GRIEVANCES

Grievance policies have been developed for clients and grantees to provide procedures related to funding decisions, including procedures for submitting grievances that cannot be resolved by binding arbitration. The legislation requires that these procedures be consistent with model grievance procedures developed by Health Resources and Services Administration (HRSA), which address grievances with respect to Ryan White funding.

Client Grievance & Options for Dispute Prevention

The Client Grievance Policy within the Oakland TGA is established to provide a mechanism for report and resolution of UNRESOLVED issues with an agency of the Ryan White network. The policy defines the particulars on who should be contacted, how to document the concern, timeline for expectation of response and follow-through if instances where resolve has not been established.

It is recommended that all complaints should initially be addressed directly with the agency leadership. In circumstances where escalation is necessary, the following Grievance policy documents should be reviewed and presented. View the Client Grievance Policy in English or Spanish for complete details.

Client Grievance Form

This form needs to be completed and submitted within ten (10) business days after informal dispute resolution with agency leadership has been attempted. If no informal discussion has been attempted, submission of such documentation should be within ten (10) business days of the event/occurrence on which the grievance is based.

Forms

Client Grievance Authorization to Release Information

Use this form if the Client of Provider feels the issue has not been resolved they may appeal in writing by submitting copies of the original completed Client Grievance Form and the final written decision from the Provider including a completed Client Grievance Appeal Form:

Forms