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The purpose of these procedures is to provide for the
equitable and consistent resolution of grievances or
disputes from any citizen relative to the delivery
of behavioral health care services in West Virginia.
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Upon filing a grievance with this office, within
five working days an acknowledgment shall be issued
indicating that the grievance has been received and
an active case file has been opened. If
appropriate, an informal conference (in person,
via telephone or email) between the Ombudsman and
grievant may be held to discuss the grievance.
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Should your grievance be resolved promptly or
without delay, it will be recorded as a contact
within the Ombudsman’s office.
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The respondent shall also receive notification
that a grievance has been filed with this office.
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In resolving the grievance the Ombudsman shall
afford all parties an opportunity to present
information regarding the issues and, if necessary,
may request additional information from either party
in order to resolve the grievance.
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The Ombudsman may convene and chair meetings between
the grievant and respondent. The purpose of the
meetings shall be for the parties and the Ombudsman
to jointly resolve the issues and /or disputes at
an informal level.
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All formal meetings and hearings with the
Ombudsman shall be mechanically recorded.
All testimony and evidence or the transcription
thereof, if any, the decision, and any other
material considered in reaching the decision
shall be made a part and shall constitute
the record of a grievance.
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The Ombudsman may recommend to the parties
involved in a dispute that they contemplate
mediation as a process for resolution.
Mediation services can be arranged and scheduled
through the Office of the Ombudsman.
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In reaching a decision, if the Ombudsman
determines that the respondent(s) is not in
compliance with the letter or spirit of the
law or court order, or if a complaint or issue
in dispute is without merit, the Ombudsman shall
present a recommended order which will be
presented to the Secretary of the Department
of Health and Human Resources. Such
recommendation will be the Ombudsman’s
independent analysis and shall be part of the
official record.
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The respondent Secretary may concur with the Ombudsman’s
recommendation or provide a written rational as to why
such recommendation is not acceptable.
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The Ombudsman may, in the alternative of a recommended
order, issue a report which will facilitate or remedy
an individual or systemic grievance.
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All decisions rendered by the Ombudsman in reaching
conclusion of a grievance shall be made in writing and
copies made available to all parties involved.
The objective of this office is to resolve all
grievance disputes in a timely manner. If it
is anticipated that the grievance cannot be resolved
in an agreed upon time frame by the parties, an
explanation as to the extenuating circumstances shall
be provided to the grievant and/or respondent by the
Ombudsman’s Office.
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An individual may withdraw a grievance at any
time by providing adequate notification to the
Office of the Ombudsman.
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The Ombudsman shall conduct all grievance proceedings
during regular working hours. All attempts shall be
made to process the grievance in a manner which does
not interfere with the normal routine of the grieved
parties.
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All proceedings shall be located in areas that are
physically accessible.
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