13205.1 Right To File A Complaint With DDA
DDA shall have a Complaint System and a Complaint System policy specifying that a person, or a third party acting on the person's behalf and with his or her consent in accordance with Section 13205.7, has a right to file a complaint with DDA in accordance with Section 13202.12 with the DDS complaint coordinator. The complaint shall provide available detail of the who, what, when and where of the event or action that took place, or did not take place when the person believes it should have, giving rise to the issue with which the person disagrees.
13205.2 Right To File A Complaint With DDS After Using DDA Provider Complaint Process Or Where DDS Director Grants Exception
The policy shall also specify that a person also has a right to file a complaint with the Complaint Coordinator if the issue is about a DDA provider and either the person has used the provider's Complaint Process and has a final decision from the provider CEO in accordance with Section 13204.10 or the DDS Director grants the person an exception from using the provider's complaint process where the person asserts a good faith, reasonable fear of retaliation from the provider if she or he files the complaint with the provider. In either case, the person who wishes to file the complaint must meet the time limits for filing in Section 13205.3.
13205.3 Time Limit On Filing
Where a person files a complaint about DDA in the DDA Complaint System (with the complaint coordinator), he or she must do so within ninety (90) calendar days from the final day of the events the person alleges took place, or did not take place when they should have, giving rise to the issue. A person filing a complaint about a provider and alleging reasonable fear of retaliation by the provider also must file his or her complaint in the DDA Complaint System (with the complaint coordinator) within ninety (90) calendar days. A person filing an appeal from a provider CEO decision to the DDA Complaint System must file the complaint with the complaint coordinator within fourteen (14) calendar days of the provider CEO decision. DDS will not accept a complaint where the events (or non-occurrences) took place more than ninety (90) calendar days prior to the first filing of the complaint with DD S (where the complaint is about DDA or where the person alleges reasonable fear of retaliation) or more than fourteen (14) calendar days of the provider CEO decision, unless the DDS Director grants the person a waiver.
13205.4 DDS shall provide information about the DDA Complaint System on its website, at intake, and at least annually to all people receiving DDA services.
13205.5 A person is not required to utilize the DDA Complaint System to address his or her dissatisfaction with DDA or a DDA provider but may pursue other legal, administrative, or informal relief including filing the complaint through DDS's customer service system.
13205.6 A third party may not file a complaint with the complaint coordinator without the consent of the person.
13205.7 The complaint coordinator shall inform each person who files a complaint that he or she has the right to choose a person to support him or her throughout the process.
(a) The complaint coordinator shall also provide notice to the person who files a complaint that she or he has the right to choose a representative at his or her own expense if they wish, and inform the person about the possibility of free legal and advocacy services.(b) Neither DDS nor DDA providers are responsible for compensating a person's or any provider's supporters, representatives, or witnesses, or any other individual a person or provider chooses to help them with an issue.13205.8 The complaint coordinator shall give the person written acknowledgement of receipt of the filed complaint.
13205.9 Complaint File
Once a person files a complaint with the complaint coordinator, the coordinator shall establish a Complaint File. In that file shall be:
(a) A copy of the complaint, dated upon receipt when the complaint is complete;(b) A document which shows the stages of the DDA Complaint System and the timeframes for each stage for the complaint;(c) One or more documents which detail the passing of the complaint through the complaints process at DDS as well as a written record of attempts at resolution, DDS's decisions at each stage, and the status of the complaint at the conclusion of each stage of the process;(d) A record of notifications to the person and their legal representative, if they have one, and their supporter, if they have filed a D.C. Supported Decision Making Agreement with the complaint coordinator;(e) If the complaint proceeds through Stage 1, a copy of the decision at that stage;(f) If the complaint proceeds through Stage 2, a copy of the external reviewer's recommendation(s) and the DDS Director's stage decision; and(g) If the complaint proceeds through Stage 3, a copy of the external reviewer's report, the DDS' Director's final decision, and the notice. In accordance with the District of Columbia Municipal Regulations (DCMR) at Title 6B, Personnel, Disclosure of Information, as set forth in 6B DCMR §§ 3113.1 to 3113.14, confidential personnel information and other legally privileged or protected information about DDS employees shall not be kept in a Complaint File nor be disclosed by DDS through the DDA Complaint System.
13205.10 The complaint coordinator shall ensure that both the person and any DDA provider named in a complaint have notice and the opportunity to be heard in the DDA Complaint System. Where a complaint is about DDA, the person and DDA shall have the opportunity to be heard and to present evidence, including witnesses. Where an external reviewer leads efforts during Stages Two and Three, the external reviewer is responsible for providing to all parties to a complaint the opportunity to be heard and to present evidence, including witnesses.
13205.11 Stage One: Internal DDS Review
Stage One of the DDA Complaint System shall be an Internal DDS Review. The length of Stage One shall be up to fourteen (14) calendar days, unless DDS, the provider agency (if the issue is about a provider) and the person who files the complaint agree to extend the time.
