Complaint/Grievance Process

What if there is a problem with mental health services?

If you or a friend or family member has a problem, we hope you will express your concerns. Here's how:

• Start by talking to your doctor, therapist, or staff at the program. Most problems are easily resolved.
• If you are not comfortable dealing with program staff, or your attempt doesn't work, you may want to file a complaint or grievance.

The Complaint and Grievance Process:

Complaint

A complaint is an informal verbal expression of concern with your mental health service. You can have a friend or family member help you with this process. Complaints can be filed:

• By Phone: call Los Angeles County Department of Mental Health's Patients' Rights Office at 800-700-9996 or 213-738-4949 or Protection and Advocacy Inc. in Los Angeles at 800-776-5746 for help with complaints about your rights as a patient in an inpatient facility or other setting.

Grievance

A grievance is a formal procedure for resolving a problem. Grievances can be made orally or in writing. To file a grievance:

• By phone: Call Los Angeles County Department of Mental Health's Patients' Rights Office at 800-700-9996 or 213-738-4949 to speak with an advocate or Protection and Advocacy Inc. Los Angeles at 800-776-5746.
• In writing: Use the complaint and grievance form available in the waiting room of your hospital program or doctor's office.

Referrals/Change of Providers:

You have the right to get a second opinion and/or to request a new doctor or therapist. Call the Department of Mental Health Access Line at 800-854-7771 or Patients' Rights Office at 800-700-9996 or 213-738-4949 and ask for a referral or a second opinion about medication or treatment. You don't have to file a complaint or grievance to do this.

Patients' Rights:

If you are or have been a patient of mental health services, you have the right to:

• To access services that are appropriate to your disability, culture, language, gender, and age;
• Be treated with respect and with due consideration for your dignity and privacy;
• Receive information on available treatment options and alternatives, presented in a manner appropriate to your condition and ability to understand;
• Participate in decisions regarding your health care, including the right to refuse treatment;
• Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation;
• Request and receive a copy of your medical records, and request that they be amended or corrected;
• Receive information in accordance with Title 42, CFR, Section 438.10, which describes information requirements;
• Be furnished health care services in accordance with Title 43, CRF. Sections 438.206 through 438.210, which cover requirements for availability of services, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services.

If you have any questions regarding your right as consumer receiving mental health services in Los Angeles County, you may contact Los Angeles County Department of Mental Health's Patients' Rights Office at 800-700-9996 or 213-738-4949 to speak with an advocate. Patients' Rights Advocates can give you information on the rights of clients and family members, including information on involuntary treatment. This may involve explaining patients' rights, assisting with negotiating a solution to a problem, or representing a client in a hearing or other dispute resolution process.

The Right to Access Your Medical Records

With certain exceptions, you have the right to inspect and copy your medical record. To inspect and copy your medical record, you can contact the HIPAA (Health Insurance Portability and Accountability Act) Privacy Officer at the program where you are receiving mental health services. A form may be provided to you to complete the request. If you request a copy of your medical record, you may be charged for a fee for the costs of copying, mailing, or other supplies associated with your request. If you experience problems obtaining your medical record, you may contact Patients' Rights Office at 800-700-9996 or 213-738-4949 for assistance.

The Right to Confidentiality

While your medical records and what you say to your therapist are held in strict confidentiality, there are 10 situations when confidentiality rights can be broken:

1. 1. When you decide to discuss your treatment with another person.
2. 2. When there is a treatment emergency that requires disclosure of information to protect your health and well being from immediate harm.
3. 3. When there is a safety emergency in which your or anyone's safety is in immediate danger.
4. 4. When therapists working in the same facility or those individuals responsible for the same patient's care must share information with each other to coordinate more effective treatment.
5. 5. When payment, insurance, peer and administrative reviews to evaluate the quality of mental health services are involved.
6. 6. When a court of law requires a mental health professional to provide information.
7. 7. When you are hospitalized and there is probable cause to believe that a serious crime had been committed by or upon you.
8. 8. When research is being conducted. However, researchers are bound by law from discussing the information that would identify you.
9. 9. When mandated reporting is involved, which requires review by agencies to provide protection to mentally disordered individuals.
10. 10. If you say that you are going to hurt another person, then according to California law the mental health provider has a duty to protect that person from being harmed. The mental health provider must either call the police or have you hospitalized if they believe that you are going to harm another person.

The Right to Refuse Treatment

You can refuse all forms of psychiatric treatment including medication and electro-convulsive therapy (ECT), but your refusal of psychiatric treatment is limited. You can be forcibly treated if a court of law finds that you lack the capacity to refuse treatment. You can also be forcibly treated if you are on conservatorship and your conservator has the appropriate legal power to mandate treatment.

