Medi-Cal Managed Care and Mental Health Office of the Ombudsman
The Medi-Cal Managed Care and Mental Health Office of the Ombudsman helps solve problems from a neutral standpoint to ensure that our members receive all medically necessary covered services for which plans are contractually responsible.
The Mental Health Ombudsman is designed to create a bridge between the Mental Health Plan system and individuals, family members and friends of individuals, in need of mental health services by providing information and assistance in navigating through the system.
The Ombudsman will not automatically take sides in a complaint. We consider all sides in an impartial and objective way. It is our job to help develop fair solutions to health care access problems.
The Office of the Ombudsman:
Serves as an objective resource to resolve issues between Medi-Cal managed care members and managed care health plans.
Helps members with urgent enrollment and disenrollment problems.
Offers information and referrals.
Identifies ways to improve the effectiveness of the Medi-Cal managed care program.
Educates members on how to effectively navigate through the Medi-Cal managed care system.
Help you find information in order to access appropriate mental health services
Connect you with the right person/department to help you resolve a problem
Connect you with local resources in your county who can help you
Connect you with patient’s’ rights services
How can I contact the Office of the Ombudsman?
Hours of Operation: Monday through Friday, 8am to 5pm PST; excluding holidays
By Phone: (888) 452-8609
By email: MMCDOmbudsmanOffice@dhcs.ca.gov
The California Department of Health Care Services (DHCS) is required to ensure that mental health laws, regulations, and policies for the rights of mental health service recipients are observed in licensed mental health facilities.
Californians with mental illnesses who are receiving treatment in mental health facilities, including those persons subject to involuntary commitment, are guaranteed numerous rights under Welfare and Institutions code (W&I Code), Section 5325, including the right to be free from abuse and neglect, the right to privacy, dignity, and humane care, and the right to basic procedural protections in the commitment process.
DHCS in agreement with Department of State Hospitals is required to enter a multi-year contract with a nonprofit organization to provide investigative and advocacy services. Currently, the contractor providing the patients’ rights investigative and advocacy services required in W&I Code, Section 5370.2 is the Disability Rights California, Office of Patients' Rights (OPR). The OPR also provides training and technical assistance to all county patients' rights advocates.
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