CHILD WELFARE MANUAL

Section 8, Chapter 1 (Grievance and Appeals), Subsection 1 – Service Delivery Grievance Process

(Effective:  05/01/19)

1.1  Service Delivery Grievance Process

The Children’s Division is committed to providing the children and families of Missouri with the best possible services in the most professional manner. The Children’s Division is mandate to provide a fair and impartial grievance processes to address licensure, case management decisions, and delivery of service issues. (See also PA-CR-3: Grievance Procedures). The Service Delivery Grievance process is the process for families to express concerns of perceived inequities, unfair treatment, or dissatisfaction with agency actions or behaviors, not covered by other grievance procedures.  

1.1.1   Who may File a Grievance:

    1. Any adult family member who is currently receiving services or has had services terminated within the past 30 days.
    2. Youth 12 years of age or older.
    3. Any child younger than 12 years of age with the assistance of a parent, guardian, resource provider, or Guardian ad Litem.
    4. Any resource provider, with the exception of resource providers who work with contracted agencies to provide care. These resource providers must utilize the process outlined by the contracted foster care case management agency.

1.1.2   What Constitutes a Grievance:

    1. A grievance is a complaint based upon an actual or perceived situation in which the person believes there is just cause for protest or disagreement.
    2. A grievance may be any disagreement or complaint a youth, family member, or resource provider has with an employee or a contractor of the Children’s Division. A grievance may be related to a variety of service provision issues. A few examples are, but not limited to:
      • Youth does not agree with placement recommendation made by worker and the Family Support Team.
      • Parent does not feel they are receiving services as provided for in the case plan.
      • Incarcerated parent is not satisfied with arrangements for visitation with child.
      • Family dissatisfied that visits and/or meetings are cancelled without appropriate notice.
      • Parents believe non-court ordered visitation with children should be extended.
      • Person disagrees with a Family Assessment determination.

1.1.3   What is Not Grievable Through this Process:

    1. Any complaint of discrimination based upon race, color, national origin, age, sex, disability, religious or political beliefs. All complaints of this nature must follow Policy 2-104 found in the Department of Social Services Administrative Manual.
    2. Any complaint involving criminal activities of employees. The Regional Director, or his/her designee, shall refer these complaints immediately to the Division Director’s Office for review and any necessary action.
    3. Any dispute with the outcome of a Child Abuse/Neglect investigation. These complaints shall proceed through the established CA/N Review process.
    4. Any court ruling or current statute.
    5. Guardian ad Litem (GAL), Court Appointed Special Advocate (CASA), or judge appointments. Complaints about these appointments must be addressed through the court of jurisdiction.
    6. Any foster/adoptive licensing revocations or denials. These complaints shall be dealt with according to the Fair Hearing Process.
    7. Any complaint by a resource provider about a case management decision regarding a child in their care. These complaints shall proceed according to Alternative Care Review Board (ACRB).
    8. Those persons receiving adoption subsidy or guardianship subsidy are not eligible to use this grievance procedure. Subsidy grievances shall proceed according to the Children’s Services Fair Hearing Process.

1.1.4   Agency Do’s:

    • Do inform youth, families, and resource providers of their rights and grievance procedures.
    • Do assist the grievant through the process, if requested.
    • Do remain solution focused and work to resolve the complaint.
    • Do document the grievance in the narrative section of the record and file the Service Delivery Grievance Form in the Administrative Section of the case file.
    • Do inform grievant of outcome and actions.

1.1.5   Agency Don’ts:

    • Don’t prevent the grievant from pursuing his/her right to file a grievance or complaint.
    • Don’t retaliate against any person who participates in or initiates the grievance process.
    • Don’t allow the process to become adversarial or accusatory.

1.1.6   Steps in the Formal Grievance Process:

The formal grievance protocol is to be utilized after all other efforts to resolve the issue or complaint have been exhausted. Other efforts include solution-focused discussions with the worker, the supervisor, and other Family Support Team members. Staff from the county office shall ensure the grievant is fully informed of their right to grieve and when appropriate assure the grievant has a Service Delivery Grievance Form (CS-131). 

 Level One – Actions taken at this level include the grievant, worker, supervisor, Family Support Team (if needed) and the Circuit Manager or Regional Designee. The goal is to resolve the complaint/grievance at the local county level:

