Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Statewide Summary Fiscal Year: 2016-17

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS NOTICE OF ACTION - A 63 2 63 1 1 NOTICE OF ACTION - B 3 2 5 0 0 NOTICE OF ACTION - C 51 0 51 0 0 NOTICE OF ACTION - D 6 0 3 3 0 NOTICE OF ACTION - E 15 0 15 0 0 ALL OTHER ACTIONS 5 1 6 0 0 TOTAL N/A 143 5 143 4 1 ACCESS SERVICE NOT AVAILABLE 39 33 4 2 SERVICE NOT ACCESSIBLE 35 32 2 1 TIMELINESS OF SERVICES 141 141 0 0 24/7 TOLL-FREE ACCESS LINE 7 7 0 0 LINGUISTIC SERVICES 3 3 0 0 OTHER ACCESS ISSUES 138 129 6 3 TOTAL 363 N/A N/A 345 12 6 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 679 635 18 26 TREATMENT ISSUES OR CONCERNS 381 343 13 25 MEDICATION CONCERN 238 214 9 15 CULTURAL APPROPRIATENESS 10 9 1 0 OTHER QUALITY OF CARE ISSUES 149 140 6 3 TOTAL 1457 N/A N/A 1341 47 69 CHANGE OF PROVIDER 297 N/A N/A 287 0 10 CONFIDENTIALITY CONCERN 34 N/A N/A 31 1 2 OTHER FINANCIAL 60 52 5 3 LOST PROPERTY 40 37 3 0 OPERATIONAL 71 68 2 1 PATIENTS' RIGHTS 96 92 2 2 PEER BEHAVIORS 33 32 0 1 PHYSICAL ENVIRONMENT 39 37 1 1 OTHER GRIEVANCE NOT LISTED ABOVE 133 94 36 5 TOTAL 472 N/A N/A 412 49 13 GRAND TOTAL 2623 143 5 2559 113 101

The Annual Beneficiary Grievance and Appeal Report (ABGAR) Statewide Summary includes aggregate and county-specific totals of grievances, appeals, expedited appeals, and their dispositions, by category. The workbook has a separate tab for the source data reported by each MHP that are used to compile the statewide summary.

Statewide Summary 10/31/2017

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 ALAMEDA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 1 0 0 NOTICE OF ACTION - B 2 0 2 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 3 0 3 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 1 1 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 1 1 0 0 OTHER ACCESS ISSUES 13 7 6 0 TOTAL 16 N/A N/A 10 6 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 31 21 8 2 TREATMENT ISSUES OR CONCERNS 22 16 4 2 MEDICATION CONCERN 28 20 7 1 CULTURAL APPROPRIATENESS 3 3 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 84 N/A N/A 60 19 5 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 3 N/A N/A 3 0 0 OTHER FINANCIAL 19 17 1 1 LOST PROPERTY 4 2 2 0 OPERATIONAL 20 17 2 1 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 4 3 0 1 PHYSICAL ENVIRONMENT 3 2 0 1 OTHER GRIEVANCE NOT LISTED ABOVE 3 3 0 0 TOTAL 53 N/A N/A 44 5 4 GRAND TOTALS 156 3 0 120 30 9

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 ALPINE

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 0 0 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 CHANGE OF PROVIDER 1 N/A N/A 1 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 1 0 0 1 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 AMADOR

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 1 0 1 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 0 0 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 3 2 1 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 3 N/A N/A 2 1 0 CHANGE OF PROVIDER 3 N/A N/A 3 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 1 1 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 GRAND TOTALS 9 1 0 9 1 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 BUTTE

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 10 0 10 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 10 0 10 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 11 11 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 5 5 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 3 3 0 0 TOTAL 19 N/A N/A 19 0 0 CHANGE OF PROVIDER 6 N/A N/A 6 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 1 1 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 6 6 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 7 N/A N/A 7 0 0 GRAND TOTALS 42 0 0 42 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 CALAVERAS

