Community Mental Health Handbook

Reviews, Complaints, Appeals and Second Opinions

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, visiting, or writing to the Recipient Rights Office. Assistance is available in the filing process by contacting local advocacy organizations. 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.

Appeals

You will be given notice 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 Recipient Rights at
    Ottawa (616) 393-5660 or Muskegon (231) 724-1107
  • You can ask at any time for a Medicaid Fair Hearing before an
    administrative law judge (a State appeal).
    Ottawa (616) 393-5660 or Muskegon (231) 724-1107

Your appeal will be completed quickly 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.
Staff with the Access Center and the Office of Recipient Rights can explain the second opinion, local appeal, and recipient rights complaint 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 appeal or complaint.
Providers in Substance Abuse Services will assist you with grievances and appeals. If you are not
able to resolve the problem, contact Karen Youngs-Hartley at Lakeshore Coordinating Council.
(616) 846-6720 or 1-877-846-522.