(a) Application.  This Section describes processes relating to grievances of Hissom class members.  The Oklahoma Department of Human Services (OKDHS) legal basis and authority for grievance policies and procedures for Hissom class members includes orders of the United States District Court for the Northern District of Oklahoma in Homeward Bound, et al., vs. The Hissom Memorial Center, Case No. 85-C-437-E.

(b) Definitions.  The definitions in OAC 340:2-3-2 and 340:2-3-46(b) apply to this Section unless the context clearly indicates otherwise.  

(c) Notice of grievance rights.  The Office of Client Advocacy (OCA) advocate assigned to a Hissom class member gives Form 15GR007E, Notice of Grievance Rights - Hissom Class Members, at least yearly to each class member or his or her guardian(s), close family members, and volunteer advocates.  This form is used to identify the OCA advocate assigned to the class member and to explain the class member's right to grieve.  After the class member, guardian(s), or both, sign the form, the advocate documents this in a contact sheet and provides copies to the client or the client's guardian, the assigned Developmental Disabilities Services Division (DDSD) case manager, and the program coordinator of the applicable provider for placement in the client's home record.  The original is maintained in OCA's record for the class member.

(d) Filing and processing of grievances.  Grievances of class members are processed in accordance with OAC 340:2-3-45 unless otherwise provided in this Section.

• (1) OCA assigns an advocate to represent each class member.  The assigned advocate serves as the grievance advisor for the class member and provides assistance to class members and persons interested in their welfare who want to file a provider or OKDHS grievance.  [OAC 340:2-3-71(h)(4)]  When an advocate files a provider or OKDHS grievance on behalf of a class member, the advocate contemporaneously provides a copy of the grievance to the DDSD case manager assigned to the class member and to the DDSD programs administrator for community services.  • 1
• (2) Class members, their guardians, volunteer advocates and other advocates, case managers, personal support team members, and persons interested in their welfare also can file an OKDHS grievance by submitting Form 15GR001E, Grievance Form, to the local grievance coordinator (LGC) in the appropriate DDSD area office.  When the LGC receives a grievance that has not been submitted by the OCA advocate representing the class member, the LGC promptly informs the advocate of the grievance by e-mail, fax, or telephone.
• (3) If a grievance involves a decision of a class member's team, the first level respondent is the supervisor of the client's DDSD case manager, unless the case manager is involved in the decision being grieved.

(e) Provider grievances.

• (1) Each residential and vocational provider that contracts with DDSD to provide services to Hissom class members 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 class member, the assigned OCA advocate, or a person interested in the welfare of the class member by using Form 15GR001E 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 Hissom class member by anyone other than the OCA advocate or the DDSD case manager for the class member, the LGC promptly informs the DDSD case manager and the advocate assigned to the class member by e-mail, fax, or phone.  If an OKDHS employee initiates a grievance on behalf of a class member, at the time the grievance is filed the employee sends a copy to the DDSD case manager and the OCA advocate assigned to the class member.
• (3) If the subject matter of a grievance can be submitted for resolution as a provider grievance or an OKDHS grievance, the class member has the option to file it as a provider grievance, an OKDHS grievance, or both.

(f) Time limits on filing grievances.  The time limit in OAC 340:2-3-45(g) does not apply to grievances filed by or on behalf of Hissom class members.

(g) Fast track grievances.  When the subject of an OKDHS grievance is such that time is of the essence, with the approval of the advocate general or designee a grievance can be submitted directly to the OCA grievance liaison for processing as a contested grievance in accordance with OAC 340:2-3-46.  When a grievance involves a time sensitive problem, the OCA grievance liaison can shorten the time for responding as warranted by the circumstances.

(h) Second level problem resolution.  The area manager of the appropriate DDSD area office is the individual responsible for responding to an OKDHS grievance at the second level of problem resolution.

(i) Contested grievances.  When the response to an OKDHS or provider grievance is contested by a class member or a grievant on behalf of a class member, the contested grievance is processed in accordance with OAC 340:2-3-46 unless otherwise provided in this Section.  The director of DDSD is the state office administrator responsible for responding to contested grievances of class members.  • 2

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

(k) Formal inquiry.  The advocate general or any OCA advocate staff may file a formal inquiry to request information relating to:  the treatment of a client; the substance or application of any policy, rule, or regulation, written or unwritten, of OKDHS or an agent or contractor of OKDHS; or any decision, behavior or action of an OKDHS employee, agent or contractor, or of another client.

• (1) A formal inquiry is submitted directly to the administrator of a community services provider or the appropriate DDSD area manager.  An advocate general formal inquiry is submitted to the director of DDSD.  The person to whom it is submitted has seven business days to respond in writing.  The advocate general can grant an extension.
• (2) If 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.
• (3) 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 OKDHS Director.

(l) Advocate grievances.  An OCA advocate may file a grievance on behalf of a class member even though a grievance has not been filed by or on behalf of the class member.

• (1) At the discretion of the advocate general or designee, an advocate grievance is submitted directly to the administrator of a provider agency or the appropriate DDSD area manager using Form 15GR003E,  Grievance – Hissom Class Member.
• (2) An advocate general grievance is submitted directly to the director of DDSD or the administrator of the provider agency, whichever is applicable.
• (3) The person to whom it is submitted has seven business days to respond in writing.  The advocate general can grant an extension.
• (4) If the response to a grievance is not acceptable, or is not timely submitted, it is processed as a contested grievance pursuant to OAC 340:2-3-46.

(m) Monitoring of grievance programs.  Providers submit their policies for review and approval by the advocate general.  OCA provides training and technical assistance to providers, at their request, in the development of grievance forms and procedures.  OCA, in cooperation with other monitoring entities to avoid unnecessary duplication, monitors provider grievance programs in accordance with OAC 340:2-3-45(d) through (h).