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(C) Complaints. The provider organization must implement
written policies and procedures for individuals' complaints.
These policies and procedures must, at a minimum, provide for:
(i) Receipt of complaints from an individual or others
acting on the individual's behalf. If the complaint is
associated in any way with abuse or the violation of the
individual's rights, the recipient of the complaint must
immediately report the issue to the provider organization
director and the CDDP;
(ii) Investigation of the facts supporting or disproving the
complaint;
(iii) Taking appropriate actions on complaints within five
working days following receipt of the complaints;
(iv) Submission to the provider organization director. If the
complaint is not resolved, the complaint must be
submitted to the provider organization director for review.
The provider organization director must complete a
review and provide a written response to the complainant
within 15 days of request for review;
(v) Submission to the brokerage. All complaints received
from an individual or others acting on the individual's
behalf must be reported to the appropriate brokerage; and
(vi) Notification. Upon entry into the program and annually
thereafter, the provider organization must inform each
individual, or the individual's legal representative, orally
and in writing, using language, format, and methods of
communication appropriate for the individual's needs and
abilities, of the provider organization's complaint policy
and procedures.
(D) Policies and procedures appropriate to scope of service
including but not limited to those required to meet minimum
standards set forth in sections (2)(f) through (2)(k) of this rule
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