(a) A contractor must develop and implement written
procedures for investigating and resolving a complaint about services
provided under a contract, other than an allegation of abuse, neglect,
or exploitation, that:
(1) allow a complaint to be submitted to the contractor:
(A) either orally or in writing; and
(B) anonymously; and
(2) require the contractor to:
(A) request, but not require disclosure of, the name,
mailing address, and telephone number of a complainant;
(B) investigate and resolve a complaint within 30 days
after the complaint is received by the contractor;
(C) document the name of the person who conducted the
investigation;
(D) document the name of persons contacted during an
investigation;
(E) obtain written statements from persons contacted
during an investigation or document conversations with those persons;
and
(F) provide the following information to the complainant
within 30 days after a complaint is received by the contractor, unless
the complainant did not provide a mailing address or phone number:
(i) the findings of the investigation;
(ii) the contractor's resolution of the complaint;
(iii) the telephone number of:
(I) HHSC Complaint and Incident Intake (1-800-458-9858),
if the contractor has a contract for:
(-a-) CLASS-CFS;
(-b-) CLASS-DSA;
(-c-) CLASS-SFS;
(-d-) the DBMD Program;
(-e-) the HCS Program;
(-f-) the TxHmL Program;
(-g-) hospice;
(-h-) the PHC Program;
(-i-) the CAS Program;
(-j-) DAHS;
(-k-) Title XX AFC and services are provided in an
AFC home serving four to eight people;
(-l-) Title XX RC;
(-m-) the CMPAS Program;
(-n-) the FC Program;
(-o-) SSPD and services are provided in a DAHS facility;
or
(-p-) SSPD-24-hour shared attendant care; or
(II) the HHSC Office of the Ombudsman (1-877-787-8999),
if the contractor has a contract for:
(-a-) CLASS-CMA;
(-b-) TAS;
(-c-) Title XX AFC and services are provided in an
AFC home serving fewer than four people;
(-d-) emergency response services;
(-e-) the HDM Program;
(-f-) SSPD and services are not provided in a DAHS
facility;
(-g-) FMSA-CLASS;
(-h-) FMSA-DBMD;
(-i-) FMSA-HCS;
(-j-) FMSA-PHC/CAS/FC; or
(-k-) FMSA-TxHmL; and
(iv) an explanation that the telephone number may be
used if the complainant is not satisfied with the contractor's resolution
of the complaint.
(b) The contractor must give the information described
in subsection (a)(2)(F) of this section as follows:
(1) in person, if the complainant is the individual
receiving services; or
(2) if the complainant is not the individual receiving
services:
(A) by mail, if the contractor knows the complainant's
mailing address; or
(B) by telephone, if the contractor does not know the
complainant's mailing address, but knows the complainant's telephone
number.
(c) A contractor must maintain a written log that contains
the following information:
(1) the date the contractor received a complaint;
(2) a description of the complaint;
(3) the findings of the investigation;
(4) the contractor's resolution of the complaint and
the date of resolution; and
(5) the date the contractor provided information to
the complainant in accordance with subsection (b) of this section.
(d) A contractor must provide the following information
to an individual and LAR:
(1) a description of the contractor's complaint process;
(2) the telephone number of:
(A) HHSC Complaint and Incident Intake (1-800-458-9858),
if the contractor has a contract for:
(i) CLASS-CFS;
(ii) CLASS-DSA;
(iii) CLASS-SFS;
(iv) the DBMD Program;
(v) the HCS Program;
(vi) the TxHmL Program;
(vii) hospice;
(viii) the PHC Program;
(ix) the CAS Program;
(x) DAHS;
(xi) Title XX AFC and services are provided in an AFC
home serving four to eight people;
(xii) Title XX RC;
(xiii) the CMPAS Program;
(xiv) the FC Program;
(xv) SSPD and services are provided in a DAHS facility;
or
(xvi) SSPD-24-hour shared attendant care; or
(B) the HHSC Office of the Ombudsman (1-877-787-8999),
if the contractor has a contract for:
(i) CLASS-CMA;
(ii) TAS;
(iii) Title XX AFC and services are provided in an
AFC home serving fewer than four people;
(iv) emergency response services;
(v) the HDM Program;
(vi) SSPD and services are not provided in a DAHS facility;
(vii) FMSA-CLASS;
(viii) FMSA-DBMD;
(ix) FMSA-HCS;
(x) FMSA-PHC/CAS/FC; or
(xi) FMSA-TxHmL; and
(3) an explanation that the telephone number may be
used to file a complaint with HHSC.
(e) A contractor must provide the information described
in subsection (d) of this section orally and in writing, as follows:
(1) before or at the time the individual begins receiving
program services from the contractor; and
(2) at least once every 12 months thereafter.
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Source Note: The provisions of this §49.309 adopted to be effective September 1, 2014, 39 TexReg 6637; amended to be effective September 1, 2018, 43 TexReg 5230; amended to be effective October 1, 2019, 44 TexReg 5149 |