Okla. Admin. Code § 310:678-5-2

Current through Vol. 42, No. 7, December 16, 2024

Section 310:678-5-2 - [Effective until 9/14/2025] Contested grievances appealed to the State Office

(a)Application. This Section describes the processes for contesting the second level response to Oklahoma Human Services (OKDHS) grievances,, and provider grievances of Hissom Class Members. For grievances of children being served by Child Welfare Services, refer to OAC 310:678-5-3. For grievances of approved foster parents refer to Oklahoma Administrative Code (OAC) 310:678-5-4.

(b)Definitions. The definitions in OAC 310:678-1-2 and 310:678-5-1 apply to this Section unless the context clearly indicates otherwise.

(c)Initiating the contested grievance. When a decision-maker asks to appeal a grievance to the State Office administrator, within three business days of notice of the request, the local grievance coordinator (LGC) transmits the grievance to the Office of Client Advocacy (OCA), Attention OCA grievance liaison, with the prescribed Local Grievance Coordinator (LGC) Worksheet, attaching the corresponding Grievance Form, and other documents and information relevant to the subject matter of the grievance.

(d)Documentation requirements. When the LGC Worksheet is submitted to OCA, attachments are:

(1) corresponding Grievance Form(s);

(2) supporting facts relating to the proposed resolution by the second level respondent, including documentation relating to the first level and second level of problem resolution processes; and

(3) any written rule, policy, procedure, regulation, or other information relevant to the grievance subject matter.

(e)OCA grievance processing. Within three business days following receipt of an OCA contested grievance, the OCA grievance liaison reviews the contested grievance and accompanying documentation and determines if additional information is necessary for disposition of the appeal. When information is missing, the OCA grievance liaison contacts the person(s) in possession of the needed information and sets deadlines for submission of the information by the most efficient means to avoid delays in processing the contested grievance.

(f)Rejected grievances. When OCA determines the subject matter of a grievance falls in one of the categories listed in OAC 310:678-5-1(c)(2), the OCA grievance liaison returns the grievance to the LGC with a cover letter indicating the reason the grievance was not accepted for processing as a contested grievance. Within three business days following receipt of the letter, the LGC contacts the grievant to inform the grievant of the status of the grievance.

(g)OCA transmittal to State Office administrator. Within three business days following receipt of an OCA contested grievance and all documents required by (d) of this Section, the advocate general or the advocate general's designee prepares and sends the prescribed Contested Grievance Transmittal Form approved by OSDH, to the State Office administrator with decision-making authority to respond to the subject of the grievance.

(h)State Office administrator's response. The State Office administrator who receives a contested grievance responds to the grievant within 10 business days or by the due date on the Contested Grievance Transmittal Form. The advocate general or the advocate general's designee may grant an extension when good cause is shown. The State Office administrator sends his or her response directly to the LGC after completing the designated portion of the Contested Grievance Transmittal Form. A copy is sent to the advocate general or the advocate general's designee. The State Office administrator attaches his or her response to the Contested Grievance Transmittal Form and includes:

(1) the proposed resolution and how it will be implemented;

(2) the names of those responsible for implementing the proposed resolution;

(3) the proposed resolution target date;

(4) the facts and analysis supporting the proposed resolution including relevant documentation; and

(5) any relevant written rules, policies, procedures, regulations, or other information.

(i)Timely response required. The OCA grievance liaison monitors the timely response by the State Office administrator. When a complete response is not timely received by the OCA grievance liaison and an extension was not granted, the OCA grievance liaison immediately processes the grievance for review by the Grievance and Review Committee (GARC), per OAC 310:678-7-3. OCA notifies the grievant and affected State Office administrator that the grievance is being processed for GARC.

(j)Presentation of proposed resolution. The LGC or the LGC's designee contacts the decision-maker within three-business days following receipt of the State Office administrator's response. When the decision-maker accepts the proposed resolution, the LGC notes this on the OCA transmittal memo and files it in the client's grievance file.

(k)Request for GARC review. When the grievant does not accept the State Office administrator's response, the LGC completes the designated portion of the Contested Grievance Transmittal Form and returns it to the OCA grievance liaison within three business days. Upon OCA receipt of the Contested Grievance Transmittal Form, the grievance is processed for review by GARC, per OAC 310:678-7-3.

Okla. Admin. Code § 310:678-5-2

Adopted by Oklahoma Register, Volume 42, Issue 7, December 16, 2024, eff. 11/1/2024, exp. 9/14/2025 (Emergency)