24 Miss. Code. R. 2-14.10 - Complaints and Investigation

A. A person/party who wishes to file a complaint to DMH on a DMH-certified provider must submit the complaint to DMH; the person/party lodging the complaint is referred to as the complainant. The provider agency on whom the complaint is lodged is referred to as the respondent.

B. The complaint must be submitted to DMH on the DMH-approved provider certification complaint form. The complaint must be submitted according to the instructions on the form(s). The complainant is responsible for completing the form(s) (according to the instructions) and returning the form(s) to DMH.

C. The approved DMH provider certification complaint form(s) is made available on the DMH website.

D. By submitting the complaint form, the complainant is waiving confidentiality as is necessary for DMH to review the complaint.

E. The following information must be included on the submitted complaint form(s):

1. The DMH-certified provider's name;

2. The name and contact information of the complaining party;

3. The date of the complaint;

4. A statement of the complaint; and

5. Disposition or attempts at settlement, if applicable.

F. The complaint should include the charges set forth with such clarity as to inform DMH and the certified provider of the issue involved.

G. Upon receipt, DMH will assign each complaint a case number and set up a case complaint file.

H. The criteria DMH, in conjunction with the DMH Office of General Counsel and/or CRC, may use for determining whether an allegation or charge should be accepted as a formal complaint include, but are not limited to, the following:

1. Whether or not the agency is currently certified by DMH (unless the complaint concerns the use of a DMH provider Certificate of Operation by an agency not holding the claimed provider certification).

2. Whether the charge, if true, would constitute a violation of the promulgated DMH Operational Standards and/or any other applicable, policy, federal, or state laws or statutes which govern DMH-certified providers.

3. Whether passage of time since the alleged violation requires that the complaint be dismissed.

4. Whether sufficient, reliable proof of the charge is available.

5. Whether or not the complainant is willing to provide proof or other required information/documentation.

6. Whether or not the charge appears to be sustainable considering the proof available.

7. Whether the complaint has arisen from or is related to a court order or a matter before the court system.

I. Complaints lodged with insufficient information DMH may not be able to address. Moreover, failure of the complainant to respond to questions or requests for information from DMH agency staff may result in complaint dismissal.

J. Priority for investigation of submitted complaints is given to complaints which suggest the possibility of imminent harm.

K. DMH shall notify the DMH-certified provider that a complaint has been filed against the provider and that the provider is under investigation. Notice of the filed complaint shall be given within a reasonable amount of time from the date of receipt of the complaint, not to exceed 10 business days. DMH shall notify the DMH-certified provider of the allegation(s) and corresponding DMH Operational Standards. The DMH-certified provider will have 15 business days to respond to the allegation(s). The DMH-certified provider may request an extension of up to 30 calendar days to respond to the complaint. Extensions will be granted on a case-by-case basis. Justification for additional time is determined by DMH. All communications should be sent to the appropriate DMH designee, as instructed on the approved complaint form instructions, and copied to the DMH Office of General Counsel.

L. Substantial, jurisdictionally appropriate formal complaints will be evaluated by the appropriate DMH designee and the CRC; the DMH Office of General Counsel may be consulted as needed. DMH may accept, but is not obligated to investigate, a complaint which lacks sufficient information to identify the source or the name of the person who filed the complaint.

M. In situations where a complaint concerns another agency, DMH may refer the complainant to the appropriate agency for investigation, if possible.

N. A copy of all substantive communications pertaining to complaints/investigations will be forwarded to the DMH Office of General Counsel. Depending on the nature of the submitted complaint, information may be shared, as needed, with other pertinent offices within DMH.

O. All documents and materials gathered by or submitted to DMH during an investigation are confidential and will not be returned to the submitting party once the complaint is resolved.

P. When the investigation of a complaint has been completed, the complaint proceeds down one (1) of two (2) pathways to final resolution. The determination of which path the complaint proceeds down is dependent upon whether sufficient cause is found following DMH's investigation. Sufficient cause means the facts and circumstances within DMH's knowledge are enough to warrant that the respondent committed a violation of the DMH Operational Standards or other law(s)/policy within the jurisdiction of DMH.

1. If no sufficient cause is found for the alleged violation(s), then the complaint is referred to DMH agency staff and/or the DMH CRC for consideration for dismissal. The respondent is informed of any resultant dismissal within 15 business days of the dismissal decision.

2. If sufficient cause is found for the alleged violation(s), then the complaint is referred for either:

(1) an informal settlement conference with the respondent and DMH agency staff; or

(2) to a subcommittee of the CRC for next steps, including the possible determination of need for an administrative hearing.

Q. Prior to conducting an informal conference and to resolve a complaint by agreement, DMH staff may send the respondent a proposed stipulation/consent/order. If the respondent rejects a proposed stipulation/order or requests an informal conference, then the complaint is set for an informal conference. Complaint matters requiring the use of expert testimony or witnesses are ineligible for informal conferences and must be held as hearings before the CRC.

R. Prior to an informal conference, at least 30 calendar days beforehand, the respondent is provided with written notice of the alleged violation(s) for which probable cause has been found to exist and is invited to participate in an informal conference. The complainant is also invited to participate in the informal conference but separate from the respondent. Both the complainant and respondent may speak with and present evidence to DMH and may be represented by legal counsel if desired.

S. Following an informal conference, a recommendation is made regarding the informal disposition of the complaint. This recommendation may include dismissal or administrative action, or the recommendation may be to remand the complaint to the full CRC for further evaluation, including the possibility for a hearing. The respondent is informed of any resultant dismissal or administrative action, within 15 business days of the informal conference.

T. Upon determination that a hearing is needed, the CRC will notify the respondent that a hearing will be held. The respondent shall be notified at least 30 calendar days before the date of the hearing. The notice will inform the respondent of the facts which are the basis of the complaint, and which are specific enough to enable the respondent to defend against the complaints. The notice of the complaint and the hearing shall also inform the respondent of the following:

1. The date, time, and location of the hearing.

2. That the respondent may appear personally at the hearing and may be represented by counsel.

3. That the respondent shall have the right to produce witnesses and evidence on their behalf and shall have the right to cross-examine adverse witnesses and evidence.

4. That the Mississippi Rules of Evidence do not apply.

5. That the hearing could result in sanctions being taken against the provider agency's/ respondent's certification.

6. That the CRC will, in writing, advise the respondent of any sanction(s) to be imposed and the basis for the CRC's action.

7. That disposition of any formal complaint may be made by consent/order or stipulation between the CRC and the respondent.

U. The hearing will be an informal hearing and will be presided over by the CRC facilitator or other member of the Committee.

V. Within 15 business days of the hearing, the CRC will provide written notification to the agency provider/respondent as to any sanction(s) being imposed and the basis for the action.

W. All hearing proceedings are matters of public record and shall be preserved pursuant to state law. The final disposition of any hearing will be recorded in the CRC minutes.

X. If administrative action is taken against an agency provider, any applicable third party, as determined by DMH, may be notified by DMH.

Y. Notifications to the respondent by DMH, as outlined above, will be considered to have been given if the notice was personally received by the respondent, or mailed "certified, return receipt requested" to the last known address as listed with the Division of Certification.

Z. Respondents may appeal any action entered against them which results in DMH provider certification termination, revocation, and/or financial penalties invoked by DMH, in accordance with the appealable matters listed in the appeals rules outlined in this manual.

Notes

24 Miss. Code. R. 2-14.10

Miss. Code Ann. § 41-4-7

Adopted 11/1/2024