N.M. Admin. Code § 8.349.2.11 - GRIEVANCE
A grievance is a recipient's expression of dissatisfaction about any matter or aspect of the CSC or its operation.
A. A recipient may file a grievance either
orally or in writing with the CSC within 90 calendar days of the date the event
causing the dissatisfaction occurred. The legal guardian of the recipient for a
minor or an incapacitated adult, a representative of the recipient as
designated in writing to the CSC, and a provider acting on behalf of the
recipient and with the recipient's written consent, have the right to file a
grievance on behalf of the recipient.
B. Within five working days of receipt of the
grievance, the CSC shall provide the grievant with written notice that the
grievance has been received and the expected date of its resolution.
C. The investigation and final CSC resolution
process for grievances shall be completed within 30 calendar days of the date
the grievance is received by the CSC and shall include a resolution letter to
the grievant or the grievant' s representative.
D. The CSC may request an extension from HCA
up to 14 calendar days if the grievant requests the extension, or the CSC
demonstrates to HCA that there is need for additional information, and the
extension is in the recipient's interest. For any extension not requested by
the grievant, the CSC shall give the grievant written notice of the reason for
the extension within two working days of the decision to extend the
timeframe.
E. Upon resolution of
the grievance, the CSC shall mail a resolution letter to the grievant, legal
guardian, representative, and provider acting on behalf of the recipient. The
resolution letter shall include, but not be limited to, the following:
(1) all information considered in
investigating the grievance;
(2)
findings and conclusions based on the investigation; and
(3) the disposition of the
grievance.
Notes
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