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 5 4 0 1 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 5 N/A N/A 4 0 1 CHANGE OF PROVIDER 5 N/A N/A 5 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 10 0 0 9 0 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 COLUSA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 1 1 0 0 TOTAL 5 N/A N/A 5 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 6 0 0 6 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 CONTRA COSTA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 1 0 1 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 2 2 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 9 9 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 2 2 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 12 N/A N/A 12 0 0 CHANGE OF PROVIDER 8 N/A N/A 8 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 5 N/A N/A 5 0 0 GRAND TOTALS 27 1 0 28 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 DEL NORTE

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 2 2 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 1 1 0 0 TOTAL 3 N/A N/A 3 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 2 N/A N/A 2 0 0 OTHER FINANCIAL 1 0 0 1 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 1 N/A N/A 0 0 1 GRAND TOTALS 6 0 0 5 0 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 EL DORADO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 7 7 0 0 TREATMENT ISSUES OR CONCERNS 2 2 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 10 N/A N/A 10 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 3 3 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 1 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 5 N/A N/A 5 0 0 GRAND TOTALS 16 0 0 16 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 FRESNO

CATEGORY PROCESS DISPOSITION

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 2 2 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 24 24 0 0 TREATMENT ISSUES OR CONCERNS 12 11 0 1 MEDICATION CONCERN 4 4 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 40 N/A N/A 39 0 1 CHANGE OF PROVIDER 22 N/A N/A 21 0 1 CONFIDENTIALITY CONCERN 1 N/A N/A 0 0 1 OTHER FINANCIAL 1 1 0 0 LOST PROPERTY 1 1 0 0 OPERATIONAL 2 2 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 1 1 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 4 4 0 0 TOTAL 9 N/A N/A 9 0 0 GRAND TOTALS 74 0 0 71 0 3

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 GLENN

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 1 1 0 0 TREATMENT ISSUES OR CONCERNS 5 5 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 6 N/A N/A 6 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 2 2 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 GRAND TOTALS 9 0 0 9 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 HUMBOLDT

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 19 18 0 1 TREATMENT ISSUES OR CONCERNS 3 3 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 2 2 0 0 TOTAL 25 N/A N/A 24 0 1 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 1 1 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 3 3 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 1 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 2 2 0 0 TOTAL 7 N/A N/A 7 0 0 GRAND TOTALS 34 0 0 33 0 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 IMPERIAL

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 1 0 1 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 6 6 0 0 TREATMENT ISSUES OR CONCERNS 3 1 0 2 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 9 N/A N/A 7 0 2 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 10 1 0 9 0 2

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 INYO

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 1 1 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 1 0 0 1 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 KERN

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 1 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 3 0 3 0 0 TOTAL N/A 4 0 4 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 2 2 0 0 TIMELINESS OF SERVICES 12 12 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 14 N/A N/A 14 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 46 45 1 0 TREATMENT ISSUES OR CONCERNS 33 29 2 2 MEDICATION CONCERN 12 11 1 0 CULTURAL APPROPRIATENESS 1 1 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 92 N/A N/A 85 4 2 CHANGE OF PROVIDER 74 N/A N/A 70 0 4 CONFIDENTIALITY CONCERN 2 N/A N/A 2 0 0 OTHER FINANCIAL 1 1 0 0 LOST PROPERTY 11 11 0 0 OPERATIONAL 9 9 0 0 PATIENTS' RIGHTS 7 7 0 0 PEER BEHAVIORS 5 5 0 0 PHYSICAL ENVIRONMENT 9 9 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 0 1 0 TOTAL 43 N/A N/A 42 1 0 GRAND TOTALS 225 4 0 218 5 6

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 KINGS

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 3 3 0 0 24/7 TOLL-FREE ACCESS LINE 1 1 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 4 N/A N/A 4 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 5 5 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 1 1 0 0 OTHER QUALITY OF CARE ISSUES 14 14 0 0 TOTAL 20 N/A N/A 20 0 0 CHANGE OF PROVIDER 1 N/A N/A 1 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 1 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 GRAND TOTALS 26 0 0 26 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 LAKE

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 4 N/A N/A 4 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 4 0 0 4 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 LASSEN

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 0 0 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 1 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 GRAND TOTALS 5 0 0 5 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 LOS ANGELES

