SECTION 87.109. Data and Reports

(a) OO staff maintain records of inquiries and complaints in the HEART system.

(b) Texas Government Code §531.0171(d), allows OO staff to access any system or process for recording inquiries and complaints used or maintained by an HHS agency.

(c) OO staff compile a monthly report of consumer contacts received by HHS programs, including those received by vendors contracted to provide services on behalf of an HHS program. OO submits this report to the HHSC Executive Commissioner and designated program management staff across the HHS agencies on a quarterly basis. OO staff may also provide reporting of program-specific contact data to management teams of particular HHS programs.

(d) HHS programs have policies and procedures in place that address:

(1) Tracking. Use of a formal tracking system that captures essential information necessary for analysis, including:

(A) contact name and other identifying information;

(B) date contact received;

(C) method of receipt;

(D) reason for contact;

(E) details to isolate potential trends, such as location or particular service;

(F) resolution actions;

(G) date of resolution;

(H) whether the complaint was substantiated; and

(I) record of final communication with consumer, including date and method.

(2) Analysis. Monthly trend analysis to address shifts in volume of contacts received greater than five percent within a program. Research to determine the root causes for variations. For example, changes in agency policy or procedures, newly implemented programs, or staffing challenges that impact service delivery. The analysis must include:

(A) a listing of the top five reasons for inquiries, the top five reasons for complaints, and the top five reasons for legislative contacts, as compared to the total number received;

(B) explanation of factors impacting changes in reasons for contact from one month to the next; and

(C) data to indicate patterns, trends, or systemic issues of which program staff should be aware.

(3) Reporting. Monthly submission of contact data in the format determined by OO. Reporting must include:

(A) the number of inquiries, complaints, and legislative contacts received;

(B) the number of complaints resolved (from that month and previous months);

(C) the number of complaints resolved that were substantiated;

(D) the average time for resolution of complaints;

(E) the percent resolved within ten business days; and

(F) summaries of cases that illustrate relevant patterns or trends.

Source Note: The provisions of this §87.109 adopted to be effective January 10, 2019, 44 TexReg 252