(a) Where a person contacts DDS's customer services or attempts to file a complaint through the complaint coordinator and the facts alleged meet the Serious Reportable Incident definition of abuse, neglect, or exploitation, it must be investigated by DDS IMEU, consistent with DDS policy and procedures. However, a person may file a complaint with the complaint coordinator, who shall place an administrative hold on the complaint and otherwise notify the person in accordance with § 13202.6(a). Upon completion of the IMEU investigation, the complaint process will resume if they are not satisfied that the investigation, findings, or recommendations have addressed the issues raised in the complaint.(b) DDS shall administratively close a complaint if it is not one of the types of issues that may be filed in the DDA Complaint System, which are listed at Section 13202.11.(c) After a complaint is filed and accepted, DDS shall attempt to resolve the complaint to the person's satisfaction or the mutual satisfaction of both the agency and the person.13205.12 Stage Two : External Review
Stage Two of the DDA Complaint System shall be an External Review. Stage Two lasts up to forty- five (45) calendar days. It shall consist of Part A and Part B, all led by the external reviewer. Stage Two may be extended at the recommendation of the external reviewer or by mutual agreement of the person who filed the complaint and DDS or the provider agency, if the complaint is about a provider.
(a) Part A: Alternative Dispute Resolution (ADR). Stage Two, Part A shall consist of the external reviewer attempting to use mediation to reach consensual resolution to the complaint. The external reviewer may attempt to mediate a consensual resolution to the grievance. Such mediation may be conducted by individual telephone calls or meetings with interested parties or by a joint meeting. The person has the right to representation during mediation, at his or her own expense. Necessary representatives from the provider or from DDA, as determined by the external reviewer, shall be required to attend the mediation. The person may terminate the mediation at any time. Part A shall last not longer than fifteen (15) calendar days, unless DDS and the person agree to extend the time. If the complaint is not resolved to the person's satisfaction at the conclusion of Part A, the external reviewer shall undertake Part B.(b) Part B: Fact-Finding Hearing and Recommendations to the DDS Director. Stage Two, Part B shall consist of the external reviewer conducting a fact-finding hearing and making recommendations to the DDS Director. Necessary representatives from DDA and any DDA provider, as determined by the external reviewer, shall be required to attend the hearing. The person has the right to representation during the hearing and may call witnesses, all at his or her own expense. A DDA provider also has the right to representation and may call witnesses, all at its own expense. DDA similarly may call witnesses. Part B shall last not longer than thirty (30) calendar days, unless DDS and the person agree to extend the time.13205.13 Stage Three: External Reviewer's Final Report And DDS Director's Decision
(a) Stage Three lasts up to sixty (60) calendar days, unless DDS, the provider agency (if the issue is about a provider) and the person who filed the complaint agree to extend the time.(b) Within twenty-one (21) calendar days of the end of Stage 2, the external reviewer shall submit a final written report to the DDS Director, the person who receives DDA supports and services, the person who filed the complaint, and the provider, if the provider is a party to the complaint. The final written report may be redacted before being sent to the third party who filed the complaint in order to protect the privacy of the person. The report shall include shall include: a summary of the evidence gathered; applicable federal or District laws and regulations and DDS policy and procedures; findings of fact; conclusions; and recommendations for how to resolve the complaint, if any.
(c) Allowing up to an additional seven (7) calendar days for receipt, each party shall have an opportunity to respond within ten (10) calendar days of receipt of the external reviewer's final written report prior to the DDS Director's final decision on the complaint.(d) Allowing up to an additional seven (7) calendar days for receipt of the parties' responses to the external reviewer's final written report, the DDS Director shall issue the final decision within fifteen (15) calendar days of receipt of the last submission and send it to the person who receives DDA supports and services, the person who filed the complaint, and the provider, if the provider is a party to the complaint. Final decisions may be redacted before being sent to the third party who filed the complaint in order to protect the privacy of the person. The DDS Director's final decision must be in writing and in plain language and shall consider the parties' responses. The DDS Director's final decision shall accompany the external reviewer's final report and clearly state whether DDS will comply with the external reviewer's recommendation(s), if any, and if so, specify what actions DDS plans to take and in what time frame. If the DDS Director determines that DDS will not comply with one or more of the external reviewer's recommendations, the final decision shall state that clearly and provide rationale for that decision, citing to any applicable law, regulation, or DDS policy or procedure supporting the final decision.13205.14 Notice Of Right To Appeal
At the conclusion of Stage Three, the Complaint Coordinator shall provide to a person notice of the right to appeal to OAH, as well as plain language information about how to file an appeal, appeals deadline(s), the right to have a representative of their own choosing, and information about possible free legal help to the person and their representative, if they have one.
13205.15 DDS Shall Provide DDS Complaint Files To OAH Upon Request
When a person and their representative, if they have one, appeals the complaint to OAH, OAH may request copies of the DDS complaint file as well as any governing DDS policies and/or procedures from the complaint coordinator. DDS shall ask for the record to be sealed to protect the confidentiality of people supported by DDA.
D.C. Mun. Regs. tit. 29, r. 29-13205
Final Rulemaking published at 67 DCR 1203 (2/7/2020)