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Complaint Grievance Appeals

Consumer Complaint, Grievance, & Appeal Procedure

 

Under Vermont Global Commitment to Health, the Department of Vermont Health Access (DVHA) has established a process for you to resolve problems about your mental health care and developmental services. For example, you might be dissatisfied because your treatment or service team changes the kind or amount of services you receive, or you might tell your case coordinator that another staff member was rude to you.

 

Northwestern Counseling & Support Services has a Grievance and Appeal Coordinator and the staff at NCSS will help you understand how the process works. If you need help filing your grievance or appeal or understanding the process, the staff will assist you.

  • You can file a complaint with any NCSS staff member.
  • You have a right to file a grievance without retaliation.
  • You can ask any NCSS staff member for information on how to file a grievance or appeal.

 Complaints:

  • A consumer expresses dissatisfaction about aspects of interpersonal relations- rudeness, failure to be respected, staff not conducting themselves properly or the quality of care the consumer receives.
  • The complaint is resolved in one response by staff. 
  • Complaints may be made orally or in writing by the consumer to any NCSS staff.

Grievance and Appeal:

There may come a time when you are not satisfied with your services and want to take steps to address your concerns. You may do so in a formal or informal manner. To address your concerns informally, you could talk to the NCSS Director of Quality & Risk Management or any staff member about a complaint you have. If you are not satisfied with the NCSS response, you can then file a formal grievance or appeal. The definitions below will help you understand the difference between grievance and an appeal.

Grievance examples may include:

  • Dissatisfaction with a staff/contractor
  • Dissatisfaction with management
  • Dissatisfaction with program decision
  • Dissatisfaction with policy decision
  • Dissatisfaction with quality of services
  • Dissatisfaction with accessibility of services
  • Dissatisfaction with services not offered or not available

Appeal examples may include:

  • Denial, in whole or in part, of payment for a service
  • Failure to provide services in a timely manner
  • Failure to provide clinically indicated covered services
  • Denial of request for covered services outside Medicaid network

The full Grievance and Appeal Mental Health and Developmental Services process is given to each person upon intake and given to each NCSS consumer when their treatment plan is updated or their ISA review is done. Additional copies can be located in the reception area.

 Unprofessional Conduct and Filing a Complaint for Licensed and Non-Licensed Psychotherapists

        Licensed and non-licensed clinical mental health counselors, marriage and family therapists and psychotherapists practice is governed by the Rules of the Board of Allied Mental Health Practitioners and it is unprofessional conduct to violate those rules. The regulations for professional practices can be obtained at https://www.sec.state.vt.us/professional-regulations.aspx. A copy of the statutory definitions of unprofessional conduct (3 V.S.A.  §129a and 26 V.S.A. § 4093) can be obtained for the Board of Allied MH Practitioners or online at http://vtprofessionals.org/

The office of Professional Regulation has a procedure for receiving, investigating, and acting on complaints of unprofessional conduct. Consumers who have inquires or wish to obtain a form to register a complaint may do so by calling (802) 828-1505, or by writing to the Director of the Office, Secretary of the State's Office, 89 Main Street, 3rd Floor Montpelier, VT 05620-3402 or online at https://www.sec.state.vt.us/professional-regulation.aspx

If you need help understanding the Consumer Complaint, Grievance, and Appeal Procedure, please ask to speak to Kim McClellan at (802) 524-6554. 

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