Complaints

Complaints regarding the DHS Coordinated Transportation System, transportation providers, vehicles, drivers, and/or passengers shall be handled promptly and objectively. Transportation Providers (TP) may file a complaint directly with the Regional Transportation Office (RTO); all other parties, including consumers, must work with their Human Service Provider (HSP) to file a complaint. The HSP shall complete a Complaint Form (Appendix 6 – Complaint Form) and send it to the appropriate RTO on behalf of the party submitting a complaint.

The RTO maintains records of all complaints filed and routes them to the appropriate parties for investigation and resolution. Information is gathered from both the Complainant and the Subject of the Complaint to determine the issue at hand and develop appropriate steps for resolution, if necessary.

Transportation Providers must submit to the Regional Transportation Office a written document that details their processes/protocols to report and respond to accidents, incidents, and complaints. The protocols must address sub-contractor compliance and outline remedies for poor performance (to include poor drive behaviors). Under no circumstances should a driver secure and transport a consumer using a wheelchair with receiving wheelchair securement training.

Accident and Incident Reporting

All urgent incidents and accidents must be reported to the authorities by calling 911 and to the RTO. Refer to Chapter 3 for additional information on incident and accident reporting.

Vehicle Incidents

Events that are health or safety hazards, such as the presence of bodily fluids or vermin in the vehicles or the lack of passenger assistance from the driver when required and resulting in an accident, are classified as incidents, not complaints. Refer to Chapter 3 for additional information on incident and accident reporting.

Passenger Incidents

The TP shall inform the RTO of any incidents experienced while transporting a consumer, whether related to safety, behavior or other reason. The RTO then informs the HSP and any other relevant parties of the incident. Refer to Chapter 3 for additional information on incident and accident reporting.

Behavior Incidents

Any conduct or action by a consumer that places himself/herself or other consumers in harm’s way while being transported by the DHS Coordinated Transportation System or in a state owned or leased vehicle is considered a behavior incident.

If behavior or actions are serious enough to require immediate assistance or intervention by police or other authorities, transportation service is immediately suspended pending a review of the incident. Behavior or actions include, but are not limited to, suicidal gestures or attempts, assaults, possession or use of weapons, homicide, frequent medical disruptions, aggressive behavior, and running away.

To remediate a behavior incident, follow the steps for Accident/Incident Reporting:

  • Call 911, if applicable

  • Call the emergency contact for each consumer involved in the incident

  • Call the appropriate RTO

See Chapter 3 for additional information and requirements on accident and incident reporting.

Disruptive or Unsafe Behavior

Other disruptive or unsafe behavior on the vehicle that has the potential of placing consumers in harm’s way can be addressed using the Complaint Process. This includes behavior that a consumer exhibits that does not endanger anyone but causes discomfort for other consumers. Examples include, but are not limited to, refusal to stay buckled and seated, playing loud music, and distracting the driver.

Complaint Process

In the case of dissatisfaction in the quality of service provided by the Coordinated Transportation System, a complaint may be filed by the aggrieved party. Only non-emergency complaints that do not address vehicle accidents, consumer-related accidents, behavior incidents, nor disruptive or unsafe behavior may follow the complaint process to file a complaint. Complaints may address such issues as the timeliness of the transportation service, vehicle condition, driver behavior, and other passengers of the vehicle.

Roles and Responsibilities Overview

Role Responsibility

Complainant

Files complaint, provides information to the investigator and participates in a group meeting as requested, and may request a case review in the event of an unsatisfactory resolution.

Subject of the Complaint

Subject of the Complaint Investigator

Consumer

HSP

HSP*

Prime Contractor, RTO

Subcontractor

Prime Contractor

Prime Contractor

(RTO)

Provides information to the Investigator and participate in a group meeting as requested, and if issued, executes the Action Plan to resolve issue or prevent similar issues in the future.

Investigator

Subject of the Complaint Investigator

Consumer

HSP

HSP*

Prime Contractor, RTO

Subcontractor

Prime Contractor

Prime Contractor

(RTO)

Investigates complaint by compiling information gathered from all parties involved and notifies them of the outcome of the investigation.

Regional Transportation Office (RTO)

  • Provides overall oversight of the complaint investigation process

  • Manages distribution of complaints and monitors the investigation’s timeliness and updates TP performance log, if needed.

Process Flow: Complaint Process

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The following process flow illustration depicts the full Complaint process from the filing of a complaint through the complaint resolution and communication of outcome to all parties involved. This process flow shows each responsible party and its steps throughout the process. The highlighted area(s) in the process flow depict the Complainant, the Subject of the Complaint, and the Investigator roles within the process. The Complainant, the Subject of the Complaint, and the Investigator specific steps are described after the process flow.

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Procedures – Complaint Process

The procedural steps and details outlined below are those that are the responsibility of the Complainant, Subject of the Complaint, and Investigator and correspond to the steps highlighted in the process flow above. Refer to the Roles and Responsibilities, above, to determine who fulfills each role in the complaint process, dependent upon whom the complaint is against.

Step 1 – File a complaint (Complainant)

TPs file their complaints directly with the RTO. All other Complainants, including consumers, must work with their HSP to file a complaint. The TP or HSP completes the Appendix 6 – Complaint Form and sends it to the appropriate RTO by email.

Steps 2-3 – (RTO)

The RTO receives the complaint, logs the complaint, and determines the Investigator of the complaint based on the Subject of the Complaint. The RTO sends a copy of the complaint to both the Subject of the Complaint and the Investigator.

Step 4 – Receive complaint (Subject of the Complaint and Investigator)

Both the Subject of the Complaint and the Investigator, as determined by the RTO based on the Complaint Form, receive a copy of the complaint. Refer to the Roles and Responsibilities section above to determine who fulfills each role in the complaint process, dependent upon whom the complaint is against.

