An Ombudsman is an official appointed to investigate an individuals’ complaints regarding their services. Our Ombudsman specializes in helping individuals voice their wishes and concerns so that they are heard and understood by their provider(s). They also assist in facilitating resolutions of grievances filed by MCCMH beneficiaries.
A grievance is an expression of dissatisfaction by a beneficiary about any matter other than an Adverse Benefit Determination. Grievances may include, but are not limited to, the quality of care or services provided, aspects of interpersonal relationships such as rudeness of a provider or beneficiary, etc. A grievance can also be filed pertaining to an extension of time proposed by MCCMH to make an authorization decision. When you file a grievance with the Ombudsman, MCCMH must acknowledge your concern in writing and must work with you to resolve it within 90 days.
A grievance must be filed in writing or verbally to the Ombudsman.
The grievance can be mailed to:
Macomb County Community Mental Health
The Community Relations Office
22550 Hall Road
Clinton Township, MI 48036
Grievances may be filed by individual(s) receiving benefits or by their legal representative. If a beneficiary has provided written consent, the provider or other authorized representative may also act on the beneficiary’s behalf to file a grievance
A grievance cannot be filed for an adverse benefit determination. Instead, beneficiaries who have received a ‘Notice of Adverse Benefit Determination’ and whose services have been reduced, suspended, or terminated, may request access to the local appeal process.