The Department of Behavioral Wellness encourages individuals to contact the program supervisor or manager as a first step in solving a problem.. Clinic contact information is here. This page lists resources are available to clients who have comments or concerns about programs or services.
Know Your Rights as a Medi-Cal Beneficiary
The following will help you learn about and ensure your rights:
Note: Written notice of termination of a contracted provider will be provided, within 15 calendar days after receipt or issuance of the termination notice, to each beneficiary who was seen on a regular basis by the terminated provider. (42 C.F.R. § 438.10(f)(1).)
Patients' Rights brochures and flyers in English and Spanish are here.
Medi-Cal Medication Formulary here.
Filing a Grievance
Beneficiary Concerns is part of the Behavioral Wellness Quality Assurance program. If a consumer, family member, or member of the community thinks that a person or program has done something improper, that person can file an official grievance form. Forms are available in English and Spanish here. All grievances are thoroughly investigated by licensed mental health professionals. The staff who investigate grievances have no connection to any person or program being investigated. Except in unusually complex situations, grievance investigations are completed within 90 days. The person who filed the grievance is notified of the result by mail.
If someone is not satisfied with the result of a grievance investigation, the person can file an another grievance, which will be investigated by a different licensed professional. If the Department of Behavioral Wellness does not help you to your satisfaction and/or you need additional help, the State Medi-Cal Managed Care Ombudsman Office can help you with any questions. You may call them Monday through Friday, 8am to 5pm PST, excluding holidays, at 1-888-452-8609.
Alcohol and Drug Program
Client Concerns is a part of the Alcohol and Drug Program (ADP). If a client, family member, or member of the community thinks that a person or program has done something improper, that person may file an ADP grievance. Forms are here in English and Spanish.
All grievances are thoroughly investigated by Alcohol and Drug Program Specialists. The staff who investigate grievances have no connection to any person or program being investigated. Except in unusually complex situations, grievance investigations are completed within 60 days. The person who filed the grievance is notified of the result by mail.
If you are a Drug Medi-Cal client, you may also request a
State Fair Hearing. All State Fair Hearings are heard by an independent administrative law judge.