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Consumer Complaints and Grievances

Publish Complaint and Grievance Policy

Policy: 

F/EA includes the Complaint and Grievance Policy in each Consumer Welcome Package and the Policy is distributed by Counselors. The F/EA Complaint and Grievance Policy is published so that consumers understand that they have a right to express grievances and that F/EA welcomes reporting of grievances. The Policy outlines the process by which consumers should report complaints and grievances to F/EA and the steps F/EA will take to resolve the complaint or grievance. 

The Complaint and Grievance Policy is updated by the <<Staff Title>> as needed. Upon request, F/EA’s Complaint and Grievance Policy and applicable Policy and Procedure documents are submitted to Program Administrator.
 
Copies of the Complaint and Grievance Policy are stored on the Welcome Package forms shelf within the F/EA Payroll Department.
 
 

 

Procedure: 

The Complaint and Grievance Policy is included in the Consumer Welcome Package distributed to consumers

  1. As the Complaint and Grievance Policy is updated, the most updated version is included in the Welcome Package.
  2. The Complaint and Grievance Policy includes the following information:

 

Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. The Complaint and Grievance Policy is reviewed for accuracy as part of the quarterly review of the Consumer Welcome Package
  2. <<Counselors review the Complaint and Grievance Policy with consumersas applciable>>
    • This ensures that consumers have an opportunity to ask questions, thereby supporting that consumers fully understand their rights to reports complaints and grievances and the process to do so

Assess, Categorize and Maintain a Log of Complaints and Grievances

Policy: 

Upon receiving communication from participants or representatives, whether via phone, in person or in writing, F/EA <<Staff Title>> determine if the communication must be classified as a complaint or grievance. Staff is trained, within 15 days of employment as a F/EA <<Staff Title>>, on handling complaints and grievances. 

Any communication that should be categorized as a complaint is recorded as such with applicable details. Complaint records are maintained for a minimum of 7 years per File Retention Policy.
Procedure: 

Assess Communication and Determine if it is a Complaint or Grievance

  1. As calls and mail are received, F/EA staff must assess whether the communication from a participant should be categorized as a complaint or grievance
  2. Some communication is clearly categorized as a complaint or grievance:
    • The participant states over the phone or in writing that they are reporting a complaint
    • The participant requests to speak with a manager or supervisor to report an unresolved issue
    • A grievance is reported in writing
  3. Some communication is more difficult to classify as a complaint or grievance and requires follow-up questions:
    • The participant is clearly upset, speaking loudly or with strong language
    • The participant accuses F/EA of negligence
    • The participant reports a negative impact that action or lack of action by F/EA has had on his/her life
  4. When communication is not clearly a complaint, Customer Service staff will ask the caller if they would like to lodge a complaint
    • If the caller responds in the affirmative, the issue should be logged as a complaint
    • If the caller declines the opportunity to lodge a complaint, the issue should not be logged as a complaint
  5. In general, issues of the following nature are not deemed complaints, unless they are also characterized by complaint criteria identified in step 2 and step 4:
    • A participant reports that a check that was expected has not yet been received
    • A participant reports that the check received was for a different amount than expected
    • A participant reports trouble faxing a timesheet to F/EA
    • A participant reports trouble completing participant or Worker start-up packages
    • A participant reports receiving an over-usage letter and questions the validity of the letter
 
Record Complaints or Grievances
  1. Once communication, either received via phone or mail, has been classified as a complaint or grievance, it must be logged
  2. <<Staff Title>> log the complaint or grievance in Payroll System per the process outlined in Policy and Procedure document
  3. The following information must always be recorded:
    • Code <<X>> in the “Caller” field for complaint
    • The participant’s name
    • The date of communication
    • The time of communication
    • The complaint or grievance
    • The method by which communication was received (phone, voicemail, writing, in person)
Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. Policies and Procedures document how to classify communication as a complaint or grievance
  2. Staff are trained on handling complaints and grievances within 15 days of employment as a <<Staff Title>>
  3. Complaints and grievances are coded as such and recorded in detail in the Customer Service System
  4. Recorded complaint and grievance data is stored for a minimum of 7 years per File Retention Policy

Develop Corrective Action Plan for Complaint or Grievance

Policy: 

After recording a complaint, F/EA develops a corrective action plan and responds to the individual submitting the complaint within <<X>> business day(s). 

<<Staff Title>> reports complaints to the <<Staff Title>> immediately upon receipt. The <<Staff Title>> investigate the complaint and perform initial fact gathering. After fact gathering, <<Staff Title>> notifies <<Staff Title>> and <<Staff Title>> that a complaint was received.
 
Within one business day of receiving a complaint, <<Staff Title>>, <<Staff Title>>, <<Staff Title>> and any other applicable Customer Service, Billing or Payroll staff meet to review the situation and develop a corrective action plan.
 
