j)   Request for review by the Grievance and Abuse Review Committee (GARC). When a DDS client requests a GARC review of the DDS director's response to a grievance, the OCA grievance liaison prepares a request for GARC review using the OCA-prescribed format that includes the information listed in subsection (i) of this Section.

(k)   Formal inquiry. The advocate general or OCA advocate staff may file a formal inquiry to request information relating to:

(1)   the treatment of a client;

(2)   the substance or application of any DHS policy, rule, or regulation of DHS or an agent or contractor of DHS; or

(3)   any decision, behavior or action of a DHS employee, agent or contractor, or of another client.

(A)   A formal inquiry is submitted directly to the community services provider administrator or the appropriate DDS area manager. An advocate general formal inquiry is submitted to the DDS director. The person to whom it is submitted has seven business days to respond in writing. The advocate general can grant an extension.

(B)   When the response to the formal inquiry does not resolve the concern that prompted the formal inquiry, the matter may be treated as a formal grievance and processed as a contested grievance.

(C)   The advocate general issues a report that sets forth the subject matter of the inquiry, the pertinent facts, and recommendations. An advocate general report is submitted to the administrator when applicable, and the State Office administrator. A copy is submitted to the DHS Director.

[Source: Added at 18 Ok Reg 3435, eff 7-1-01 (emergency); Added at 19 Ok Reg 1117, eff 5-13-02; Amended at 20 Ok Reg 1994, eff 7-1-03; Amended at 21 Ok Reg 2330, eff 6-25-04; Amended at 23 Ok Reg 1776, eff 6-11-06; Amended at 24 Ok Reg 978, eff 7-1-07; Amended at 31 Ok Reg 1790, eff 9-15-14; Amended at 34 Ok Reg 1402, eff 9-15-17]