Legal Aspects Manual

0130.010.05 Handling Complaints From the Participant or Their Representative

IM-73 June 2, 2022

Upon receiving a complaint from the participant or their representative, staff must:

  1. Review the complaint promptly and:
    • If the staff can resolve the complaint, they should do so and make a comment in the eligibility system as to the issue and action taken, and discuss the complaint with their immediate supervisor.
    • If staff are unable to resolve the issue, advise the participant that the complaint will be reviewed by the supervisor
    • Schedule a time for staff to contact the participant for follow-up.
  2. Forward this information to their immediate supervisor,
  3. Understand that the participant has the opportunity to discuss their complaint with staff at any time.

The immediate supervisor will:

  1. Review comments in the eligibility system regarding the complaint issues.
  2. Prepare for and schedule a conference with the staff member.

Staff and the supervisor must jointly decide upon the action to be taken.

Staff will complete any necessary follow-up action, i.e.:

  • Notify the participant of findings;
  • Record a complete, clear, and concise comment in the eligibility system of action(s) taken and resolution(s) reached; and
  • Submit the completed actions to the immediate supervisor, for sign-off.