Complaint/Grievance Process

Client's Rights and Grievance Policy

The Community Mental Health and Recovery Board of Wayne and Holmes Counties requires each contract agency to appoint a Client's Rights Officer and alternate to be available to discuss concerns or complaints from consumers, family members or advocates regarding adherence to the following list of consumer's rights. A consumer grievance may be filed with the agency Client's Rights Officer when there is a concern.

In addition, the Board appoints a Client's Rights Officer for the system and has an established protocol for responding to concerns as well. (See policy below after list of rights.)

Each person who receives services from a provider under contract with the Mental Health and Recovery Board of Wayne and Holmes Counties has the following rights:

1. The right to be treated with consideration and respect for personal dignity, autonomy, and privacy;
2. The right to service in a humane setting which is the least restrictive feasible as defined in the treatment plan;
3. The right to be informed of one's own condition, of proposed or current services, treatment or therapies, and of the alternatives;
4. The right to consent or refuse any service, treatment, or therapy upon full explanation of the expected consequences of such consent or refusal. A parent or legal guardian may consent to or refuse any service, treatment or therapy on behalf of a minor client;
5. The right to a current, written, individualized service plan that addresses one's own mental health, physical health, social and economic needs, and that specifies the provision of appropriate and adequate services, as available, either directly or by referral;
6. The right to active and informed participation in the establishment, periodic review, and reassessment of the service plan;
7. The right to freedom from unnecessary or excessive medication;
8. The right to freedom from unnecessary restraint or seclusion;
9. The right to participate in any appropriate and available agency service, regardless of refusal of one or more other services, treatments, or therapies, or regardless of relapse from earlier treatment in that or another service, unless there is a valid and specific necessity which precludes and/or requires the client's participation in other services. This necessity shall be explained to the client and written in the client's current service plan;
10. The right to be informed of and refuse any unusual or hazardous treatment procedures;
11. The right to be advised of and refuse observation by such techniques such as one-way mirrors, tape recorders, televisions, movies, or photographs;
12. The right to have the opportunity to consult with independent treatment specialists or legal counsel, at one's own expense;
13. The right to confidentiality of communications and of all personally identifying information within the limitations and requirements for disclosure of various funding and /or certifying sources, state or federal statutes, unless release of information is specifically authorized by the client or parent or legal guardian of a minor client or court-appointed guardian of the person of an adult client in accordance with rule 5122:2-3-11 of the administrative code;
14. The right to have access to one's own psychiatric, medical or other treatment records, unless access to particular identified items of information is specifically restricted for that individual client for clear treatment reasons in the client's treatment plan. "Clear treatment reasons" shall be understood to mean only severe emotional damage to the client such that dangerous or self-injurious behavior is an imminent risk. The person restricting the information shall explain to the client and other persons authorized by the client the factual information about the individual client that necessitates the restriction. The restriction must be renewed at least annually to retain validity. Any person authorized by the client has unrestricted access to all information. Clients shall be informed in writing of agency policies and procedures for viewing or obtaining copies of personal records;
15. The right to be informed in advance of the reason(s) for discontinuance of service provision, and to be involved in planning for the consequences of that event;
16. The right to receive an explanation of the reasons for denial of service;
17. The right to not be discriminated against in the provision of service on the basis of religion, race, color, creed, sex, national origin, age, lifestyle, physical or mental handicap, developmental disability, or inability to pay;
18. The right to know the cost of services;
19. The right to be fully informed of all rights;
20. The right to exercise any and all rights without reprisal in any form including continued uncompromised access to service;
21. The right to file a grievance; and
22. The right to have oral and written instructions for filing a grievance.

    Purpose

    The purpose of this policy is to protect and enhance the rights of persons applying for or receiving public mental health services or substance abuse by establishing specific rights of clients and procedures for responsive and impartial resolution of client grievances.

    Definitions

    Board The Mental Health and Recovery Board of Wayne and Holmes Counties

    Complaint Means any concern communicated by a person questioning the personal care or clinical treatment received by the person served, the environmental conditions, or any aspect of services received. Complaints consist of issues less severe and complex than a grievance. Any complaint alleging violation, denial, exercise or abuse of client rights is considered a grievance. A complaint is a less formal process than a grievance.