    1. The grievant shall initiate the grievance process by submitting a completed Service Delivery Grievance Form, CS-131, to the county office.
    2. The grievant shall complete Section A of the grievance form detailing a description of the grievance, and all efforts made by the grievant to resolve the issue with the worker, the worker’s immediate supervisor, and the Family Support Team.
    3. The Children’s Service Worker shall help the grievant complete the form if requested.
    4. Staff will immediately enter the details of the grievance, as documented by the client, into the Service Delivery Grievance Database upon receiving the completed form.
    5. Service Delivery Grievance Database will generate an email notification of the grievance to the Circuit Manager or regional designee. (This however, should not take the place of other communication through supervisory channels regarding the Service Delivery Grievance)
    6. Upon receiving the completed Service Delivery Grievance Form, the Circuit Manager or regional designee shall access the Service Delivery Grievance Database and screen the grievance according to policy.
    7. Within 15 working days, the Circuit Manager or designee shall by phone or in person, review and discuss in detail the complaint with the grievant, the worker, and the supervisor; and work with all parties to resolve the disagreement or complaint.
    8. The Circuit Manager or designee shall prepare and provide the grievant, the worker, and the supervisor with a written response to the grievance by completing Section B of the Service Delivery Grievance Form, indicating actions taken at Level One to resolve the issue.
    9. The Circuit Manager or designee shall update the Grievance Delivery Database; and upload the updated CS-131 into the system.
    10. The Circuit Manager or designee shall provide the updated copy of the form to the grievant, worker, and supervisor.
    11. A copy of the updated grievance form with Level One response shall be placed in the Administrative section of the family record.

Level Two – Actions taken during this step include the grievant and the Regional Director or his/her designee:

    1. If the grievant does not agree with the response from Level One, he/she may continue the grievance process by returning the grievance form to the Regional Director’s office within 15 working days from the date the written response was received.
    2. Within 15 working days of receiving the grievance form, the Regional Director or his/her designee shall review all pertinent information obtained at Level One such as worker involvement and contacts with all necessary individuals.
    3. The Regional Director or his/her designee shall contact grievant, by telephone or in person, to listen to and discuss grievance in detail and work together with grievant to resolve the disagreement or complaint.
    4. The Regional Director or his/her designee shall prepare and provide the grievant and the Circuit Manager or Regional Designee a written response by completing Section C of the grievance form, indicating actions taken at Level Two to resolve the issue.
    5. The Regional Director or his/her designee shall update the Service Delivery Grievance Database, upload the completed grievance form into the system, and provide the updated copy of the form to the grievant and to the Circuit Manager or Regional Designee.
    6. A copy of the updated Service Delivery Grievance Form with the Level Two response shall be placed in the Administrative section of the family record.

Level Three – This is the final step in the grievance process and involves the grievant and the Children’s Division Director or his/her designee:

    1. If the grievant does not agree with the response from Level Two, they may continue the grievance process by submitting the grievance form received from Level Two to the Division Director’s office within 15 working days, by mail or in person, from the date the written response is received from Level Two.
    2. Within 15 days of receiving the grievance form, the Children’s Division Director or his/her designee shall review all information pertaining to the grievance at the first two levels such as worker involvement and contacts with other necessary individuals including grievant.
    3. The Children’s Division Director or his/her designee shall contact grievant, by telephone or in person, to listen and discuss the grievance in detail.
    4. The Children’s Division Director or his/her designee shall complete Section D of the grievance form.
    5. The Children’s Division Director or his/her designee shall prepare and mail the grievant a copy of the Service Delivery Grievance Form with the final written response in Section D and forward a copy of the final grievance form to the Regional Director or his/her designee.
    6. The Regional Director or his/her designee shall ensure that the final Service Delivery Grievance Form is placed into the Administrative section of the family record.
    7. A copy of the final grievance form from Level Three shall be maintained in the office of the Division Director.
    8. The Division Director or his/her designee shall enter information regarding Level Three determination from the Service Delivery Grievance Form into the Service Delivery Grievance Database, and upload a copy of the completed form into the system.

Confidentiality and Access to Records

The documentation that is generated from this process shall be maintained in the family case record, filed in the Administrative Section. Agency personnel will follow the same confidentiality guidelines for information gathered during the grievance process as any other information gathered during Service Delivery.

Data for the Continuous Quality Improvement Process

The need to track outcomes and the means by which they were achieved is an important part of the quality improvement process. Staff are required to document the grievance in the narrative section of the record and file the Service Delivery Grievance Form in the Administrative Section of the case file.

The information received from Level One through Level Three of the grievance process is collected in the Service Delivery Grievance Database and may be aggregated for use in the CQI process. Circuit Managers or Regional Designees, Regional Directors or his/her designee, and the Division Director or his/her designee are responsible for making sure that all Service Delivery Grievance Form information is entered into the Service Delivery Grievance Database at each of their perspective levels in a timely manner.  Reports generated from the Service Delivery Grievance Database are available for discussion during CQI group meetings or may be accessed for the purposes of identifying grievance trends or gaps in service delivery, locally, or statewide.

The ultimate goal is to use the information gained from the process to continually build upon our quality service delivery system. Each team that reviews the reports should look for trends related to the quality of services being delivered, program issues, communication, etc. that led to the grievances.  If trends are identified, it is expected that an action plan is developed to remedy the identified area of concern.  Steps that are taken to rectify any of the identified issues should be reported to the next level CQI team and followed-up at the next quarter local team meeting to monitor progress.