Within one business day of receiving the complaint, <<Staff Title>> (or <<Staff Title>> or <<Staff Title>>, when appropriate) contact the participant or representative who placed the complaint and report F/EA’s corrective action plan for his/her complaint. The corrective action plan is submitted to the participant in writing on the same day that verbal communication of the corrective action plan is performed. Corrective action plans are submitted in writing for all complaints, regardless of if complaint was received via phone, mail or in person.
 
If implementation of the corrective action plan is not sufficient to resolve the participant’s complaint, F/EA arranges for a hearing with the participant, including the presence of a neutral party in accordance with the American Board of Arbitration guidelines.
 
All communication is recorded. All written documentation is scanned to the participant’s scan folder and maintained for a minimum of 7 years per File Retention Policy.
Procedure: 

 

  1. After recording a complaint or grievance <<Staff Title>> notifies <<Staff Title>> verbally or via e-mail that a complaint has been received
  2. <<Staff Title>> works with <<Staff Title>> to find as many facts about the situation as possible
  3. Facts sought vary by issue, but facts often sought are:
  • Check date of payment in question
  • Check number of payment in question
  • Worker/vendor associated with payment in question
  • Timesheet(s)/invoice(s) associated with payment in question
  • Date timesheet(s)/invoice(s) faxed or mailed
  • Individual budget details associated with payment in question

 4.  After fact-seeking, and on the same day that the complaint is received, <<Staff Title>> notifies <<Staff Title>> and <<Staff Title>>, verbally or in writing, that a complaint has been received

 5.  <<Staff Title>> schedules meeting with <<Staff Title>>, <<Staff Title>> and applicable Customer Service, Payroll or Billing staff to occur on or within one day of receiving complaint

 6.  During meeting, all parties review facts as presented by <<Staff Title>> and seek additional facts as necessary

 7.  After collecting relevant facts, meeting attendees develop a corrective action plan to resolve the participant or representative’s complaint or grievance while maintaining compliance with program rules and regulations

 8.  <<Staff Title>> drafts a letter that outlines the corrective action plan

 9.  Corrective action plan must include expected dates of completion for each element in plan

10.  <<Staff Title>> calls participant or representative

11. <<Staff Title>> shares with participant or representative F/EA’s corrective action plan to resolve the complaint or grievance

12. <<Staff Title>> records communication in Payroll System per Policy and Procedure document

13. <<Staff Title>> submits written corrective action plan to participant or representative

14. <<Staff Title>> records in Customer Service System per Policy and Procedure that written corrective action plan was submitted to participant

15. Written corrective action plan and fact-seeking document are scanned to participant’s scan folder and maintained for a minimum of 7 years per File Retention Policy

16. If the participant or representative is not satisfied with the corrective action plan, he/she will contact F/EA within 3 business days of receiving the plan in writing

17. <<Staff Title>> will schedule a hearing with a mediator in an effort to resolve the issue to both partys' satisfaction

Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All complaints and grievances are coded and recorded in Payroll System
  2. All complaints and grievances are reported to the <<Staff Title>> for review immediately upon receipt
  3. All complaints and grievances are reported to the <<Staff Title>> and <<Staff Title>> on the same business day as they are received
  4. All facts pertaining to complaint or grievance are sought and documented within 1 business day of receipt of complaint
  5. A corrective action plan is submitted to the participant in writing
  6. The corrective action plan and fact seeking document are scanned to the participant’s scan folder and maintained for a minimum of 7 years per File Retention Policy

Perform Internal Review of Complaints and Grievances

Policy: 

On a monthly basis, <<Staff Title>> reviews complaints received for the month. <<Staff Title>> and other F/EA staff members determine if processes can be improved to minimize complaints and improve services to program stakeholders. Processes that can be improved are reviewed with <<Staff Title>> and Chief Financial Officer as applicable and process changes are implemented. 

As applicable, Counselors and consumers are notified of any changes to policies or procedures.
Procedure: 

 

  1. On a monthly basis, <<Staff Title>> reviews complaints and resolutions for the month that just ended
  2. <<Staff Title>> double clicks on Shortcut to Note Viewer icon on desktop
  3. <<Staff Title>> identifies any themes of complaints
  4. Where possible, <<Staff Title>> identifies opportunities to adjust processes to increase participant satisfaction and minimize complaints
  5. <<Staff Title>> reports suggested process improvements to <<Staff Title>> Per <<Staff Title>> approval, <<Staff Title>> works with applicable staff and Chief Financial Officer to implement process changes.
Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All complaints and grievances are coded and recorded in Payroll System
  2. Complaints are recorded by Customer Service staff and independently reviewed by <<Staff Title>>
  3. <<Staff Title>> and Chief Financial Officer work with staff to implement changes to F/EA processes