Title III Administrative and Financial Requirements Policy #19: Grievance Process for Older Individuals and Family Caregivers

This content is part of a public comment period. For more information, refer to Minnesota Board on Aging – State Plan on Aging.

Authority Reference	45 CFR Part 1321.9(c)(1)(viii)
Operating Category	Title III Administrative and Financial Requirements

Policy

1. Individuals served through Title III-funded programs have the right to respectful and responsive services. MBA is committed to ensuring a simple grievance process is available to older individuals and family caregivers, as well as their designated representatives. The grievance process is designed to bring complaints forward related to dissatisfaction with or denial of services under the Older Americans Act and have them resolved in a timely manner.

2. The grievance process must be designed to facilitate a path for resolution closest to the point of service delivery. Therefore, service providers must have a policy and procedure in place to notify recipients of services and those interested in receiving services of the grievance process available to them. The first steps of the grievance process must be managed by the service provider and is ideally resolved by the service provider.

3. MBA recognizes the limited funding available to provide services. The grievance process is not in place to require service providers or AAAs to provide services to individuals or family caregivers if resources are not available to provide those services, if the individuals filing a grievance are not eligible to receive services, or if individuals filing grievances do not meet prioritization criteria related to having greatest social need and/or greatest economic need. However, the grievance process must be available to all older individuals and family caregivers to address complaints related to dissatisfaction with or denial of services under the Older Americans Act.

4. The grievance process must include an opportunity for individuals to file an appeal if they are unsatisfied with the initial resolution by the service provider. AAAs must have a grievance process for individuals if they wish to appeal of the grievance resolution from the service provider. Likewise, the individual may subsequently appeal the AAA’s decision to MBA.

5. Service provider, AAA and MBA employees have the right to be treated with respect. If an individual filing a complaint behaves inappropriately by using profane or derogatory language or threatens the employee or employee’s family in any way, the service provider, AAA or MBA employee has the right to terminate the interaction. Service provider, AAA and MBA employees must first provide a verbal warning to the individual engaging in inappropriate behavior; if the individual continues to engage in inappropriate behavior, the service provider, AAA, or MBA employee may terminate the interaction or phone call. Should this occur, the service provider, AAA or MBA employee should document the situation.

6. The terms “grievance” and “complaint” are used interchangeably within this policy. Feedback and suggestions (for example, comments provided by a client satisfaction survey) are not considered a documented grievance or complaint and are therefore not subject to this policy. Service providers and AAAs should, however, take feedback and suggestions seriously as part of their ongoing quality assurance processes.

7. Concerns Related to Abuse, Neglect, or Financial Exploitation of Vulnerable Adults

All members of Minnesota’s aging network must be mindful of the Vulnerable Adults Act, maltreatment issues, and mandated reporting requirements. Maltreatment includes abuse, neglect, and/or financial exploitation. Any concerns about abuse, neglect, and/or financial exploitation should be reported by calling 1-844-880-1574.

If a grievance raises concerns about potential maltreatment, those concerns must be addressed through mandated reporting processes. This grievance policy is not the appropriate avenue to address those concerns.

8. Concerns about Fraud

Any concerns about potential fraud should be reported either on line at https://fraudhotline.dhs.mn.gov/ or by calling the Minnesota Fraud Hotline toll-free at 1-800-627-9977.

Procedures

1. Service providers must develop policies and procedures for a grievance process and must make information available about how to file a grievance related to dissatisfaction or denial of services. Notices about grievance processes must be posted prominently at congregate dining sites; at the offices of service providers; and on the websites of service providers.

A. Service providers must make an electronic or paper form available to individuals requesting to file a complaint. The complaint form must include fields for an individual’s contact information as well as the nature of the complaint and what, specifically, the individual would like to have resolved. The MBA will provide a template form that may be used; service providers may choose to use their own form if it includes at least the same information as the MBA template form. Forms must be made available in alternate languages upon request.

