Chapter DHS 94

DHS 94.43(1) (1) Request for review.

DHS 94.43(1)(a) (a) For a program operated by or under contract with a county department, if the program manager, the client or the grievant, if other than the client, disagrees with the decision of the county director under s. DHS 94.42 (5), that person may seek a review of the decision by the office or unit designated by the secretary under s. DHS 94.42 (1) (b) 2.

DHS 94.43(1)(b) (b) If a grievant wishes to seek a state review of the county director’s decision, he or she shall make the request to the program manager. The program manager shall forward the request and supporting materials to the office or unit designated under s. DHS 94.42 (1) (b) 2. in the same manner as provided in s. DHS 94.42 (2) (c), with a copy sent by first class mail to the county director. All other parties shall make their request to the office or unit designated under s. DHS 94.42 (1) (b) 2., with copies of the request given personally or sent by first class mail to the other parties.

DHS 94.43(2) (2) Procedures and time limits. State review of a decision of a county director shall be conducted in the same manner and under the same time limits as an administrative review of a program operating independently of a county department under s. DHS 94.42.

DHS 94.43(3) (3) Distribution of decision. Copies of the decision by the state grievance examiner shall be given personally or sent by first class mail to the program manager, the client, the grievant, if other than the client, the county director, the client rights specialist and the client’s parent or guardian if that person’s consent is required for treatment.

DHS 94.43(4) (4) Notice of right to final state review. The decision shall include a notice which explains how and where and under what time limits a party who disagrees with the decision of the state grievance examiner may seek final state review of the grievance under s. DHS 94.44.

DHS 94.43(5) (5) Protection of client confidentiality. The state grievance examiner shall purge the names or other client identifying information of any client involved in the grievance, including the client directly involved, when providing copies of the decision to persons other than the client, or a person acting on behalf of the client, the parent or guardian of the client, the staff directly involved, or the program manager or other staff who have a need to know the information.

DHS 94.43 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.44 DHS 94.44 Final state review.

DHS 94.44(1) (1) Designation of administrator. The secretary of the department shall designate a specific division administrator or administrators to conduct final reviews of client grievances.

DHS 94.44(2) (2) Request for review.

DHS 94.44(2)(a) (a) A grievant seeking final state review shall present his or her request to the program manager who shall transmit the request to an administrator designated under sub. (1) along with copies of the original grievance and all prior decisions and reports.

DHS 94.44(2)(b) (b) A request by a program manager or county director for final state review shall be presented to the designated administrator or administrators on forms provided by the department and include with the request copies of the original grievance and all subsequent decisions and reports. A copy of the request for review shall be sent by first class mail to all other parties, including the client and the grievant, if other than the client.

DHS 94.44(2)(c) (c) A request shall describe the portion or portions of the prior decision with which the party disagrees, the basis for the disagreement and any arguments or additional information the party wishes the department to consider.

DHS 94.44(2)(d) (d) If the grievant is unable to prepare a written request for final state review, the program manager or his or her designee shall assist in completing the necessary forms.

DHS 94.44(3) (3) Information for review. The administrator conducting the final state review may request that additional information be submitted by any party or may conduct the final review based solely on the information already received.

DHS 94.44(4) (4) Final administrative determination.

DHS 94.44(4)(a) (a) The administrator shall prepare a final administrative determination for resolution of the grievance.

DHS 94.44(4)(b) (b) The administrator shall affirm the prior decision unless it is contrary to state statutes or administrative rules.

DHS 94.44(4)(c) (c) If the administrator determines that the prior decision should be modified or reversed, he or she shall state the basis for the modification or reversal and shall include in the final administrative determination specific instructions for carrying out any acts or adjustments being ordered to resolve the grievance and the timelines for carrying them out.

DHS 94.44(5) (5) Distribution of decision.

DHS 94.44(5)(a) (a) Copies of the decision shall be sent by first class mail to the grievance examiner, the county director, if the program was operated by or under contract with a county department, the program manager, the client, the grievant, if other than the client, the client rights specialist, the parent or guardian of a client, if that person’s consent is required for treatment, and all staff who received a copy of the state grievance examiner’s decision..

