Community Grievance Decision Digest

GRIEVANCES, RIGHT TO FILE

THE LAW:

Each patient shall... “Have the right to present grievances under the procedures established under sub. (5) on his or her own behalf or that of others to the staff or administrator of the treatment facility or community mental health program without justifiable fear of reprisal and to communicate, subject to par. (p) [the right to make phone calls], with public officials or with any other person without  justifiable fear of reprisal.”

 § 51.61(1)(u), Wis. Stats. [Emphasis added.]

“(a) The department shall establish procedures to assure protection of patients’ rights guaranteed under this chapter, and shall.... implement a grievance procedure which complies with par. (b) to assure the rights of patients under this chapter are protected and enforced by the department, by service providers and by county departments under ss. 51.42 and 51.437. The procedures established by the department under this subsection apply to patients in private hospitals or public general hospitals.

(b) The department shall promulgate rules that establish standards for the grievance procedure used as specified in par. (a) by the department, county departments under ss. 51.42 and 51.437 and service providers.  The standards shall include the following components:

1.      Written policies and procedures regarding the uses and operation of the grievance system

2.      A requirement that a person, who is the contact for initiating and processing grievances, be identified within the department and in each county department under ss. 51.42 and 51.437 and by each service provider.

3.      An informal process for resolving grievances.

4.      A formal process for resolving grievances, in cases where the informal process fails to resolve grievances to the patient’s satisfaction.

5.      A process for notification of all patients of the grievance process.

6.      Time limits for responses to emergency and non-emergency grievances, as well as time limits for deciding appeals.

7.      A process which patients may use to appeal unfavorable decisions within the department or county department under s. 51.42 or 51.437 or through service providers.

8.      A process which may be used to appeal final decisions under subd. 7. Of the department, county department under s. 51.42 or 51.437 or service provider to the department of health and family services.

9.      Protection against the application of sanctions against any complainant or person, including an employee of the department, county department under s. 51.42 or 51.437 or service provider who assists in filing a grievance.”

§ 51.61(5)(a) and (b), Wis. Stats. [Emphasis added.]

[Note:  The department promulgated Subchapter III of HFS 94 to comply with this law.]

“(1) A patient or a person acting on behalf of a patient may file a grievance under s. HFS 94.29 procedures with the administrator of a facility or other service provider or with a staff member of the facility or other service provider without fear of reprisal and may communicate, subject to s. 51.61(1)(p), Stats., [right to make phone calls] with any public official or any other person without fear of reprisal.

(2) No person may intentionally retaliate or discriminate against any patient, person acting on behalf of a patient or employee for contacting or providing information to any official or to an employee of any state protection and advocacy agency, or for initiating, participating in or testifying in a grievance procedure or in any action for any remedy authorized by law.

(3) No person may deprive a patient of the ability to seek redress for alleged violations of his or her rights by unreasonably precluding the patient from using the grievance procedure established under s. HFS 94.29 or from communicating, subject to any valid telephone or visitor restriction under s. HFS 94.05, with a court, government official, grievance investigator or staff member of a protection and advocacy agency or with legal counsel.”

HFS 94.28, Wis. Admin. Code [Emphasis added.]

“Failure of a treatment facility to comply with any provision of rights under s. 51.61, Stats., or this chapter may be processed as a grievance under s.51.61(5), Stats., and subch. III of this chapter.”

HFS 94.29, Wis. Admin. Code [Emphasis added.]

“No person who, in good faith, files a report with the appropriate examining board concerning the violation of rights under this section by persons licensed under ch. 441 [nurses], 446 [chiropractors], 450 [pharmacists], 455 [psychologists] or 456 [nursing home administrators], or who participates in an investigation of an allegation by the appropriate examining board, is liable for civil damages for the filing or participation.”

§ 51.61(10), Wis. Stats. [Emphasis added.]

[NOTE: See the subsection of this digest entitled Grievance Procedure for the cases dealing with issues related to the grievance process.]

Last Updated: November 07, 2006