13202.1 DDA Complaint System
DDS shall establish a DDA Complaint System that complies with the applicable federal and District laws and regulations including the Disability Services Reform Amendment Act of 2018 and these rules. DDA shall adopt a complaint policy and procedure(s), and involve DDA stakeholders in the policy and procedure development process. The DDA Complaint System shall be available to people receiving DDA supports and services.
13202.2 Representatives
A person has the right to representation when using the DDA Complaint System, but DDS shall not appoint, assign or compensate a person's representative.
13202.3 Supporters
A person may choose one or more informal or formal supporters to assist them throughout the DDA Complaint System. DDS shall not appoint, assign or compensate a person's supporter, except that support may be available through the Peer Support Pilot Program governed by Section 13203. In the event that a person brings a supporter to or requests their presence during any DDA Complaint System process, DDS, the external reviewer or the provider, respectively, may disclose persona l information during the meeting without first obtaining written consent from the person or the person's representative. By inviting a third-party supporter to participate in any Complaint System process, the person is considered to have provided implied consent to release information in the presence of the third party during the proceeding.
13202.4 Representatives and supporters are subject to the requirements of federal and District law regarding the confidentiality of protected mental health, medical and other information about a person.
13202.5 Witnesses
DDS has no obligation to compensate any witnesses through the DDA Complaint System, except that DDS staff may serve as witnesses as part of their official duties when DDS requires them to do so.
13202.6 Incidents
(a) When the complaint coordinator receives a complaint that appears to be a Serious Reportable Incident (SRI) under DDS policy, the complaint coordinator shall refer the matter to the DDS Incident Management and Enforcement Unit (IMEU) for consideration of whether an investigation should be initiated under DDS's IMEU Policy and Procedures. The complaint coordinator shall place an administrative hold on the complaint in the DDA Complaint System when the IMEU accepts it. DDS shall provide notice to the person of the administrative hold on the complaint.(b) Upon completion of the IMEU investigation, the complaint coordinator will contact the person to determine whether the resolution and recommendations from the investigation adequately addressed the complaint raised. If not, the complaint process will resume. If all issues have been addressed, the complaint will be administratively closed with a note that the investigation addressed all concerns.13202.7 Provider Complaint Files and Records
(a) Unless a person expresses a good faith, reasonable fear of retaliation, he or she is generally required to file a complaint about a provider with the provider and use the provider's complaint process as outlined at Section 13204, Filing A Complaint With A Developmental Disabilities Administration Provider. The result of the provider complaint process may be a provider Chief Executive Officer (CEO) written decision, which the person, if not satisfied with the result, may then appeal to DDA under Section 13205, Filing a Complaint With the Department On Disability Services, Developmental Disabilities Administration. (b) When a person appeals the provider CEO written decision by filing a complaint with the DDA Complaint System, DDS shall request a copy of the provider CEO final decision from the person.(c) If a person appeals a provider CEO final decision to DDS, the provider is required to supply records to DDS, including the provider's complaint file and provider CEO final decision, within five (5) business days of DDS's request.(d) The DDA Complaint System shall begin when DDS receives from the provider the complaint file including the provider CEO final decision, or on the 6th business day, whichever is sooner.13202.8 A person's issue involving a specific DD A provider staff member or contractor shall be treated as involving the DDA provider that employs or contracts with the staff member or contractor.
13202.9 Time Limit For Filing A Complaint
(a) A person must file their complaint within 90 calendar days from the last date on which the events which took place, or did not take place when the person believes they should have, giving rise to the issue.(b) A person may also file a complaint while the events are ongoing.13202.10 Waiver Of The 90 Calendar Day Complaint Filing Deadline
A person may request a waiver of the 90 calendar day filing requirement from the DDS Director, or his or her designee. The request must include the facts the person asserts supports their request for waiver.
