Problems, Grievances & Appeals
Washtenaw County Community Support and Treatment Services works to ensure that all consumers have a high level of satisfaction with the services provided by our staff. If you are not satisfied, we are committed to addressing your concerns or complaints. Often, there is more than one way to appeal so if one method doesn't work, you may use another. When you disagree with a decision its usually a good idea to talk to your staff worker first. If that doesn't work, you can talk to the supervisor.
Grievance, Appeals & Recipient Rights Complaints
A grievance is filed when you are not satisfied with your services or supports. For example, you might file a grievance if you have concerns about the quality of care or services provided, or if you experience interpersonal relationship problems with a service provider. You can file a grievance at any time by calling or writing to your Member Services or to your Local Grievance and Appeals Officer. If you do not get an answer about your grievance in 60 days, you can file an appeal.
An appeal is filed when a decision is made about your services that you do not agree with. For example you might file a grievance if you have been denied services that you have requested, if your services are denied, reduced, suspended or stopped. You can also appeal your Person Centered Plan if you weren't invited to participate or if you do not agree with the final plan.
The methods to file an appeal will depend on what you are filing the appeal for. If your services are being denied or otherwise changed, you will receive a notice about the denial or change along with instructions on how to file an appeal.
Recipient Rights Complaint
A Recipient Rights Complaint is filed any time you think staff have violated your rights. Your rights include the right to be free from abuse, the right to confidentiality, and the right to be treated with dignity and respect. If you would like to make a recipient rights complaint, call 734-219-8519 or 734-544-3000 and ask to speak with the Rights Officer of the Day.
If You Disagree With the Decision
If you disagree with a decision about what services you will or will not get, it is a good idea to try talking it out first with the person who made that decision. If your first conversation doesn't solve the problem, go to the supervisor.
An important step to getting your problem resolved is to put it in writing! If it is about a specific incident, you should include:
- What happened
- When it happened
- Who was involved
The Problem Resolution Process Brochure includes a form to assist you in putting your complaint in writing. The supervisor must respond to you within five working days of receipt of the stated problem and send a copy of the answer to your client services manager or supports coordinator if appropriate. The supervisor may offer to meet with you in person to help work out the details of any problem resolution.
If You Are Still Not Satisfied
If you are still not satisfied, you have the choice of appealing the decision to the Local Dispute Resolution Committee. The committee will meet to hear the grievance within 10 days and give their recommendations for a resolution of the problem.
If you have Medicaid, you can appeal whenever services paid for by Medicaid are denied, stopped or reduced. You should receive a letter telling you that your services are changing. To use this type of appeal, get a Request for Hearing form from the agency.
- If you do not have Medicaid, the Local Dispute Resolution Committee's decision can also be appealed to a State of Michigan Department of Community Health Committee.
- If you are denied access to services, you have the right to request a second opinion.
Federal Medicaid regulations allow a person to request a hearing if a provider doesn't act with "reasonable promptness." Your Individualized Plan of Service should be written using a person-centered planning process. If this did not happen (if you weren't invited to participate and choose other participants) or you do not agree with the final plan, you may appeal. Once you file an appeal, the agency has 30 days to review the plan.
Consumer Satisfaction Is Our Primary Goal
One of our primary goals is for you to be satisfied with the services that you receive. You should feel safe and comfortable about letting us know how to better serve you. There will be no negative consequences for filing a complaint. If you are concerned at all about a negative reaction, please let us know by calling our Director at 734-544-3000.
Ask questions, seek information, and know that a resolution is always available!