Step 5 – Investigate complaint (Investigator, Complainant, and Subject of the Complaint)

The Investigator is responsible for leading the investigation into the complaint. The Investigator requests information from both the Complainant and the Subject of the Complaint. The Investigator receives the information from both parties and documents the investigation findings with the complaint. Both the Complainant and the Subject of the Complaint are responsible for gathering their own documentation, such as photographs and videos, doctors' notes, records, driver logs, Individual Service Plan (ISP), etc., and sending it to the Investigator by email.

Steps 6 and 7 – Is the investigation exceeding the predefined time limit? (Investigator)

The Investigator has 3 days to provide an update or close the investigation and relay the findings to the RTO for distribution back to all involved parties. If the Investigator cannot complete the tasks within this time frame, the Investigator must provide a case update to both the RTO and the Complainant. The process restarts and the Investigator has 3 more days to provide an update or close the investigation and relay the findings to the RTO.

Step 8 – Receive case update (Complainant and RTO)

In the case of an investigation taking longer than the predefined time limit, the Investigator provides a case update to the Complainant and RTO.

Steps 9-10 – (RTO)

The RTO notes of any lag in resolving the complaint in the performance log (see Exhibit 15 – Sample DHS Complaint Performance Log).

Step 11 – Complete the Complaint Resolution Form (Investigator)

Once the investigation is complete, the Investigator fills out the Appendix 7 – Complaint Resolution Form based on the information gathered by the Complainant and the Subject of the Complaint.

Step 12 – Send Complaint Resolution Form (Investigator)

The Investigator sends the completed Complaint Resolution Form by email to the RTO and all parties involved. The Complaint Resolution Form may detail steps the Subject of the Complaint should follow to correct the issue and/or prevent the issue from reoccurring.

Step 13 – Receive Complaint Resolution Form (Complainant, Subject of the Complaint, and RTO)

The Complainant, Subject of the Complaint, and RTO receive a copy of the Complaint Resolution Form sent by the Investigator.

Step 14 – Close complaint (Investigator and RTO)

The Investigator and RTO close the complaint.

Step 15 – Store complaint (Investigator and RTO)

The Investigator and RTO store the complaint for future reference, if needed.

Step 16 – Satisfied with resolution?

The Complainant and the Subject of the Complaint have the option to review the Complaint Resolution Form and decide if the outcome is satisfactory. If the complaint is resolved with proper satisfaction from all parties, the process ends.

Step 17 – Request a case review (Complainant and Subject of the Complaint)

This step occurs only if the Complainant or Subject of the Complaint finds the results of the complaint unsatisfactory (Step 17), in which case either party has 10 days to request a case review by email to the RTO. The case is subsequently re-opened and investigated by the RTO.

Steps 18-20 – (RTO)

If a case is appealed and a review is requested by the Complainant or Subject of the Complaint, the RTO reopens the case and reviews the complaint and resolution to determine if appropriate steps were taken to resolve the issue. If the RTO determines appropriate action was taken, it may close the complaint and alert parties of the decision (continue to Step 24).

Step 21 – Lead/participate group meeting and collect additional info (Complainant, Subject of the Complaint, Investigator, and RTO)

This step occurs only if the RTO deems the appropriate steps were not taken to resolve the issue. If the RTO deems the steps to resolve the complaint were inadequate, the RTO requests and leads a group meeting, in-person or by phone, with all parties involved to discuss the matter and review the evidence.

Steps 22-24 – (RTO)

The RTO decides on the appropriate action steps for the outcome of the meeting. If an Action Plan is not needed, it may close the complaint and alert parties of the decision (continue to Step 24). If one is needed, the RTO develops an Action Plan with the appropriate steps to be taken by either the Complainant or the Subject of the Complaint, files the Action Plan with the complaint, and notifies all parties of the outcome.

Step 25 – Receive complaint final outcome (Complainant, Subject of the Complaint, and Investigator)

The RTO notifies all parties involved of the final outcome of the case review by email, including the Action Plan if one was developed.

Step 26 – Was an Action Plan assigned? (Complainant and/or Subject of the Complaint)

If no Action Plan was developed, the process ends. In the case the RTO finds additional steps need to be taken by the Complainant and/or the Subject of the Complaint to adequately resolve the issue and/or prevent recurrence, the Complainant and/or the subject of the complaint must execute the Action Plan.

Step 27 – Execute Action Plan (Complainant and/or Subject of the Complaint)

The Complainant and/or Subject of the Complaint must execute the steps assigned in the Action Plan within 3 days, or as instructed in the Action Plan. Failure from TPs to abide by the Action Plan may affect the Corrective Action Plan (and thus, the contract) for the TP; failure from the consumer or HSP to abide by the Action Plan may result in the restriction of transportation privileges.

Step 28 – Notify RTO of Action Plan execution

The party executing the action plan steps notify the RTO by email that the plan has been executed.

Steps 29-30 – (RTO)

The RTO updates the complaint with the information received regarding steps taken to implement the Action Plan and updates all parties involved in the investigation.

Step 31 – Receive complaint update

All parties involved in the investigation receive an update from the RTO on the complaint and steps taken on the Action Plan.

Document Description

Appendix 6 – Complaint Form

Form used for a TP or HSP to submit a formal complaint to the RTO.

Appendix 7 – Complaint Resolution Form

Form filled out by an Investigator once a complaint investigation is completed; it details steps the Subject of the Complaint; should follow to correct the issue and/or prevent the issue from reoccurring.

Exhibit 15 – Sample DHS Complaint Performance Log

Log used by the TSS State Office to track TP performance issues and their resolution.