Client Interests - Client Grievance Process
- To develop a process for capturing and utilizing client feedback and concerns to enhance the provision of services at Riverview Psychiatric Center.
- To utilize Peer Specialists to support clients in participating in organizational improvement through sharing Concerns / Suggestions/ Grievances.
- To utilize Peer Support in assisting clients to solve concerns and suggestions in a less formal more appropriate means than the formal grievance process.
- To assist clients in having even rights violations solved at the lowest level possible and to provide feedback on what are concerns or problems maybe more easily or expeditiously addressed in a different manner than the grievance process.
- To uphold each clients right to file grievances in accordance with all federal, state, licensing, accreditation, and other legal standards.
Client Concerns / Suggestions/ Grievances will be sought as an important source of information useful in continuously improving service.
- Clients have the right to due process with regard to grievances. This due process is spelled out in Code of Maine Rules, 14-193 CMR ch. 1, Part A, section VII, and "Rights of Recipients of Mental Health Services."
- Notwithstanding any other civil or criminal recourse the person bringing the grievance may have, the Hospital welcomes and affords every opportunity for informal resolution of concerns, or grievances or formal resolution of grievances.
- Notice summarizing a client's right to due process with regard to grievances, as well as copies of forms to be used for that purpose, are available within each program area. Each client is informed of this right, in a manner designed to be comprehensible to the individual recipient, by an employee of the hospital.
- Burden of proof in all grievances is on the Hospital to show compliance, or remedial action to comply with policies and procedures established to ensure the rights of Clients under Department rules.
Concern/ Suggestions and Grievances
The Hospitals Concerns or Suggestion procedure is the following:
- A Concern / Suggestion/ Grievance box shall be placed on each treatment unit, the treatment mall, and the cafeteria. A Concern/suggestion form shall be made available in the same location of each box. Any person, on behalf of a client, may also initiate a Concern/suggestion or Grievance by completing a form and placing it in the box or handing it to any RPC employee who will deposit it in the box for them.
- Clients will be informed of this opportunity upon admission by the peer support worker.
- A client or a staff member may help a client complete a Concern / Suggestion/ form as the client directs, or a client may fill out the form independently. A client or staff may place the completed form in the locked box on the clients behalf.
- The morning of each business day a Peer Specialist will collect the forms and schedule a meeting with each client to: (1) enhance understanding of the clients area of concern and (2) enhance understanding of the outcome sought by the client (3). Assist the client in choosing the most appropriate means of solving their concern or suggestion. The Peer Specialist may rewrite the form with the clients permission to augment the communication.
- Within 24 hours of receipt of the Concern/Suggestion form the Peer Specialist shall send a copy the form to the RPC Risk Manager as well as to whoever the responder will be.
- The Risk Manager will maintain a file of reviewed forms and assure that clients concerns or suggestions are responded to in a timely fashion.
- The Peer Specialist shall send the original form to the appropriate first review party.
- The first review party shall review the form and meet with the client to discuss the Concern, or suggestion and look for resolution. The first responder shall write the proposed outcome on the form after discussion with the client. The recommendation must be made by the end of the 5th regular business day unless the Superintendent grants an extension (up to an additional 5 days).
- The first responder shall review the form with the client and ask the client to mark his/her reaction at the bottom: [ ] Agrees, [ ] Disagrees, [ ] Disagrees, please move to a grievance and obtain the clients signature on the form and date it.
- A Grievance form shall be made available, upon request, to the client.
- Within 24 hours of receipt of the Grievance form the Peer Specialist shall send a copy the form to the Office of Advocacy and to the RPC Risk Manager.
- The Peer Specialist shall send the original form to the appropriate first review party.
- Grievances marked urgent will be forwarded to the Superintendent for review. Upon receipt of the grievance form in the Superintendents office, a date stamp will be affixed to the grievance form.
- Grievances marked non-urgent will be forwarded to the appropriate PSD or a designee for review. Upon receipt of the grievance form, the PSD or designee will sign, date and time the form in the appropriate location.
- The PSD will be the primary responsible party for the review of all Level I grievances. In the absence of the PSD, the unit RN-IV will be the secondary responsible party and the section ADON will be the tertiary responsible party.
- The Superintendent may, upon initial review of a grievance marked urgent, address the grievance as a Level II grievance, or send the grievance to the appropriate PSD for review as a Level I grievance.
- The first review party shall review the Level I grievance and meet with the client to discuss the grievance and look for resolution. The first responder shall write the proposed outcome on the form after discussion with the client. Recommendations must be made by the end of the 5th regular business day unless the responder asks for a five day extension and the Superintendent grants an extension. The client is notified in writing of the extension.
- The first responder shall review the form with the client, sign and date it and ask the client to mark his/her reaction at the bottom: [ ] Agrees or [ ] Disagrees and obtain the clients signature on the form.
- In the event that a resolution of a grievance cannot be investigated or resolved with the client within the prescribed time frame due to the clients clinical condition, documentation of a thorough investigation of the issue including the accurate and diverse statements of reliable and impartial witnesses, absent of the clients input, will suffice as a resolution of the subject of the grievance.
- Any grievance that requires extensive time or expenditures to fully be resolved will be considered to be resolved when a plan of action has been defined and approved by the appropriate hospital administrator.
- The Risk Manager will maintain a file of clients grievances.
- If a client disagrees with the grievance response he or she has 10 days to appeal the decision of the PSD to the Superintendent.
- The Superintendent shall review the grievance and any investigative material available and offer a proposed outcome to the client. This response will most often be in the form of a personal letter. The client shall review the letter and mark his/her reaction at the bottom: [ ] Agrees or [ ] Disagrees.
- If the client disagrees, he or she has 10 days to appeal the decision of the Superintendent to the Deputy Commissioner of Program Services in the Department of Health and Human Services.
- The Grievance Rules shall then be implemented consistent with the Code of Maine Rules, 14-193 CMR ch. 1, Part A, section VII, and "The Rights of Recipients of Mental Health Services." Grievances may be found without merit by the superintendent, who may first confer with the advocates for concurrence.
Any Concern, Suggestion or Grievance regarding abuse, mistreatment, or exploitation.
- The Allegations of Client Mistreatment Including Abuse, Neglect or Exploitation policy (# PC 3.10.2) is to be followed.
- Any allegation of abuse, mistreatment, or exploitation shall be immediately reported to the Advocates office and to the Department.
- Peer Specialists shall forward any grievance that the grievant considers urgent within one working day to the Superintendent. This will be considered a Level II grievance. A copy of the grievance will be sent to the Advocates office. The Superintendent, who shall either arrange to hear the grievance within three working days or immediately refer the grievance to Level I, must review such grievances.
Note: Once all levels of administrative redress have been exhausted, the grievant may appeal civil issues to the Superior Court under the Maine Rules of Civil Procedure.
- Responsibility: Risk Manager
- Policy Stored In: Superintendents office
- Policy Applies To: Riverview Psychiatric Center
- Key Search Words: Client Grievances
- References:Joint Commission. 2.120 CMS 482.13a2Me Hospital Licensing XXAA.2d; XXI.C.b. Allegations of Client Mistreatment Including Abuse, Neglect, or Exploitation PC 3.10.2