File a Grievance

Beneficiaries may file a written or oral grievance at any time regarding the provision of mental health services. A grievance is an expression of dissatisfaction about any matter other than an Adverse Benefit Determination. You may file a grievance:

• By phone: Contact CCBHS between 9 am and 5 pm by calling 925-957-5160. Or, if you cannot hear or speak well, please call 711.
• In writing: Fill out a complaint form or write a letter and send it to:
  Contra Costa Behavioral Health Services Administration
  Attn: Quality Improvement Coordinator
  1340 Arnold Drive, Suite 200
  Martinez, CA 94553
• In person: Visit you CCBHS program site and say you want to file a grievance.
• Electronically: The Beneficiary Grievance Review Request Form can be located at: cchealth.org/mentalhealth/provider/

Important Information You Should Know

1. If you need assistance with completing this form:
   • You may ask any staff person at each program, and someone will be designated to assist you.
   • You may call the Grievance Advocate (not a direct County employee) at 925-293-4942. Collect calls accepted.
2. You may authorize another person to act on your behalf if you sign a Release of Information form for that person to know confidential information.
3. You may, in addition to this form, submit written materials and present additional clinical or medical evidence in support of your position at the hearing.
4. Within sixty (90) working days of receipt of a grievance, the Quality Improvement Coordinator will review the grievance and provide a decision on the grievance. This timeframe may be extended by you for up to 14 days by request, or by the Mental Health Plan determines that there is a need for additional information and that the delay is in your interest.
5. Client/families will not be subject to any manner of discrimination, penalty, sanction or restriction for exercising their appeal or rights.
6. For grievances related to concerns of discrimination based on sex, race, color, religion, national origin, ancestry, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender identity, or sexual orientation you may file the complaint directly with CCBHS or you may file with the Department of Health Care Services Office of Civil Rights and the United States Department of Health and Human Services Office for Civil Rights.
7. For Additional information, please call:
   • Office of Quality Improvement 925-957-5160
   • Mental Health Access Line 1-888-678-7277

Medi-Cal Beneficiary Grievance Procedures Policy