DHS 94.44(5)(b) (b) The decision shall contain a notice to the parties that there is no further administrative appeal beyond this stage. The grievant shall be advised of the client’s right to pursue additional consideration of the matter by bringing action in a court under s. 51.61 (7), Stats.

DHS 94.44(6) (6) Time limits.

DHS 94.44(6)(a) (a) Request for review. A party shall have 14 days from the date he or she receives the written decision by the state grievance examiner under s. DHS 94.42 (6) or 94.43 to request a final state review.

DHS 94.44(6)(b) (b) Non-emergency situations.

DHS 94.44(6)(b)1. 1. In situations in which there is not an emergency, the following time limits apply:

DHS 94.44(6)(b)1.a. a. The program manager or his or her designee shall, upon receipt of the request for review by a grievant, transmit by first class mail the materials identified in sub. (2) (a) to the administrator designated under sub. (1) within 7 days of receiving the request;

DHS 94.44(6)(b)1.b. b. Other parties shall transmit by first class mail their request for review along with all of the materials directly to the department administrator within 14 days of receiving the decision of the state grievance examiner; and

DHS 94.44(6)(b)1.c. c. The designated department administrator shall issue a final decision on the review within 30 days after the request for review was presented to the program manager by the grievant or a request for review by any other party was received by the designated department administrator.

DHS 94.44(6)(b)2. 2. The department administrator in non-emergency situations may extend the time limit for completing the administrative review for up to 30 additional days with the approval of the program director, the client and the grievant, if other than the client, or upon a showing that additional time is necessary to complete the inquiry or evaluation of the matters presented for review.

DHS 94.44(6)(c) (c) Emergency situations.

DHS 94.44(6)(c)1. 1. In emergency situations, the following time limits apply:

DHS 94.44(6)(c)1.a. a. The program manager or his or her designee shall, upon receipt of the request for review by a grievant, transmit by overnight mail the materials identified in sub. (2) (a) to the administrator designated under sub. (1) within 3 business days of receiving the request.

DHS 94.44(6)(c)1.b. b. Other parties shall transmit by overnight mail their request for review along with all of the materials directly to the department administrator within 7 days of receiving the decision of the state grievance examiner; and

DHS 94.44(6)(c)1.c. c. The final decision on the review shall be issued within 10 days after the request for review was presented to the program manager by the grievant or a request for review by any other party was received by the department administrator.

DHS 94.44(6)(c)2. 2. If after a preliminary investigation it appears that there is no emergency, the department administrator may treat the situation as a non-emergency for the remainder of the process.

DHS 94.44(7) (7) Protection of clients. If the department administrator determines that a client or group of clients continues at risk of harm and the program has not yet acted to eliminate this risk, he or she shall take immediate action to protect the client or clients, pending further investigation.

DHS 94.44(8) (8) Protection of client confidentiality. The department administrator shall purge the names or other client identifying information of any client involved in the grievance, including the client directly involved, when providing copies of the decision to persons other than the client or a person acting on behalf of the client, the parent or guardian of the client, the staff directly involved, or the program manager or other staff who have a need to know the information.

DHS 94.44 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.45 DHS 94.45 Program coalitions.

DHS 94.45(1) (1) A group of programs may form a coalition to operate a combined grievance resolution system in order to share the costs of operating the system and to increase the independence and expertise of the individuals acting as client rights specialists.

DHS 94.45(2) (2) The coalition may establish a common process for conducting program level reviews and for offering informal resolution services, or may identify specific variations of the process as it applies to each coalition member, so long as each variation complies with this subchapter.

DHS 94.45(3) (3) The programs in the coalition may agree to share the costs of training existing staff to act as client rights specialists or may jointly contract with one or more private individuals to provide this service upon request for any member of the coalition.

DHS 94.45(4) (4) A coalition shall operate in accordance with a written agreement signed by the member programs. The terms of the agreement shall provide for meeting the requirements of this subchapter in the operation of the grievance resolution system and for maintaining the impartiality of the client rights specialist.

DHS 94.45 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.46 DHS 94.46 Multiple grievances by one client.