    Client An individual applying for or receiving mental health services from the Board or a mental health agency with a contract with the Board.

    Client's Rights Officer The individual designated by a mental health agency or the Board with the responsibility for assuring compliance with the client rights and grievance procedure as implemented within each agency and Board. For these purposes, the individual holds the specific title of Client's Rights Officer.

    Contract Agency A public or private service provider with which the Board enters into a contract for the delivery of providing mental health services.

    Grievance A written complaint initiated either orally or in writing by a client or by any other person or agency on behalf of a client regarding denial or abuse of any client's rights.

    Investigation Any steps taken toward substantiating or refuting the allegations and arriving at the resolution of a complaint, grievance or appeal. Steps may include chart reviews, interviews of persons involved, background information and review of appropriate policies, procedures and standards.

    Client Rights and Grievance Policy

    This grievance/complaint policy is to provide for prompt and equitable resolution of grievances/complaints brought to the Board by a client, regarding denial or abuse of any client's rights pursuant to ODMH rule 5122:2-01-02, ODADAS rules, and to register a complaint about the Board's privacy policies or procedures.

    1. Any contractual client services provider of the Mental Health and Recovery Board (MHRB) shall have policies and procedures pertaining to client's rights, grievances and or complaints about the agency's privacy policies.

    a. These policies/procedures shall be in written form and have been officially approved by the governing body of the service provider.
    b. As applicable these policies/procedures shall comply with the requirements of ODMH rule 5122:2-01-02, and CFR 45 164, HIPAA, and ORC 1347.
    c. Compliance with the above will be part of the written terms of the Board services contract and shall be reviewed annually.
    d. The Board shall receive annually from each of the agency Client's Rights Officers a summary of the number of grievances received, types of grievances, and resolution status of grievances.

    2. The Board will ensure compliance with ODMH 5122:2-01-02 as part of its community plan.

    Procedure:

    1. The Mental Health and Recovery Board client rights and privacy grievance/complaint procedure will be as follows:

    a. A grievance/complaint must be in writing and signed by the person filing the action. If necessary, the Board's Client's Rights Officer will assist in putting the grievance in written form. The grievance must identify (a) the name and address of the person who allegedly was grieved, (b) the name and address of the person filing the grievance/complaint [if different from (a)], (c) the person and/or organization against which the grievance is being filed, and (d) briefly describe the action upon which the grievance is based.
    1. Any grievances/complaints will be directed to the designated Client's Rights Officer of the Board, who also serves as the Board Privacy Officer.
    2. The PHI Complaint Form will be used to file a privacy complaint.
    3. All other grievances/complaints will use the Client Grievance Form.
    4. The Client's Rights Officer shall conduct an investigation of a grievance/complaint to determine its validity and make efforts toward its resolution among the parties involved. All interested persons and their representatives, if any, will have an opportunity to submit evidence relevant to a grievance. If the subject of the grievance is a contract agency or its employee, rather than the Board itself, the procedures listed in paragraph b, 2) will be followed.
    5. The Client's Rights Officer shall issue a written decision determining the validity of the grievance/complaint and describing its disposition no later than 20 days after its filing.
    6. If the grievance/complaint has not been resolved at this point, the Client's Rights Officer will forward it to the Executive Director of the ADMH Board, who shall have an additional 20 days to resolve the grievance. The Executive Director shall notify the grievant in writing of the decision and list the evidence on which the decision is based.
    7. If the grievance is still unresolved, the grievant may request that the Executive Director submit the grievance/complaint to the Board and this shall be done. In such instances, the matter shall be referred to the Board's Personnel Committee (or other group designated by the Board Chair) and a recommendation for final disposition shall be made at a meeting of the full Board, which shall take place not later than 45 days following the appeal to the Board level.
    8. 8) The Board shall also advise any grievant of the grievant's option to grieve further with any or all of the following: Department of Mental Health, Department of Alcohol and Drug Addiction Services, Ohio Legal Rights Service, the Secretary of the U.S. Department of Health and Human Services, appropriate professional licensing or regulatory boards. Relevant names, addresses, and phone numbers shall also be provided.
    9. 9) No Board officer, employee or agent shall intimidate, threaten, coerce, discriminate against, or take other retaliatory action against any individual who files a complaint with the Board or with other appropriate entities to receive complaints and grievances. An officer, employee or agent who discriminates or retaliates against an individual who files a complaint to the Board shall be subject to disciplinary action up to and including termination.

