| (a) OO staff maintain records of inquiries and complaints
in the HEART system.
(b) Texas Government Code §531.0171(d), allows
OO staff to access any system or process for recording inquiries and
complaints used or maintained by an HHS agency.
(c) OO staff compile a monthly report of consumer contacts
received by HHS programs, including those received by vendors contracted
to provide services on behalf of an HHS program. OO submits this report
to the HHSC Executive Commissioner and designated program management
staff across the HHS agencies on a quarterly basis. OO staff may also
provide reporting of program-specific contact data to management teams
of particular HHS programs.
(d) HHS programs have policies and procedures in place
that address:
(1) Tracking. Use of a formal tracking system that
captures essential information necessary for analysis, including:
(A) contact name and other identifying information;
(B) date contact received;
(C) method of receipt;
(D) reason for contact;
(E) details to isolate potential trends, such as location
or particular service;
(F) resolution actions;
(G) date of resolution;
(H) whether the complaint was substantiated; and
(I) record of final communication with consumer, including
date and method.
(2) Analysis. Monthly trend analysis to address shifts
in volume of contacts received greater than five percent within a
program. Research to determine the root causes for variations. For
example, changes in agency policy or procedures, newly implemented
programs, or staffing challenges that impact service delivery. The
analysis must include:
(A) a listing of the top five reasons for inquiries,
the top five reasons for complaints, and the top five reasons for
legislative contacts, as compared to the total number received;
(B) explanation of factors impacting changes in reasons
for contact from one month to the next; and
(C) data to indicate patterns, trends, or systemic
issues of which program staff should be aware.
(3) Reporting. Monthly submission of contact data in
the format determined by OO. Reporting must include:
(A) the number of inquiries, complaints, and legislative
contacts received;
(B) the number of complaints resolved (from that month
and previous months);
(C) the number of complaints resolved that were substantiated;
(D) the average time for resolution of complaints;
(E) the percent resolved within ten business days;
and
(F) summaries of cases that illustrate relevant patterns
or trends.
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