OAR 309-035-0183: Individual Grievances and Appeals

(1) The provider must post the Division complaint poster and abuse reporting information in a prominent location in the common area. (2) The provider must develop and implement written policies and procedures concerning the grievance and appeal process. A copy of the grievance and appeal process must be posted in a place readily accessible to residents. A copy of the grievance and appeal process must be provided to each resident at the time of admission to the program in the resident’s primary language. (3) A provider's process for grievances must, at a minimum, include the following: (a) Residents must be encouraged to informally resolve complaints through discussion with program staff. Informal complaints and resolutions must be documented by staff and include the name of the resident, date of the complaint, description of the complaint, and how it was resolved; and (b) If the resident is not satisfied with the informal process or does not wish to use it, the resident may proceed as follows: (A) The resident may submit a formal grievance in writing to the program administrator. The resident may receive assistance in submitting the grievance from any person whom the resident chooses. If requested by the resident, program staff must be available to assist the resident; (B) The written grievance must go directly to the program administrator without being read by other program staff unless the resident requests or permits other program staff to read the grievance; (C) The grievance must include the reasons for the grievance and the proposed resolutions. No grievance shall be disregarded because it is incomplete; (D) Within five calendar days of receipt of the grievance, the program administrator must meet with the resident to discuss the grievance. The resident may have an advocate or other person of their choosing present for this discussion; (E) Within five calendar days of meeting with the resident, the program administrator must provide a written decision to the resident. As part of the written decision, the program administrator must provide information about the appeal process; and (F) In circumstances where the matter of the grievance is likely to cause irreparable harm to a substantial right of the resident before the grievance procedures outlined in OAR 309-035-0183 are completed, the resident may request an expedited review. If an expedited review is requested, the program administrator must review and respond in writing to the grievance within 48 hours. The written decision must include information about the appeal process. (4) A resident, a resident’s legal representative if applicable, the Division or other Division-approved party, shall have the right to appeal admission and grievance decisions as follows: (a) If the resident or proposed resident is not satisfied with the decision, the resident, the resident’s legal representative if applicable, the Division or other Division-approved party may file an appeal in writing within ten calendar days of the date of the program administrator's decision to the grievance, or notification of admission denial (b) If program services are delivered by a person or entity other than the Oregon State Hospital or the CMHP, the appeal must be submitted to the CMHP director or designee in the county where the program is located. The CMHP must hold an appeal conference no later than 10 calendar days after the request is received unless otherwise mutually agreed upon by the program and the resident or the resident’s legal representative, if applicable. (A) The resident may receive assistance in submitting the request for an appeal conference. If requested by the resident, program staff must be available to assist the resident; (B) If a resolution is reached at the appeal conference, the resolution must be documented in writing and the resolution considered final. The CMHP director or designee must provide the written resolution within ten calendar days of the appeal conference; and (C) If a resolution is not reached at the appeal conference, the CMHP Director or designee must issue a written decision of the appeal and provide a copy to the provider, the resident, and the resident’s legal representative, if applicable or the proposed resident as applicable; (D) If the resident is not satisfied with the appeal conference decision, the resident may request a second appeal in writing within ten calendar days of the date of the appeal conference decision to the Division. Any supporting documentation must be submitted with the request. (E) The Division will review the appeal and all supporting documentation and issue a written decision within 10 calendar days of receipt of the appeal to the resident, the program and the CMHP. The Division’s decision shall be final. (c) If program services are delivered by a CMHP, the appeal must be submitted to the Division: (A) The resident may receive assistance in submitting the request for appeal. If requested by the resident, program staff must be available to assist the resident; (B) The Division’s designee must review the appeal and all supporting documentation and issue a written decision within 10 calendar days of receipt of the appeal to the resident, the program and the CMHP; and (C) If the resident is not satisfied with the Division designee’s decision, the resident, may submit a second appeal in writing within ten calendar days of the date of the written decision to the deputy director of the Division. (D) The deputy director must review the appeal and all supporting documentation and issue a written decision within 10 calendar days of receipt of the appeal to the resident, the program and the CMHP. The deputy director’s decision shall be final.