DHCS Discrimination Grievance Policies and Procedures
The Department of Health Care Services (DHCS) administers Medi-Cal. DHCS does not unlawfully discriminate on the basis of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, sexual orientation, or any other basis protected by federal or State civil rights laws.
DHCS has adopted a grievance procedure providing for the resolution of complaints alleging unlawful discrimination in the Medi-Cal program. Any person who believes they or someone else has been subjected to unlawful discrimination in the Medi-Cal program may file a grievance under this procedure.
Policies and Procedures:
Discrimination grievances must be submitted to the DHCS Office of Civil Rights within 365 days from the day the discrimination took place.
Discrimination grievances may be submitted by filling out the
DHCS Discrimination Complaint Form. Please include additional sheets of paper if needed to fully describe your grievance. Completed grievance forms may be filed by mail addressed to the Office of Civil Rights, Department of Health Care Services, PO Box 997413, MS 0009, Sacramento, CA 95899-7413, or by email addressed to
CivilRights@dhcs.ca.gov. Complaints may also be filed by calling the DHCS Office of Civil Rights at (916) 440-7370 or by written correspondence.
DHCS Provides free aids and services to people with disabilities to communicate effectively with DHCS. If you need these services, call the Office of Civil Rights, at (916) 440-7370, 711 (California State Relay) or email
CivilRights@dhcs.ca.gov.
Within five (5) days of receipt of a discrimination grievance, the DHCS Office of Civil Rights will send you written notification that your grievance has been received. The Office of Civil Rights will let you know if more information is needed.
Within thirty (30) days of receipt of a discrimination grievance, the DHCS Office of Civil Rights will begin an investigation if the grievance is within its jurisdiction.
As part of its investigation, the DHCS Office of Civil Rights may share information about your grievance with your Medi-Cal managed care plan or the person or entity complained about. To the extent possible, and in accordance with applicable law, the DHCS Office of Civil Rights will take appropriate steps to preserve the confidentiality of files and records relating to grievances and will share them only with those who have a need to know.
Within ninety (90) days of receipt of a discrimination grievance, the DHCS Office of Civil Rights will issue a written determination explaining its findings, or, if the investigation is ongoing, will provide an update on the status of the investigation and the expected date of completion. Upon completion of its investigation, the DHCS Office of Civil Rights will issue a written determination. The written determination will be based on a preponderance of the evidence and will include a notice of your right to pursue further administrative or legal remedies. In the event the DHCS Office of Civil Rights determines the grievance is not within its jurisdiction, it will notify you of that determination in writing within 90 days of receipt of the discrimination grievance.
Appeal:
You may appeal the written determination of your discrimination grievance within fifteen (15) days of receiving it. The written determination will be deemed received five (5) days after mailing, if mailed, or immediately upon electronic transmission, if faxed or emailed. Appeals may be filed by mail addressed to the Office of Civil Rights, Department of Health Care Services, PO Box 997413, MS 0009, Sacramento, CA 95899-7413, or by email addressed to
CivilRights@dhcs.ca.gov.
Appeals must identify the written determination being appealed or include a copy of the DHCS Office of Civil Rights written determination and an explanation of the reason you are appealing the determination.
The DHCS Director, or his designee, will issue a written determination of an appeal no later than sixty (60) days after the DHCS Office of Civil Rights receives the appeal. The determination on appeal will not be decided upon by any person who participated in the determination of the discrimination grievance that is being appealed.
Help in Your Language and Assistance for People with Disabilities:
If you need help in your language to file a discrimination grievance or appeal, or if you have a disability and need help communicating, DHCS:
Provides free aids and services to people with disabilities to communicate effectively with DHCS, such as:
Qualified sign language interpreters and real-time captioning
Written information in other formats such as Braille, large print, audio, accessible electronic formats and other formats
Provides free language services to people whose primary language is not English, such as:
If you need these services, call the Office of Civil Rights, at (916) 440-7370, 711 (California State Relay) or email
CivilRights@dhcs.ca.gov.
Other Remedies:
The availability and use of the DHCS discrimination grievance procedure does not prevent a person from pursuing other legal or administrative remedies, including filing a discrimination grievance with a Medi-Cal managed care plan, or filing a complaint of discrimination in court. Complaints of discrimination on the basis of race, color, national origin, sex, age or disability may also be filed with the U.S. Department of Health and Human Services, Office for Civil Rights. A person can file a complaint of discrimination electronically through the
Office for Civil Rights Complaint Portal or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201.
Complaint forms are available at the
U.S. Department of Health and Human Services website. Complaints filed with the U.S. Department of Health and Human Services, Office for Civil Rights must be filed within 180 days of the date of the alleged discrimination.