    1. Formal grievances/complaints which come directly to the Board involving contract service providers will be handled as follows:

    a. A written copy of the Board's grievance/complaint procedure will be available to the griever upon request.
    b. The Board's designated client's rights officer will conduct a preliminary investigation of the grievance within ten working days of its filing. Based upon this preliminary investigation, the disposition will be as follows:
    1. If the agency's internal grievance procedure has not yet been exhausted, the matter will be referred to the agency for further consideration and attempt at resolution. If the client so chooses they can opt to file a complaint directly to the Board and follow the procedures in 1., a.
    2. If the agency's internal grievance procedure has already been exhausted and the matter under dispute lies within the scope of the Board's direct responsibility and authority under ORC 340, and/or the Board-Agency Contract, the Board shall conduct a full investigation and work toward resolution of the issue involved following the Board's grievance/complaint procedure, as described in Section III-A of this document.
    3. If the agency's internal grievance procedure has already been exhausted and the matter under dispute lies outside the scope of the Board's direct responsibility and authority under ORC 340, and/or the Board-Agency Contract, the Board shall conduct an investigation to the extent appropriate for the issue involved. As part of this process, the Board may make recommendations to appropriate parties as to how the specific issue might be resolved and/or pursue revisions of the Board's community plan, the Board- Agency Contract, or Board policies and procedures.

    3. The Client's Rights Officer shall create an annual summary concerning all formal grievances filed with the Board, including the subject of the grievance, the resolution of each, and any policy recommendations resulting from consideration of the grievances. The Executive Director will keep the Board informed, on an as needed basis, of any problematic cases that may require special attention.

    4. The Client's Rights Officer for the Board will be that person designated as such by the Executive Director. The name, address, and telephone number of the Client's Rights Officer shall be posted, along with a statement of client rights, in the Board offices.

    a. The current Client's Rights Officer for the Board is Associate
    Director Kim Tapie,215 S. Walnut St., Wooster, Ohio 44691.
    Phone: 330-264-2527. Availability 8 a.m.-5 p.m. Monday through Friday
    b. Should the current officer leave that position, another officer will be appointed and this policy updated to reflect that name change.
    c. Should the current officer be unavailable, the Executive Director can fill in for the Client's Rights Officer or designate another staff person to carry out the procedure.

    Other Agencies Where You May File a Complaint

    Ohio Department of Mental Health
    30 E. Broad St., Suite 1180
    Columbus, OH 43215-3430
    (614) 466-2596

    Ohio Legal Rights Service
    8 E. Long St., 8th Floor
    Columbus, OH 43266-0568
    (614) 466-726
    800-466-7264

    Attorney General's Office, Medicaid Fraud Control Section
    30 E. Broad St., 17th Floor
    Columbus, OH 43215-3428
    (614) 466-4320

    Governor's Office of Advocacy for People with Disabilities
    8 E. Long St., 7th Floor
    Columbus, OH 43266-0400
    (614)466-9956

    HIPAA - Privacy Complaint
    Secretary of Health and Human Services
    7500 Security Blvd. C5-24-04
    Baltimore, MD 21244

    Counselor & Social Worker Board
    65 S. Front St., Suite 210
    Columbus, OH 43266-0329
    (614) 466-0912

    State Medical Board
    65 S. Front St., Suite 510
    Columbus, OH 43266
    (614) 466-3934

    Nursing Education & Nurse Registration Board
    65 S. Front St., Room 509
    Columbus, OH 43266
    (614) 466-3947

    State Board of Psychology
    65 S. Front St., Suite 507
    Columbus, OH 43266
    (614) 466-8808

    US Department of Health and Human Services
    Office of Civil Rights Region 5
    300 Walker Drive
    Chicago, IL 60606
    (312) 886-5078