Revision 13-0; Effective September 3, 2013

 

6100 Complaints, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.43

 

6200 Complaints

Revision 13-0; Effective September 3, 2013

 

A complaint is a situation, problem or concern that alleges abuse, neglect or exploitation of an individual, may pose a health or safety threat, may cause harm or that appears to be a violation of state standards, program standards or contract requirements. The complaint may be general or specific, and could involve the provider agency’s staff, beneficiaries, volunteers, physical environment, administration or services.

In accordance with Human Resources Code, Chapter 48, Subchapter B, a person must report to the Texas Department of Family and Protective Services (DFPS) Adult Protective Services (APS) if the person has cause to believe that an elderly or disabled person is in the state of abuse, neglect or exploitation. A provider agency must also report any suspected cases of abuse, neglect or exploitation to DFPS Adult Protective Services.

When the reporter contacts APS to report abuse, neglect or exploitation, the reporter is filing a complaint alleging that harm may be occurring, or may have occurred. If APS determines the harm does not meet its threshold for conducting an investigation, the report is forwarded to the Department of Aging and Disability Services (DADS) Consumer Rights and Services for follow up.

In situations where the provider agency receives a complaint regarding services from the individual or the individual’s designated representative, the provider agency must document and investigate the complaint. Title 40 Texas Administrative Code, §49.17, defines complaint procedures. If the complaint alleges abuse, neglect or exploitation, the provider agency must submit a report to APS, as previously stated.

The provider agency must send the documented complaint and resolution to the assigned DADS contract manager and must send a copy to the DADS staff if the complaint was submitted by a DADS staff member, who may have reported on behalf or in place of the individual, as applicable.

A contract manager monitors for compliance with this requirement. A contract manager looks for possible violations of contract and program requirements when reviewing the complaint log and the provider agency's investigation of the complaint.

 

6210 Notification of Rights and Responsibilities and Complaint Procedure

Revision 13-0; Effective September 3, 2013

 

Notification

A provider agency of Title XIX and Title XX Home-Delivered Meals (HDM) is required by 40 Texas Administrative Code, §49.18, to notify, orally and in writing and annually, each individual or authorized representative of the individual’s rights and responsibilities under Texas Human Resources Code, Chapter 102, Rights of the Elderly; and procedures for filing a complaint, including the name, title and telephone number of the person to whom a verbal complaint may be made.

A provider agency may use DADS “Your Rights in a DADS Community Program” booklet to inform an individual or the individual’s representative of this information.

Also, a provider agency may order copies of the booklet by emailing crscomplaints@dads.state.tx.us. The provider agency must note in the subject line of the email that Consumer Rights booklets are being requested, and include the following in the body of the email:

  • Name of the Consumer Rights booklet requested;
  • Number of booklets requested; and
  • Physical address to which the booklets are to be delivered.

Documentation

A provider agency must document delivery of the notification in one of two ways:

  • By developing a form for documenting that it has notified an individual or authorized representative of rights and responsibilities and of procedures for filing a complaint; or
  • By using Form 3053, Notification of Rights and Responsibilities, Complaint Procedures, and Allegations of Abuse, Neglect or Exploitation.

The provider agency must keep the signed and dated original notification form in the individual’s
record and must give the individual or authorized representative a copy of the signed and dated form.