DHS 94.46(1) (1) When a client or a person acting on behalf of a client has presented multiple grievances involving a variety of circumstances, the client rights specialist may establish an expanded timetable with specific priorities for investigating the allegations in a manner which appears most likely to deal with the issues in an efficient manner while addressing the most serious allegations first. This timetable may exceed the time limits in this subchapter, but shall include reasonable time limits for completing the investigation of each grievance. The client rights specialist shall notify the client or person acting on behalf of the client and the program manager of the timetable and priorities for resolution of multiple grievances within 10 days after beginning the inquiry.

DHS 94.46(2) (2) If there is an objection to the proposed timetable or priorities, the client rights specialist shall attempt to reach an informal resolution of the objection. If the client, person acting on behalf of the client or the program manager continues to object, that person may request a review of the issue by the county department or the state grievance examiner, whichever would normally hear an appeal of the program level review. In the absence of a request, the timetable and priorities established by the client rights specialist shall be controlling.

DHS 94.46 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.47 DHS 94.47 Related grievances by several clients.

DHS 94.47(1) (1) When 2 or more clients have presented individual grievances involving the same circumstances or a related group of circumstances relating to a single program, the client rights specialist may conduct the investigation as if it were one grievance.

DHS 94.47(2) (2) If the client rights specialist believes the investigation of the grievance will require more time to complete than is allowed under the time limits established in this subchapter, the client rights specialist shall establish a reasonable time limit for completing the investigation. The client rights specialist shall notify the clients, any person or persons acting on their behalf and the program manager of the time limit within 10 days after beginning the inquiry.

DHS 94.47(3) (3) If there is an objection to the proposed time limit for completing the investigation, the client rights specialist shall attempt to reach an informal resolution of the objection. If a client, any person acting on behalf of any of the clients or the program manager continues to object, that person may request a review of the issue by the county department or the state grievance examiner, whichever would normally hear an appeal of the program level review. In the absence of a request, the timetable established by the client rights specialist for completing the investigation shall be controlling.

DHS 94.47 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.48 DHS 94.48 Grievances involving several programs.

DHS 94.48(1) (1) If a client has presented the same grievance against several programs, each of which would ordinarily use a different client rights specialist, the client rights specialists from all the programs named in the grievance may:

DHS 94.48(1)(a) (a) Jointly conduct the investigation;

DHS 94.48(1)(b) (b) Delegate the task to one or more of the client rights specialists involved; or

DHS 94.48(1)(c) (c) Refer the matter to the county department or the office of the department with jurisdiction over the services offered by the program for an immediate county or first state review.

DHS 94.48(2) (2) If the client rights specialist or specialists believe the investigation of the grievance will require more time to complete than is allowed under the time limits established in this subchapter, the client rights specialist or specialists shall establish a reasonable time limit for completing the investigation. The client rights specialist or specialists shall notify the client, any person acting on the client’s behalf and the program manager of the time limit within 10 days after beginning the inquiry.

DHS 94.48(3) (3) If there is an objection to the proposed time limit for completing the investigation, the client rights specialist shall attempt to reach an informal resolution of the objection. If the client, person acting on behalf of the client or the program manager continues to object, that person may request a review of the issue by the county department or the state grievance examiner, whichever would normally hear an appeal of the program level review. In the absence of a request, the time limit established by the client rights specialist or specialists for completing the investigation shall be controlling.

DHS 94.48 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.49 DHS 94.49 Grievances presented on behalf of clients.

DHS 94.49(1) (1) Any person who is aware of a possible violation of a client’s rights under ch. 51, Stats., ch. DHS 92 or this chapter may present a grievance on behalf of the client.

DHS 94.49(2) (2) When a grievance is presented on behalf of a client by someone other than the client’s parent or guardian, and the parent or guardian’s consent is required for treatment, the client rights specialist shall meet with the client and the client’s parent or guardian, to determine if the client or the client’s parent or guardian, as appropriate, wishes the grievance investigated and resolved through the formal resolution process.

DHS 94.49(3) (3) If the client or, when the parent’s or guardian’s consent is required for treatment, the parent or guardian is opposed to using the formal resolution process, the client rights specialist may proceed with the investigation only if there are reasonable grounds to believe that failure to proceed may place the client or other clients at risk of physical or emotional harm. If there is no parent or guardian, or that person is not available, and the client is unable to express an opinion, the client rights specialist shall proceed.

