California Code of Regulations
Title 15 - Crime Prevention and Corrections
Division 3 - Adult Institutions, Programs and Parole
Chapter 2 - Rules and Regulations of Health Care Services
Subchapter 2 - Patient's Entitlements and Responsibilities
Article 5 - Health Care Grievances
Section 3999.234 - Health Care Grievance and Health Care Grievance Appeal Rejection

Universal Citation: 15 CA Code of Regs 3999.234

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) A health care grievance or health care grievance appeal may be rejected for reasons, which include, but are not limited to:

(1) The patient did not submit the health care grievance or health care grievance appeal pursuant to Subchapter 2, Article 5.

(2) The health care grievance concerns an anticipated action or decision.

(3) The patient submitted the health care grievance without a prior attempt to obtain health care services through approved processes. In this case, HCGO staff shall submit a request for health care services, if medically necessary, to the appropriate facility clinic on behalf of the patient.

(4) An individual submitted a health care grievance or health care grievance appeal on behalf of another person.

(5) The patient is temporarily outside health care jurisdiction for an indeterminate amount of time, including, but not limited to, out-to-court or at an offsite hospital, and not expected to return before the time limits for responding to the health care grievance or health care grievance appeal have expired.

(6) The health care grievance duplicates the patient's previous health care grievance upon which a decision was rendered or is pending and the patient has not provided any new information that would indicate additional review is warranted.

(7) A health care grievance is submitted as a group grievance by more than one patient related to a policy, decision, action, condition, or omission affecting all members of the group.

(b) When a health care grievance or health care grievance appeal is rejected, a response to the patient shall provide written instruction regarding further action the patient must take to qualify the health care grievance or health care grievance appeal for processing and the timeframe necessary, as determined by the HCGO or HCCAB, to correct and resubmit the health care grievance or health care grievance appeal to the identified office.

(1) If the patient submits a health care grievance or health care grievance appeal more than twice without complying with the written instruction, the health care grievance or health care grievance appeal will be adjudicated based on available information. Adjudication of a health care grievance or health care grievance appeal without complying with written instruction to correct submission does not preclude consideration for abuse pursuant to section 3999.236(a)(2).

Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; Americans With Disabilities Act, Public Law 101-336, July 26, 1990, 104 Stat. 328; Civil Rights of Institutionalized Persons Act, Title 42 U.S.C. Section 1997 et seq., Public Law 96-247, 94 Stat. 349; Section 35.107, Title 28, Code of Federal Regulations; Armstrong v. Newsom (No. C-94-2307-CW), U.S. District Court, Northern District of California; Coleman v. Newsom (No. S90-0520 LKK JFM P) U.S. District Court, Eastern District of California; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.

Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; Americans With Disabilities Act, Public Law 101-336, July 26, 1990, 104 Stat. 328; Civil Rights of Institutionalized Persons Act, Title 42 U.S.C. Section 1997 et seq., Public Law 96-247, 94 Stat. 349; Section 35.107, Title 28, Code of Federal Regulations; Armstrong v. Newsom (No. C-94-2307-CW), U.S. District Court, Northern District of California; Coleman v. Newsom (No. S 90-0520 LKK JFM P) U.S. District Court, Eastern District of California; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.

Disclaimer: These regulations may not be the most recent version. California may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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