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 9 9 0 0 TOTAL 9 N/A N/A 9 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 48 48 0 0 TREATMENT ISSUES OR CONCERNS 96 80 6 10 MEDICATION CONCERN 15 15 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 10 10 0 0 TOTAL 169 N/A N/A 159 6 10 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 2 N/A N/A 2 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 8 8 0 0 OPERATIONAL 2 2 0 0 PATIENTS' RIGHTS 22 21 0 1 PEER BEHAVIORS 3 3 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 15 14 2 1 TOTAL 50 N/A N/A 46 2 2 GRAND TOTALS 230 0 0 210 8 12

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MADERA

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 2 2 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 3 3 0 0 TOTAL 9 N/A N/A 9 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 9 0 0 9 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MARIN

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 1 1 0 0 TREATMENT ISSUES OR CONCERNS 5 4 0 1 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 1 0 0 1 TOTAL 8 N/A N/A 6 0 2 CHANGE OF PROVIDER 8 N/A N/A 6 0 2 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 6 5 0 1 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 0 1 0 OTHER GRIEVANCE NOT LISTED ABOVE 5 2 2 1 TOTAL 12 N/A N/A 7 3 2 GRAND TOTALS 29 0 0 20 3 6

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MARIPOSA

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 3 0 0 3 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 3 0 0 3 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 2 2 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 6 2 3 1 TREATMENT ISSUES OR CONCERNS 3 3 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 2 2 0 0 TOTAL 11 N/A N/A 7 3 1 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 1 1 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 1 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 3 N/A N/A 3 0 0 GRAND TOTALS 16 3 0 12 6 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MENDOCINO

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 13 13 0 0 TREATMENT ISSUES OR CONCERNS 2 2 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 1 1 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 17 N/A N/A 17 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 3 3 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 2 2 0 0 TOTAL 5 N/A N/A 5 0 0 GRAND TOTALS 25 0 0 25 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MERCED

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 6 6 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 4 4 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 1 1 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 11 N/A N/A 11 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 21 21 0 0 TREATMENT ISSUES OR CONCERNS 3 3 0 0 MEDICATION CONCERN 10 10 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 34 N/A N/A 34 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 9 9 0 0 PATIENTS' RIGHTS 5 5 0 0 PEER BEHAVIORS 5 5 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 3 3 0 0 TOTAL 26 N/A N/A 26 0 0 GRAND TOTALS 72 0 0 72 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MODOC

CATEGORY PROCESS DISPOSITION

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 0 0 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 0 0 0 0 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MONO

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 0 0 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 0 0 0 0 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 MONTEREY

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 5 5 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 2 2 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 8 N/A N/A 8 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 8 0 0 8 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 NAPA

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 2 2 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 3 3 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 1 1 0 0 TOTAL 7 N/A N/A 7 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 1 1 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 GRAND TOTALS 11 0 0 11 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 NEVADA

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 0 1 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 0 1 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 1 0 0 1 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 4 N/A N/A 3 0 1 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 2 2 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 GRAND TOTALS 7 1 0 6 1 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 ORANGE

CATEGORY PROCESS DISPOSITION

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 2 0 2 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 2 0 2 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 16 16 0 0 TREATMENT ISSUES OR CONCERNS 5 5 0 0 MEDICATION CONCERN 7 7 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 2 2 0 0 TOTAL 30 N/A N/A 30 0 0 CHANGE OF PROVIDER 5 N/A N/A 5 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 1 1 0 0 PATIENTS' RIGHTS 2 2 0 0 PEER BEHAVIORS 3 3 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 2 2 0 0 TOTAL 8 N/A N/A 8 0 0 GRAND TOTALS 45 2 0 47 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 PLACER-SIERRA

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 1 1 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 1 0 0 1 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 PLUMAS

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 2 2 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 1 1 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 1 1 0 0 TOTAL 3 N/A N/A 3 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 2 N/A N/A 2 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 GRAND TOTALS 7 0 0 7 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 RIVERSIDE