· i. Service providers must also have a form that allows an older Minnesotan to designate a representative to act on their behalf only for purposes of filing a complaint. The MBA will provide a template form that may be used for this purpose; service providers may choose to use their own form if it includes at least the same information as the MBA template form.

· ii. If an individual provides documentation of an established Power of Attorney, the service provider must accept that as documentation the individual designated as having Power of Attorney is the designated representative with no further documentation required.

· iii. A designated representative may receive information about the older adult filing the complaint.

· iv. The completed form designating a representative, or other legal documentation establishing the same, must be maintained on file and shared with the AAA and/or MBA.

B. Service providers must accept verbal or written complaints. Individuals may request assistance in filing a complaint; if such a request is made, the service provider must assist the individual in filing a complaint. If the complaint is verbal, the service provider must document the filing of the complaint in writing as explained by the individual filing the grievance.

C. A service provider who has received a complaint must assess the complaint and determine whether the complaint involves immediate health or safety issues for the individual filing the complaint. The service provider must address any health and safety-related complaints promptly, including by referring an individual to other community-based services if that service provider is unable to provide services to the individual.

D. A service provider must also make a determination as to whether the underlying circumstance may be reasonably remedied. Service providers must make reasonable efforts to address the underlying grievance within the limits of available funding and other relevant circumstances.

E. A service provider must follow up in writing with the individual filing a grievance with a response to the issue the individual has raised within 14 calendar days of receiving the complaint. The response must include whether or not the individual’s grievance can be remedied, how it can remedied, or if the complaint cannot be remedied, an explanation of the reason why this is the case. Service providers should aim to resolve all complaints within 30 calendar days of receipt. If the complaint is not resolved in 30 calendar days, the service provider will document the reason for the delay and a plan for resolution.

F. Service providers receiving a documented grievance must report this information in writing to the AAA with which they are contracted, within seven calendar days of receiving the complaint. Service providers must also report resolution of the complaint, within 30 calendar days of receiving the complaint. Information reported to the AAA must include the written complaint, the completed form authorizing a representative to act on the older adult’s behalf if one was completed, and the service provider’s written response to the grievance.

2. AAAs must also develop policies and procedures for a grievance process and must make information available about how to file a grievance related to dissatisfaction or denial of services. Notices about grievance processes must be posted prominently at AAA offices and on AAA websites.

A. AAAs must accept verbal or written complaints if an individual has already filed a complaint directly with a service provider and has received a documented response from the service provider as outlined in 1.D above.

B. The AAA must review the original complaint and the service provider’s response. The AAA may choose to conduct additional inquiry based on the unique circumstances of the situation or may determine the service provider already appropriately addressed the situation.

C. The AAA may work with the service provider to more fully address the individual’s complaint or refer the individual to another service provider as a potential avenue to remedy the complaint. AAAs must make reasonable effort to address the underlying grievance within the limits of available funding and other relevant circumstances.

D. In any case, the AAA must respond to the complainant in writing within 21 calendar days of receiving the grievance.

E. AAAs receiving a documented grievance must report this information in writing to MBA, along with the resolution to the complaint, within 30 calendar days of receiving the complaint. Information reported to MBA must include the written complaint, the completed form authorizing a representative to act on the older adult’s behalf if one was completed, and the AAA’s response.

F. AAAs must also maintain documentation about complaints filed and use that information as part of their monitoring and oversight processes for service providers.

G. Service providers and AAAs must maintain documentation associated with grievances for four years from the date the complaint or grievance was filed.

3. The final step of the grievance process within the aging network is with the MBA.

A. If an individual chooses to appeal previous responses to their complaint from both the service provider and the AAA, the individual or their representative may file a grievance with the MBA. The MBA must provide the individual appealing the prior responses to their grievance with an opportunity to explain why they are appealing.

B. The MBA may work with the AAA to more fully address the individual’s complaint or refer the individual to another service provider as a potential avenue to remedy the complaint. The MBA must make reasonable effort to address the underlying grievance within the limits of available funding and other relevant circumstances.

C. The MBA must respond to the complainant in writing within 21 calendar days of receiving the grievance.