The Right to Grieve a Suspected Violation of Rights

Explicit policies and procedures in the area of basic rights are the foundation for protecting persons served against abuse or mistreatment by human service organizations or persons acting on their behalf. Organizations, that are CARF accredited, or attempting to become accredited, must meet minimum requirements in the area of rights of the persons served. This tutorial will provide an overview of an important component of the rights of the persons served, that being grievance policies and procedures.

The atmosphere of your organization’s environment and culture will play a major role in the degree that persons served are involved in complaining about services or filing grievances. Organizations that are typically open to input and involve persons served in all aspects of programming tend to have a lower incidence of complaints and grievances. The degree of openness and inclusiveness that organizations demonstrate generally correlates with a lower level of complaints from both persons served and employees. For this to be an organization’s cultural norm, leadership has to consider openness and inclusiveness as core values and demonstrate this behavior to employees and clients on a daily basis.

Standards of Care Regarding The Right to Grieve

The CARF standards of accreditation require that organizations implement a policy through which a person served may make a formal complaint, file a grievance, or appeal a decision made by the organization’s personnel or team members.

The components of such a policy are as follows:

1. That the action of filing a grievance will not result in retaliation or barriers to services. 

There are three factors that most often result in grievances not being filed within organizations. First, as was mentioned earlier, a culture of inclusiveness within an organization can result in the minimal filing of grievances. Second, if the grievance process is not well understood or is not communicated clearly to persons served there are usually fewer grievances, and finally, if a culture of fear exists within the organization, persons served may feel that filing a grievance might result in retaliation or barriers to services. Certainly, the first factor (a culture of inclusiveness) would be the preferable reason that grievances were not being filed!

2. Grievance procedures should contain how efforts will be made to resolve a complaint. 

An organization’s policies should clearly communicate how the organization will attempt to resolve a complaint in a fair and equitable manner. Most organizations address all initial complaints with an immediate informal attempt to assist the complainant with working out the problem/complaint to their satisfaction. This initial approach may help minimize the disruption of programming. During this process, it is important to communicate to the complainant that there is a structured process available should they not be satisfied with the outcome of immediate informal assistance.

3. Grievance procedures for reviewing the complaint should be explained to the persons served in a manner that is understandable. 

Keep it simple! It is important that persons served have easy-to-read and understandable instructions on how to address a complaint.

4. Grievance procedures should include levels of review, which include the availability of external review. 

Levels of review usually include who receives the initial complaint, the availability of alternative reviewers should the complaint be against someone involved in the review process, and various multiple levels of review should the complainant appeal the initial decision of the first level of review.

5. Grievance procedures should include time frames that are adequate for prompt consideration of the complaint and result in timely decisions for the persons served.

6. Grievance procedures should include written notification regarding the actions to be taken to address the complaint. 

The outcome of all decisions regarding the complaint should be in writing to ensure that the person seeking redress is aware of the specific response, and so the organization can be held accountable for the process of remediation through written documentation of the outcome of the decision.

7. Grievance procedures should include the rights and responsibilities of each party. 

An important component in this process is the responsibility of the organization to abide by the procedures, and of the complainant to communicate clearly the issues and circumstances that led to the action.

8. The availability of advocates or assistance. 

Persons served should be informed of the existence of someone to assist in the process should the person desire an advocate who is not connected with the situation they are grieving. While this can be an internal person who usually is not directly connected with the daily operations, such as a board member, designated advocates are usually selected from outside community resources to provide a greater degree of bias-free representation. Many states provide advocacy services and also require standard rights and grievance policies and procedures that all human service organizations must follow.

9. Grievance policies should include the provision of reporting forms and the actual procedures being made readily available to the persons served.  All persons served in an accredited organization should know where to access grievance reporting forms and have a basic understanding of how the process works.

In summary, explicit, easy-to-understand, and well-communicated procedures that allow persons to address complaints are a foundational component of organizations that are advocates for the persons they serve. All employees of CARF accredited organizations should have a basic understanding of their organization’s grievance system, whether it is an internally created and functioning system, or designed and managed by a government entity outside the organization.

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