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 2 2 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 2 2 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 2 2 0 0 TIMELINESS OF SERVICES 5 5 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 8 N/A N/A 8 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 18 18 0 0 TREATMENT ISSUES OR CONCERNS 5 5 0 0 MEDICATION CONCERN 5 5 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 5 5 0 0 TOTAL 33 N/A N/A 33 0 0 CHANGE OF PROVIDER 3 N/A N/A 3 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 10 10 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 12 N/A N/A 12 0 0 GRAND TOTALS 57 0 2 59 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SACRAMENTO

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 3 3 0 0 SERVICE NOT ACCESSIBLE 1 1 0 0 TIMELINESS OF SERVICES 50 50 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 49 47 0 2 TOTAL 103 N/A N/A 101 0 2 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 17 17 0 0 TREATMENT ISSUES OR CONCERNS 38 37 0 1 MEDICATION CONCERN 30 28 0 2 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 85 N/A N/A 82 0 3 CHANGE OF PROVIDER 46 N/A N/A 44 0 2 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 5 3 2 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 6 6 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 56 27 28 1 TOTAL 69 N/A N/A 38 30 1 GRAND TOTALS 303 0 0 265 30 8

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN BENITO

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ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 2 2 0 0 TREATMENT ISSUES OR CONCERNS 2 2 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 4 N/A N/A 4 0 0 CHANGE OF PROVIDER 2 N/A N/A 2 0 0 CONFIDENTIALITY CONCERN 2 N/A N/A 1 0 1 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 1 1 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 GRAND TOTALS 9 0 0 8 0 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN BERNARDINO

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REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 2 1 1 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 4 4 0 0 TOTAL 7 N/A N/A 6 1 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 74 58 6 10 TREATMENT ISSUES OR CONCERNS 19 16 1 2 MEDICATION CONCERN 1 0 0 1 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 23 17 6 0 TOTAL 117 N/A N/A 91 13 13 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 4 4 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 6 4 2 0 TOTAL 10 N/A N/A 8 2 0 GRAND TOTALS 135 0 0 106 16 13

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN DIEGO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 1 0 0 1 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 3 3 0 0 TOTAL 5 N/A N/A 4 0 1 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 30 30 0 0 TREATMENT ISSUES OR CONCERNS 18 18 0 0 MEDICATION CONCERN 30 25 0 5 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 8 7 0 1 TOTAL 86 N/A N/A 80 0 6 CHANGE OF PROVIDER 1 N/A N/A 1 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 2 2 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 7 7 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 14 N/A N/A 14 0 0 GRAND TOTALS 107 0 0 100 0 7

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN FRANCISCO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 1 1 0 0 TIMELINESS OF SERVICES 2 2 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 5 5 0 0 TOTAL 8 N/A N/A 8 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 24 24 0 0 TREATMENT ISSUES OR CONCERNS 10 9 0 1 MEDICATION CONCERN 4 3 0 1 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 3 3 0 0 TOTAL 41 N/A N/A 39 0 2 CHANGE OF PROVIDER 6 N/A N/A 6 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 1 1 0 0 OPERATIONAL 4 4 0 0 PATIENTS' RIGHTS 1 1 0 0 PEER BEHAVIORS 5 5 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 11 N/A N/A 11 0 0 GRAND TOTALS 66 0 0 64 0 2

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN JOAQUIN

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 2 1 0 1 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 6 6 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 5 5 0 0 TOTAL 13 N/A N/A 12 0 1 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 31 29 0 2 TREATMENT ISSUES OR CONCERNS 2 2 0 0 MEDICATION CONCERN 13 13 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 5 5 0 0 TOTAL 51 N/A N/A 49 0 2 CHANGE OF PROVIDER 1 N/A N/A 1 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 1 1 0 0 PATIENTS' RIGHTS 2 2 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 3 3 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 8 N/A N/A 8 0 0 GRAND TOTALS 74 0 0 71 0 3

