Revision 17-2; Effective October 20, 2017

 

 

16100 Overview of Consumer Rights and Services

Revision 17-2; Effective October 20, 2017

 

Provision of Consumer Rights Booklets

At the time an individual  is enrolled into the Home and Community-based Services (HCS) waiver program, the Local Intellectual and Developmental Disability Authority (LIDDA) must give a copy of Your Rights in Local Authority Services, Your Rights in A Home and Community-based Services (HCS) Program and the Texas Health and Human Services Commission (HHSC) publication titled Rights of Individuals to be Protected and Promoted by the HCS Provider to the individual or the individual's  legally authorized representative (LAR), as well as an oral explanation of such rights.

Annually thereafter, and in accordance with Texas Administrative Code (TAC) governing rights of individuals with intellectual disability (40 TAC, Chapter 4, Subchapter C), the LIDDA must provide an individual, LAR or family member with a copy of the rights of the individual as described in the booklet titled Your Rights In Local Authority Services, and an oral explanation of such rights. However, to provide a meaningful and complete explanation of all rights to individuals receiving HCS services on an annual basis, the LIDDA service coordinator (SC) is also expected to give a copy of Your Rights in a Home and Community-based Services (HCS) Program and the HHSC publication titled Rights of Individuals to be Protected and Promoted by the HCS Provider to the individual or the individual's LAR, and an oral explanation of such rights annually.

Consumer rights booklets are available on the HHS website at https://hhs.texas.gov/about-hhs/your-rights/consumer-rights-services/what-are-my-rights.

Consumer rights booklets may also be ordered by sending an email to crscomplaints@hhsc.state.tx.us.

The HHS publication titled Rights of Individuals to be Protected and Promoted by the HCS Provider is available on the HHS website at https://hhs.texas.gov/laws-regulations/handbooks/local-intellectual-developmental-disability-authority-handbook/publications/lidda-rights-individuals-be-protected-promoted-hcs-provider.

 

16200 General Complaint Information

Revision 17-2; Effective October 20, 2017

 

Local Intellectual and Developmental Disability Authority (LIDDA)

At the time of enrollment and annually thereafter, the LIDDA must inform the applicant and legally authorized representative (LAR), orally and in writing, of the processes for filing complaints about the provision of service coordination. This must be an easily understood process for persons and LARs to request a review of their concerns or dissatisfaction. The policy must explain how the person may receive assistance to request the review, the time frames for the review and the method by which the person is informed of the outcome of that review. The LIDDA must present this policy in the language with which the individual and LAR are most comfortable.

Each LIDDA must develop a process for receiving and resolving complaints from a program provider related to the LIDDA's provision of service coordination or the LIDDA's process to enroll an applicant in the Home and Community-based Services (HCS) Program. This process must include the LIDDA's telephone number and the toll-free number to Consumer Rights and Services (CRS).

HCS Program Provider

The HCS provider must publicize and make available a process for eliciting complaints. The HCS provider must maintain a record of all verifiable resolutions of complaints received from individuals, their families and their LARs, as well as staff members, service providers, Consumer Directed Services (CDS) providers, the general public and the LIDDA. The HCS provider must establish a consumer/advocate advisory committee that will solicit, address and review all complaints from individuals and LARs about the program provider's operations.

When to Call CRS

CRS receives complaints from individuals, family members and the general public about the care, treatment or services provided to an individual. Individuals receiving services or family members of the individual may prefer to call CRS to assist in resolving an issue rather than speaking with their service coordinator (SC) or HCS provider.

A complaint may be reported by anyone, at any time, to CRS by calling 1-800-458-9858. A complaint may also be made online at: crscomplaints@hhsc.state.tx.us.

Written complaints may be mailed to:

Texas Health and Human Services Commission
Consumer Rights and Services, Mail Code E-249
P.O. Box 149030
Austin, TX 78714

Resolution of Issues Between LIDDAs and Program Providers

LIDDAs and HCS providers are encouraged to work together to resolve any issues regarding service provision.

If an SC identifies an issue of concern regarding an HCS provider, the SC should:

  • discuss the issue with the HCS provider to attempt to come to a resolution;
  • if the issue is resolved, document the resolution;
  • if the issue is not resolved, file a formal complaint with the HCS provider;
  • if the formal complaint process with the provider resolves the issue, document the resolution; and
  • if the formal complaint process does not resolve the issue, file a complaint with CRS.

If an HCS provider identifies an issue of concern regarding an SC the program provider should:

  • discuss the issue with the SC to attempt to come to a resolution;
  • if the issue is resolved, document the resolution;
  • if the issue is not resolved, file a formal complaint with the LIDDA;
  • if the formal complaint process with the LIDDA resolves the issue, document the resolution; and
  • if the formal complaint process does not resolve the issue, file a complaint with CRS.

CRS Website

The CRS website provides useful information regarding filing a complaint. Visit the website here: https://hhs.texas.gov/about-hhs/your-rights/consumer-rights-services.

Notification and Appeals Process (Regarding Complaints)

LIDDAs are required to develop processes for receiving complaints about the provision of LIDDA services. For the HCS Program, the LIDDA must notify individuals of the LIDDA's process for addressing concerns or dissatisfaction with service coordination, as required in TAC rules governing notification and appeal (40 TAC, Chapter 2, Subchapter A).