Sec. 3999.228 - Institutional Level Health Care Grievance Review

ยง 3999.228. Institutional Level Health Care Grievance Review

(a) The institutional level is for initial clinical/administrative review of health care grievances.

(b) Health care staff at a level no less than a Registered Nurse, utilizing clinical expertise within the scope of his or her licensure, shall triage each health care grievance within one business day of receipt and:

(1) Determine if the health care grievance identifies a health care issue that may require clinical intervention.

(2) Determine if the health care grievance warrants expedited processing.

(3) Determine if the health care grievance is administrative or clinical.

(c) All submitted health care grievances shall be screened to identify whether the submitted health care grievance complies with the requirements under section 3999.227 and may be rejected pursuant to section 3999.234.

(d) Any health care grievance received outside the time limits pursuant to section 3999.227 may be accepted at the discretion of the HCGO if it is determined that the health care grievance should be subject to further review for reasons including, but not limited to:

(1) Good cause exists for untimely submission of the health care grievance.

(2) Issues stated in the health care grievance allege facts that warrant further inquiry.

(e) Health care grievances accepted as clinical in nature shall receive a clinical review by the appropriate health care discipline as determined during the triage.

(f) An interview with the grievant shall be conducted in any of the following circumstances:

(1) The grievant requested an interview by initialing the appropriate box on the CDCR 602 HC.

(2) Health care staff has determined an interview is necessary.

(3) The grievant has been identified as the first grievant to submit an accepted health care grievance that has been designated as a multiple health care grievance pursuant to section 3999.232.

(4) The health care grievance is deemed a health care staff complaint and in such case, health care staff shall conduct the interview pursuant to section 3999.231.

(g) If the grievant refuses the health care grievance interview, the HCGO shall complete the health care grievance without grievant input.

(h) Health care staff who participated in the event or decision being grieved may not interview the grievant.

(i) Time limits for processing a health care grievance commence on the day it is received by the HCGO and shall be completed and returned to the grievant within 45 business days, unless processed as an expedited health care grievance pursuant to section 3999.233(b).

(j) Health care grievance responses shall be approved and signed pursuant to section 3999.225(x).

(1. Change without regulatory effect renumbering and amending former section 3087.3 to new section 3999.228 filed 8-6-2018 pursuant to section 100, title 1, California Code of Regulations (Register 2018, No. 32). 2. Change without regulatory effect amending Note filed 4-15-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 16).)

Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; Americans With Disabilities Act, Public Law 101-336, July 26, 1990, 104 Stat. 328; Civil Rights of Institutionalized Persons Act, Title 42 U.S.C. Section 1997 et seq., Public Law 96-247, 94 Stat. 349; Section 35.107, Title 28, Code of Federal Regulations; Armstrong v. Newsom (No. C-94-2307-CW), U.S. District Court, Northern District of California; Coleman v. Newsom (No. S 90-0520 LKK JFM P) U.S. District Court, Eastern District of California; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.

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