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN LUIS OBISPO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 9 0 9 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 1 0 1 0 0 NOTICE OF ACTION - D 3 0 3 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 13 0 13 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 1 1 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 4 4 0 0 TOTAL 5 N/A N/A 5 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 13 13 0 0 TREATMENT ISSUES OR CONCERNS 5 5 0 0 MEDICATION CONCERN 4 4 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 10 10 0 0 TOTAL 32 N/A N/A 32 0 0 CHANGE OF PROVIDER 10 N/A N/A 10 0 0 CONFIDENTIALITY CONCERN 3 N/A N/A 3 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 3 3 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 5 N/A N/A 5 0 0 GRAND TOTALS 55 13 0 68 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SAN MATEO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 1 0 1 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 3 3 0 0 TIMELINESS OF SERVICES 2 2 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 6 N/A N/A 6 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 16 15 0 1 TREATMENT ISSUES OR CONCERNS 12 12 0 0 MEDICATION CONCERN 7 6 0 1 CULTURAL APPROPRIATENESS 1 1 0 0 OTHER QUALITY OF CARE ISSUES 2 2 0 0 TOTAL 38 N/A N/A 36 0 2 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 1 1 0 0 PATIENTS' RIGHTS 2 2 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 3 N/A N/A 3 0 0 GRAND TOTALS 48 1 0 47 0 2

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SANTA BARBARA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 1 0 1 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 2 2 0 0 SERVICE NOT ACCESSIBLE 2 1 0 1 TIMELINESS OF SERVICES 2 2 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 6 N/A N/A 5 0 1 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 11 10 0 1 TREATMENT ISSUES OR CONCERNS 5 5 0 MEDICATION CONCERN 3 1 0 2 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 19 N/A N/A 16 0 3 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 1 1 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 1 1 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 GRAND TOTALS 27 1 0 24 0 4

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SANTA CLARA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 2 0 2 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 15 0 15 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 17 0 17 0 0 ACCESS SERVICE NOT AVAILABLE 8 8 0 0 SERVICE NOT ACCESSIBLE 11 11 0 0 TIMELINESS OF SERVICES 33 33 0 0 24/7 TOLL-FREE ACCESS LINE 3 3 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 26 26 0 0 TOTAL 81 N/A N/A 81 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 33 33 0 0 TREATMENT ISSUES OR CONCERNS 11 11 0 0 MEDICATION CONCERN 6 6 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 33 33 0 0 TOTAL 83 N/A N/A 83 0 0 CHANGE OF PROVIDER 19 N/A N/A 19 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 4 3 1 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 3 3 0 0 PATIENTS' RIGHTS 4 3 1 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 5 5 0 0 TOTAL 18 N/A N/A 16 2 0 GRAND TOTALS 201 17 0 216 2 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SANTA CRUZ

CATEGORY PROCESS DISPOSITION

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APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 1 N/A N/A 1 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 5 5 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 7 N/A N/A 7 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 2 2 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 3 N/A N/A 3 0 0 GRAND TOTALS 11 0 0 11 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SHASTA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 1 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 6 6 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 1 0 1 0 OTHER QUALITY OF CARE ISSUES 3 2 0 1 TOTAL 11 N/A N/A 9 1 1 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 1 0 1 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 1 N/A N/A 0 1 0 GRAND TOTALS 14 1 0 12 2 1

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SISKIYOU

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 1 2 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 1 2 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 1 N/A N/A 1 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 10 10 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 1 1 0 0 CULTURAL APPROPRIATENESS 1 1 0 0 OTHER QUALITY OF CARE ISSUES 4 4 0 0 TOTAL 16 N/A N/A 16 0 0 CHANGE OF PROVIDER 3 N/A N/A 3 0 0 CONFIDENTIALITY CONCERN 2 N/A N/A 2 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 1 N/A N/A 1 0 0 GRAND TOTALS 23 1 1 25 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SOLANO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 1 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 2 2 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 1 1 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 4 N/A N/A 4 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 20 19 0 1 TREATMENT ISSUES OR CONCERNS 14 13 0 1 MEDICATION CONCERN 5 5 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 3 3 0 0 TOTAL 42 N/A N/A 40 0 2 CHANGE OF PROVIDER 52 N/A N/A 51 0 1 CONFIDENTIALITY CONCERN 1 N/A N/A 0 1 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 3 3 0 0 PATIENTS' RIGHTS 8 8 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 3 3 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 17 N/A N/A 17 0 0 GRAND TOTALS 116 1 0 113 1 3

