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OPC Board agenda 072605
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OPC Board agenda 072605
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A . Informal Review Process <br /> Informal reviews of complaints regarding Administrative Issues and Service Quality <br /> follow the Informal Review Process for Potential Rights Violations as detailed in that <br /> section of this policy. <br /> B . Administrative Review Process <br /> 1 . If the issue is not resolved or the complainant is not satisfied with the decision <br /> resulting from the Informal Review Process , the complainant may file a complaint to <br /> the Customer Service Department within 10 days from the date of the completion of <br /> the Informal Review process . <br /> 2 . The Customer Service Manager or his/her designee will acknowledge receipt of the <br /> complaint the same or next business day following the date the complaint was <br /> received . <br /> 3 . The Customer Service Manager or his/her designee will deliver the complaint to the <br /> OPC Area Director along with all documentation regarding the original complaint, <br /> including a copy of the written decision from the Informal Review Process , <br /> 4 . The OPC Area Director will review the complaint . <br /> 5 . The Customer Service Manager or his/her designee will send the written decision of <br /> the OPC Area Director to the complainant within 10 days from the date the <br /> complaint was received by the Customer Service Manager . <br /> III . Complaints regarding CLINICAL SERVICE DECISIONS <br /> For procedures related to complaints regarding clinical service decisions , please see <br /> OPC ' s Utilization Management Policy & Procedure. <br /> Data Collection/Management <br /> The CSR ' s will enter data gathered from the complaint process . Routine summary <br /> reports will be provided to the Area Quality Improvement Committee (AQIC) , the Care <br /> Management Division, the Service Systems & Provider Community Division, the Client <br /> Rights Committee and the Consumer and Family Advisory Committee . These reports <br /> shall be used as a part of OPC ' s continuous quality improvement process . Complaints <br /> are filed in the OPC ' s Customer Services Department. <br /> External Advocacy Groups /Resources <br /> Consumers should be encouraged to contact the Advocacy & Customer Service Office at <br /> the Division of MH/DD/ SAS or the Governor ' s Advocacy Council with any concerns <br /> relating to services or providers in the OPC catchment area : <br /> Advocacy & Customer Service Office <br /> Division of MH/DD/ SAS Governor 's Advocacy Council for Persons <br /> 3009 Mail Service Center with Disabilities <br /> Raleigh, NC 27699 - 3009 2113 Cameron Street , Suite 218 <br /> (919 ) 715 - 3197 (voice) Raleigh, NC 276054 344 <br /> ( 800) 662 - 7030 (voice) or ( 800 ) 821 - 6922 (voice) or <br /> ( 877 ) 452 - 2514 (TTY) ( 888 ) 268 - 5535 (TDD ) <br /> V <br />
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