The Right to Informed Consent

You have the right to be given information that explains the risks of receiving certain medications, and any other procedure or therapy so that you can make a rational decision about whether to take the medicine, have the procedure or undergo therapy. The mental health provider must give you written or oral explanations of all proposed treatments including psychotropic medications and ECT in regards to the risks, benefits and side effects of the proposed treatment.

The Right to Treatment and Services

The county mental health plan must provide you with services if you meet its criteria. The criteria include your diagnosis, level of functioning, whether your condition is likely to improve with treatment and whether the services are medically necessary. If you are denied services by your clinic or private practitioner, you have a right to a second opinion as well as the complaint/grievance process through your local advocacy office or the Department of Social Services.

The Complaint and Grievance Process

When your right(s) have been violated or you are dissatisfied wit any aspect of your treatment, you may go through the complaint and grievance process:

• By phone: Call Los Angeles County Department of Mental Health's Patients' Rights Office at 800-700-9996 or 213-738-4949 to speak with an advocate or Protection and Advocacy Inc. Los Angeles at 800-776-5746.
• In writing: Use the complaint and grievance form available in the waiting room of your hospital program or doctor's office.

Your Rights When You Are Denied Services

If you are denied services, you have three options:

1. The right to a second opinion.
2. The complaint and grievance process.
3. The right to receive a Notice of Action. You may receive a Notice of Action when the Local Mental Health Plan for Los Angeles County has decided, after reviewing the results of an assessment of your mental condition, that your mental condition does not meet the medical necessity criteria to be eligible for specialty mental health services through the plan.
4. The right to file a State Fair Hearing. After you have exhausted the complaint and grievance process and you are dissatisfied with resolution of Patients' Rights Office, you may request a State Fair Hearing by calling Patients' Rights Office at 213-738-4949 or State Department of Social Services at (800) 952-5253.

For more information regarding your rights as a mental health client, contact:

Office of Patients' Rights - Los Angeles County Department of Mental Health
550 S. Vermont Ave., 6th Floor
Los Angeles, CA 90020
213-738-4949 (Outpatient Services)
213-738-4888 (Inpatient Services)

Legal Rights
There are several resources available for legal rights.

Mental Health Advocacy Services, Inc.
213-389-2077

Mental Health Advocacy Services Inc. (MHAS) is a private, nonprofit organization established by the Los Angeles County Bar Association and the Beverly Hills Bar Association to provide free legal services to people with mental and developmental disabilities in Los Angeles County. MHAS assists both children and adults in obtaining government benefits and services, protecting rights and fighting discrimination. MHAS also serves as a resource to the community by providing training and technical assistance to attorneys, mental health professionals, consumer and family member groups, and other advocates. MHAS also participates in impact litigation in an effort to improve the lives of people with mental and developmental disabilities.

Mental Health Court Program
323-478-8232
Public Defender for Mental Health Court
323-226-2932

The Mental Health Court Program consists of Los Angeles County Department of Mental Health employees who are located in the courts. Their job is to interact with judges, attorneys, public defenders, and clients in an effort to come up with alternatives for people convicted of a crime and who have a mental illness.

Legal Aid Foundation of Los Angeles
323-801-7989

If you need immediate legal assistance and cannot find help, call the LAFLA hotline at: 800-399-4529. As Los Angeles' frontline law firm for low-income people, Legal Aid Foundation (LAFLA) promotes access to justice, strengthens communities, combat discrimination, and effects systemic change through representation, advocacy and community education. LAFLA can provide emergency legal help to low-income people in Los Angeles, Long Beach and Santa Monica, especially concerning housing eviction and domestic abuse.

Legal Aid Society of Orange County
800-834-5001

Legal Aid Society of Orange County provides free, civil legal services to low-income persons and seniors who live in Orange County and southeast Los Angeles County. Hours are 9 a.m. - 6 p.m. Monday through Thursday, and 9 a.m. - 4 p.m. Friday.

Neighborhood Legal Services of Los Angeles County
800-433-6251

Neighborhood Legal Services of Los Angeles County (NLS) provides free legal services to low-income residents. Serving all of Los Angeles County, including the San Fernando and San Gabriel Valleys, the neighboring communities in the Pomona, Santa Clarita and Antelope Valleys, and the cities of Burbank, Glendale, and Pasadena. NLS provides services for housing law, domestic violence/family law, immigration law, employment law, community development, consumer protection education, discrimination, community, legal education, public benefits and health access.

Protection and Advocacy Inc.
800-781-4546 (TTY)
800-776-5746
213-427-8747 (Voice)

Protection and Advocacy Inc. (PAI) is a nonprofit agency that works in partnership with people with disabilities to protect, advocate for and advance their human, legal and service rights. Under a contract with California's Department of Mental Health, PAI operates the Office of Patients' Rights to advocate for the rights of people who have a psychiatric disability or emotional impairment.