DHS 94.49(4) (4) Where a grievance is filed on behalf of a client by a person who does not have a right to information about the client because of confidentiality statutes, the person may only receive confidential information as part of the investigation or resolution of the grievance with the informed consent of the client or his or her guardian, if there is one, the parent of a client who is under the age of 18, if the parent’s consent is required for a release of information, or pursuant to an order of a court with jurisdiction over matters relating to the client under ch. 48, 51 or 55, Stats.

DHS 94.49(5) (5) In the absence of this consent, a person presenting a grievance on behalf of a client shall be informed of the determination of the client rights specialist and decision of the program manager, if any, regarding the merit of the grievance, but if the text of the determination contains confidential information to which the person is not privileged or for which a release has not been obtained, the text may not be disclosed to the person.

DHS 94.49(6) (6) 

DHS 94.49(6)(a) (a) A person presenting a grievance on behalf of a client may request additional review of an adverse decision, up to and including final state review under s. DHS 94.44.

DHS 94.49(6)(b) (b) If the client is opposed to requesting additional review, or when the parent or guardian’s consent is required for treatment and the parent or guardian is opposed to requesting additional review, the reviewing officer may only proceed if the person presenting the grievance provides sufficient information to demonstrate that there are reasonable grounds for believing that failure to proceed may place the client or other clients at risk of physical or emotional harm.

DHS 94.49 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96; correction in (1) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 2000, No. 532; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 94.50 DHS 94.50 Interim relief.

DHS 94.50(1) (1) If the client rights specialist or a person conducting an administrative review of a grievance finds that interim relief is necessary to protect a client’s well-being pending resolution of a grievance, a directive may be given to the program manager to modify the services being provided to the client to the extent necessary to protect the client.

DHS 94.50(2) (2) A directive for interim relief shall be designed to provide the necessary protection at the minimum expense to the program while protecting the rights of the client.

DHS 94.50(3) (3) A program manager may appeal a directive for interim relief to the department administrator designated under s. DHS 94.44 (1).

DHS 94.50 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.51 DHS 94.51 Complaints related to the existence or operation of grievance resolution systems.

DHS 94.51(1) (1) Clients or persons acting on behalf of clients under s. DHS 94.49 may register complaints relating to failure of a program to have a grievance resolution system as required by s. 51.61 (5) (b), Stats., and this subchapter, or relating to the operation of an existing grievance resolution system directly to the unit or office of the department designated to conduct administrative reviews under s. DHS 94.42 (1) (b) 2.

DHS 94.51(2) (2) If a complaint regarding the existence or operation of a grievance resolution system is filed with the department, a state grievance examiner shall conduct an investigation to determine whether a grievance resolution system meeting the requirements of s. 51.61 (5) (b), Stats., and this subchapter is in place in the program.

DHS 94.51(3) (3) If the program lacks a grievance resolution system, or if the operation of an existing grievance resolution system is not in substantial compliance with the requirements of this subchapter, the state grievance examiner shall issue a report identifying the steps necessary for the program to implement a grievance resolution system that complies with this subchapter, with a timeline for implementation.

DHS 94.51(4) (4) The client or a person acting on behalf of the client or the program manager may seek a review of the state grievance examiner’s report under sub. (3) by the administrator designated under s. DHS 94.44 (1).

DHS 94.51(5) (5) If the program fails to implement the required steps in the expected time period, the matter shall be referred by the grievance examiner to the appropriate unit or office of the department or the county department with responsibility for oversight of the program for action related to certification, licensure or reimbursement or for censure of the program.

DHS 94.51(6) (6) Nothing in this section shall be read as prohibiting or limiting in any way the beginning of an action under s. 51.61 (7) or (7m), Stats., or any other civil or criminal prosecution by or on behalf of a client.

DHS 94.51 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 94.52 DHS 94.52 Investigation by the department. The department may investigate any alleged violation of this chapter and shall, in accordance with ch. DHS 92, have access to treatment records and other materials and to individuals having information relating to the alleged violation.

DHS 94.52 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96; correction made under s. 13.93 (2m) (b) 7., Stats., Register, April, 2000, No. 532; correction made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 94.53 DHS 94.53 Support for development of grievance resolution systems.