(a) The Director shall grant a waiver for the following reasons: (1) The events that form the basis of the issue could not reasonably be expected to be known by the person or their representative within the 90-day period;(2) The person was not able to effectively communicate their is sue or supporters were not able to understand a person's communication well enough to help him or her file an issue;(3) Illness or incapacitation of the person; or(b) The Director may grant a waiver for other reasons that he or she determines to be reasonable.(c) The length of waiver granted by the DDS Director shall be reasonable and be based on the nature and timing of the circumstances.(d) In the interests of resolving a person's issue as quickly as possible, customer service may continue to attempt to resolve an issue that is past the complaint-filing deadline.13202.11 Types Of Complaints That May Be Filed
The DDA Complaint System shall be limited to the following types of issues (and to use by people receiving DDA supports and services as specified in Section 13202.1):
(a) The denial, delay, reduction or termination of DDA supports or services;(b) The application of DDA policies, procedures or practices to the person; and(c) The application of DDA providers' policies, procedures, or practices to the person.13202.12 Types Of Complaints Not Allowed
The DDA Complaint System may not be used to challenge a pending IMEU investigation or to appeal the report of an IMEU investigation. Where DDS accepts a complaint and then discovers during any time that it is not the type of issue that can be resolved through the DDA Complaint System, DDS shall stop the process and administratively close the complaint. DDS shall provide written notice, including the reason for administrative closure, to the person who filed the comp laint.
13202.13 Administrative Closure
DDS or the provider, as appropriate, shall administratively close a complaint that is outside of the types of issues that may be filed or resolved through the DDA Complaint System under Section 13202.11. DDS or the provider shall provide the person with notice, based on the person's preferred mode of communication, including the reason for administrative closure.
13202.14 Reconsideration On Administrative Closure
If a person disagrees with DDS' administrative closure under Section 13202.13, the person may file a request for reconsideration of that decision with the DDS Director, or his or her designee, within fourteen (14) calendar days. DDS will issue a decision on the request for reconsideration within fourteen (14) calendar days of the request. A DDS reconsideration decision is a final agency decision.
13202.15 No Retaliation
Neither DDS nor a provider shall retaliate against a person, his or her supporter or representative, a third-party complaint filer, or a person's witness to facts alleged in a complaint, because of a complaint filed with a provider or DDS. An allegation of retaliation for filing a complaint shall be treated and filed as a new complaint with the provider or DDS or, if it meets the DDS definition of an SRI, be investigated in accordance with DDS's IMEU policy and procedures.
13202.16 External Reviewers
DDS shall contract with one or more external reviewer(s) to provide timely, neutral and impartial review of and recommendations for resolution of issues in Stage 3 of the DDA Complaint System in accordance with these rules. The Director, or his or her designee, shall select the external reviewer. Any external reviewer with whom DDS contracts to review and resolve one or more complaints shall be required to have the following minimum qualifications:
(a) Experience with alternative dispute resolution, including mediation and/or arbitration;(b) Experience working with people with intellectual disabilities; and(c) An understanding of the DDA service delivery system.13202.17 Release Of Records
(a) A DDA provider shall release information regarding an issue to the person or their representative, upon receipt of a valid authorization for disclosure from the person, including those documents in the possession, custody or control of the provider, which includes the person's file as well as provider policies, procedures and protocols which relate to the issue and the provider CEO final decision.(b) The DDA provider shall also release all of the above documents to DDS or its contractors upon request, regardless of whether there is a release of information form. Further, the DDA provider shall make all documents regarding its Complaint System available to DDS or its contractors, upon request.13202.18 Provider Sanctions
DDS may impose sanctions on a provider, if:
(a) DDS substantiates an allegation that the DDA provider retaliated against a person, or third party, for filing a complaint;(b) The DDA provider fails to develop, implement or revise its provider complaint policy or procedure when required to do so by DDS in accordance with law, regulations or DDS policy.(c) The DDA provider fails to abide by or implement a final decision by DDS in response to a complaint; or(d) The DDA provider evidences a pattern of untimely or incomplete responses to complaints from the people DDA supports, or fails to complete action promised by the DDA provider in response to a complaint.D.C. Mun. Regs. tit. 29, r. 29-13202
Final Rulemaking published at 67 DCR 1203 (2/7/2020)