I/DD Adult Services
What happens when I want to file a grievance?
If you are dissatisfied with your CMH services, supports, or staff who provide them, you can file a grievance. You can do this at any time by calling CMH Customer Services at 616-494-5545 or email us at email@example.com Grievances can be filed by a consumer, parent of a minor, guardian, or their legal representative.
Once we have received your grievance, we will send a letter acknowledging receipt of the grievance. We may reach out to you for more information, or you can provide us with new information at any time. A written resolution will be sent within 90 days of the date of the request.
What is the Appeal Process?
When a service has been reduced, terminated, suspended or denied or an Individual Plan of Service has been completed a Notice of Adverse Benefits Determination (NABD) will be sent to the Consumer or Parent/Guardian. The NABD provides information about the action being taken and what the action was based on. If you disagree with the action, you have the right to an Internal Appeal for Medicaid Beneficiaries or the Local Dispute Resolution Process for people not covered by Medicaid. A sample NABD is here for you to review. You have the right to concurrently file an Appeal of an Adverse Benefit Determination an a Grievance regarding other services complaints. If you have questions about the process you can contact Customer Services at 616-494-5545 or email us at firstname.lastname@example.org
Habilitation Support Waiver Explanation
In the 1970's the Habilitation Support Waiver (HSW) was originally intended to help Community Mental Health (CMH) providers to bring people out of State institutions and support them in their communities. The “waiver” waived some Federal Regulations allowing CMH to provide services in the community that were otherwise not Medicaid allowable in the institution. Since then, other waivers have been developed providing almost the same services. However, CMH must still use the habilitation support waiver as an option. The Federal government would not eliminate the Habilitation Support Waiver and allow all people to be served under the same funding source.
There is a limited number of HSW slots in the State of Michigan which are dispersed to the 10 Prepaid Inpatient Health Plans (PIHP). Our PIHP, the Lakeshore Regional Entity has a designated number of slots which need to be filled. If the slots are not filled, they will be assigned to another PIHP and the Lakeshore Regional Entity will lose the funding associated with it. We typically enroll those that have a higher service need.
To be eligible for a HSW, a person would otherwise require ICF level of care services (in an institution). The application for the HSW involves the person or their guardian signing a consent initially and then once every three years. Certification and Major Life Activity (MLA) Forms are completed initially and annually by the Support Coordinator Aide to demonstrate eligibility. The HSW/Home and Community Based Services (HCBS) Team Supervisor submits the completed packet to the Lakeshore Regional Entity including the certification form, the MLA form, Individual Plan of Service, Psychosocial, the Supports Intensity Scale (SIS), and any other clinical assessments that may be necessary. The Lakeshore Regional Entity reviews the information and sends it to the State for waiver approval. Applications are prioritized based on level of need.
What is Independent Facilitation and Independent Supports Coordination?
As you prepare for your upcoming Person-Centered Planning Process, we wanted to provide you with some information regarding Independent Facilitation and Independent Supports Coordination. In Michigan, individuals' receiving support through the Community Mental Health Service Provider (CMHSP) have a right to choose an independent facilitator for their PCP and/or an Independent Supports Coordinator.
An Independent Facilitator is an individual who facilitates the Person- Centered Planning (PCP) process in collaboration with the person. This individual is independent from but paid by Ottawa County Community Mental Health. An independent facilitator will get to know the individual and help with all pre-planning activities and facilitate the meeting and assist with developing an Individual Plan of Service to help a person achieve their goals.
Independent Supports Coordination
A Supports Coordinator assists an individual with an Intellectual or Developmental Disability find and coordinate necessary services, supports and resources within the community to help meet their goals. They guide someone through the Person-Centered Planning Process to assist with having the best life possible. Independent Supports Coordination is someone assigned to do the above that is not directly hired through Ottawa Community Mental Health. You have a right to choose an Independent Support Coordinator individually or through a contracted agency if you desire.