Grievances and Appeals
Community Mental Health of Ottawa County strives to provide an immediate response to concerns and issues from consumers, guardians, or community members. If you have a concern or issue you would like to have addressed please contact the Customer Services Department at 616-494-5545 or 866-710-7378.
You may contact the Customer Services Department regarding the following:
- Questions about CMH services
- Inquiries about current services
- Concerns about current services
- Information on due process rights including how to file a grievance or appeal
Grievances
You have the right to say that you are unhappy with your services or supports or the staff who provide them, by filing a “grievance”. You can file a grievance any time by calling the Customer Services Department at 616-494-5545. You will be given detailed information about grievance and appeal processes when you first start services and then again annually. You may ask for this information at any time by contacting the Customer Services Office.
Local Appeals
You will be given Notice of Adverse Benefit Determination (NABD) when a decision is made that denies your request for services or reduces, suspends, or terminates the services you already receive. You have the right to file an appeal when you do not agree with such a decision. There are two ways you can appeal these decisions. There are also time limits on when you can file an appeal once you receive a decision about your services.
You may:
Ask for a Local Appeal by contacting the LRE Customer Service number 1-800-897-3301.
Your local appeal will be completed in a timely manner and you will have the chance to provide information or have someone speak for you regarding the appeal. You may ask for assistance from local advocacy organizations to file an appeal. Contact Customer Service for information.
Mediation
Mediation is a confidential process in which a neutral third party facilitates communication between parties, assists in identifying issues, and helps explore solutions to promote a mutually acceptable resolution.
You or your individual representative have the right to be notified of mediation at the time services or supports are initiated and at least annually after that. An individual representative is defined as a legal guardian, parent of a minor or another person who is authorized by law to represent you in decision making related to your behavioral health services and supports. If you have requested a local dispute resolution, a local appeal, or a state Medicaid fair hearing you also have the right to request mediation at the same time. Please reach out to Customer Services for more information on mediation services.
Staff with the Access Center and the Customer Services Department can explain the second opinion, local appeal, and grievances processes. They will provide the paperwork you need and help you with filling it out. Staff will give you information so you can check the status of your grievance or local appeal.