(a) Application.  Grievance and Abuse Review (GARC) reviews unresolved contested grievances when the advocate general receives a proper request for GARC review in accordance with OAC 340:2-3-46(k).

(b) The GARC worksheet.  If the grievance was filed by or on behalf of a Developmental Disabilities Services Division (DDSD) services recipient who receives Office of Client Advocacy (OCA) advocacy services, including residents of the Southern Oklahoma Resource Center (SORC), the Northern Oklahoma Resource Center of Enid (NORCE), or the Greer Center Facility (Greer), the OCA advocate prepares a GARC worksheet using a format prescribed by OCA which includes:

• (1) the grievance number and the names of the resident, grievant, guardian, parent(s), case manager, and OCA advocate;
• (2) a summary of the grievance process, resolutions offered at each level and the decision makers' responses;
• (3) the applicable statutes, policies, and other authorities;
• (4) the resolution sought by the grievant;
• (5) relevant documentation;
• (6) the OCA advocacy position with regard to the subject of the grievance; and
• (7) a copy of Form 15GR001E, Grievance Form, and Form 15GR002E, Local Grievance Coordinator (LGC) Worksheet.

(c) GARC review summary.  For all grievances being reviewed by GARC, the OCA grievance liaison prepares a GARC review summary that is included in the GARC file.

(d) Scope of GARC review.  GARC conducts a de novo paper review of the grievance.

• (1) Within three business days of receiving a proper request for GARC review pursuant to OAC 340:2-3-46(k), the advocate general or designee informs the affected state office administrator and administrator of the date of the GARC meeting.
• (2) The grievant, administrators, state office administrators, and their designees may attend the GARC meeting to answer questions.  If a grievance involves a Hissom class member, the OCA programs administrator for the community advocacy program may also attend.
• (3) If the grievant wants to submit additional evidence not considered during the processing of the grievance, it is submitted to the advocate general within five business days of the request for GARC review, but not less than seven business days prior to the GARC meeting.  If the administrator or affected state office administrator wants to submit additional evidence not considered during the processing of the grievance, or when GARC review is the result of an untimely response in accordance with OAC 340:2-3-46(I), or for good cause shown, evidence can be submitted to the advocate general seven business days before the GARC meeting.
• (4) When additional information is needed in order for GARC to complete its review, GARC may continue its review of a grievance until its next meeting.  GARC may request additional information from OCA, an administrator, or a state office administrator.

(e) GARC report contents.  Within 15 business days of a GARC meeting to review an unresolved grievance, GARC prepares a report that includes:

• (1) the subject of the grievance and identifying information about the grievant, the administrator, and the state office administrator;
• (2) the procedural history of the grievance, identifying proposed resolutions and responses at each level in the grievance process prior to the GARC review;
• (3) the resolution sought by the grievant and the resolution proposed by the state office administrator;
• (4) GARC recommended resolution of the grievance;
• (5) the facts on which GARC bases its recommendation;
• (6) the information GARC considered in making its recommendation; and
• (7) areas of concern identified by GARC during its review of the grievance.

(f) Distribution of GARC report.  The advocate general forwards the GARC report to the applicable local grievance coordinator (LGC).  Within three business days of receipt of  the GARC report, the LGC contacts the decisionmaker to inform him or her of  the GARC recommended resolution, and determines if the decisionmaker is satisfied with it.

• (1) If the decisionmaker needs time to decide whether to accept the proposed resolution, the decisionmaker has three business days to make a decision.  If no decision is communicated to the LGC within three business days, the decisionmaker is deemed to have accepted the proposed resolution.
• (2) If the decisionmaker is satisfied, the LGC notifies the advocate general, and the advocate general then notifies interested parties.  An affected state office administrator has three business days from receipt of this notification to submit to the advocate general a written request for review by the Oklahoma Department of Human Services (OKDHS) Director.
• (3) If the decisionmaker is not satisfied with  the GARC recommended resolution and elects to contest it, the LGC notifies the advocate general within four business days of receipt of the GARC report.  The advocate general or designee transmits the request and  the GARC report for review by the OKDHS Director.

(g) OKDHS Director's review of a GARC recommendation.  Upon receipt by the advocate general of a proper and timely written request for review by the OKDHS Director, pursuant subsection (e) of this Section, the advocate general or designee transmits the request and the GARC report to the OKDHS Director.

• (1) Within 15 business days of receipt of  the GARC report, the OKDHS Director decides whether to:
  • (A) adopt the GARC recommended resolution;
  • (B) adopt the GARC recommendation with modifications;
  • (C) return the matter to GARC for further consideration; or
  • (D) direct another resolution of the grievance.
• (2) If the OKDHS Director does not respond within 15 business days, the grievance is deemed resolved in accordance with the GARC recommended resolution.
• (3) The advocate general notifies the grievant and other interested parties of the result of the OKDHS Director's review.  The decisionmaker is informed that this concludes the grievant's administrative remedies.  If the grievant is a minor, a copy of the grievance and related materials are forwarded to the Office of Juvenile Systems Oversight in the Oklahoma Commission for Children and Youth.

(h) Monitoring of resolution.  If the resolution of the grievance involves an action to be taken by an OKDHS employee by a future target date, the OCA grievance liaison monitors compliance with that target date.  In the event the resolution is not implemented or not implemented within the time specified, the OCA grievance liaison informs the advocate general and the advocate general notifies the OKDHS Director in writing.