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SONOMA

CATEGORY PROCESS DISPOSITION

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APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 5 4 0 1 TOTAL 5 N/A N/A 4 0 1 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 7 4 0 3 TREATMENT ISSUES OR CONCERNS 6 6 0 0 MEDICATION CONCERN 2 2 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 3 3 0 0 TOTAL 18 N/A N/A 15 0 3 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 6 6 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 1 1 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 2 2 0 0 TOTAL 9 N/A N/A 9 0 0 GRAND TOTALS 32 0 0 28 0 4

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 STANISLAUS

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 1 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 1 1 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 13 12 0 1 TREATMENT ISSUES OR CONCERNS 3 3 0 0 MEDICATION CONCERN 2 1 0 1 CULTURAL APPROPRIATENESS 1 1 0 0 OTHER QUALITY OF CARE ISSUES 1 1 0 0 TOTAL 20 N/A N/A 18 0 2 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 2 N/A N/A 2 0 0 OTHER FINANCIAL 1 1 0 0 LOST PROPERTY 1 1 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 1 1 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 2 2 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 6 N/A N/A 6 0 0 GRAND TOTALS 30 1 0 29 0 2

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 SUTTER-YUBA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 1 1 0 0 TOTAL N/A 0 1 1 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 1 1 0 0 TOTAL 1 N/A N/A 1 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 4 3 0 1 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 8 N/A N/A 7 0 1 CHANGE OF PROVIDER 1 N/A N/A 1 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 2 2 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 2 1 0 1 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 1 1 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 4 4 0 0 TOTAL 9 N/A N/A 8 0 1 GRAND TOTALS 19 0 1 18 0 2

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 TEHAMA

CATEGORY PROCESS DISPOSITION

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APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 4 0 4 0 SERVICE NOT ACCESSIBLE 1 1 0 0 TIMELINESS OF SERVICES 1 1 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 6 N/A N/A 2 4 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 3 3 0 0 TREATMENT ISSUES OR CONCERNS 5 5 0 0 MEDICATION CONCERN 2 2 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 10 N/A N/A 10 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 1 1 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 GRAND TOTALS 18 0 0 14 4 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 TRINITY

CATEGORY PROCESS DISPOSITION

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APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 0 0 0 0 TREATMENT ISSUES OR CONCERNS 1 1 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 1 1 0 0 TOTAL 2 N/A N/A 2 0 0 CHANGE OF PROVIDER 4 N/A N/A 4 0 0 CONFIDENTIALITY CONCERN 1 N/A N/A 1 0 0 OTHER FINANCIAL 1 1 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 2 2 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 3 N/A N/A 3 0 0 GRAND TOTALS 10 0 0 10 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 TULARE

CATEGORY PROCESS DISPOSITION

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APPEAL COMPLETED

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PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 30 1 30 0 1 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 30 0 30 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 60 1 60 0 1 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 0 N/A N/A 0 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 9 9 0 0 TREATMENT ISSUES OR CONCERNS 4 4 0 0 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 4 4 0 0 TOTAL 17 N/A N/A 17 0 0 CHANGE OF PROVIDER 3 N/A N/A 3 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 7 5 0 2 TOTAL 7 N/A N/A 5 0 2 GRAND TOTALS 27 60 1 85 0 3

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 TUOLUMNE

CATEGORY PROCESS DISPOSITION

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APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 1 0 1 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 1 0 1 0 0 ACCESS SERVICE NOT AVAILABLE 2 2 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 6 6 0 0 24/7 TOLL-FREE ACCESS LINE 2 2 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 2 2 0 0 TOTAL 12 N/A N/A 12 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 4 4 0 0 TREATMENT ISSUES OR CONCERNS 6 6 0 0 MEDICATION CONCERN 12 12 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 22 N/A N/A 22 0 0 CHANGE OF PROVIDER 0 N/A N/A 0 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 0 0 0 0 PATIENTS' RIGHTS 2 2 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 0 0 0 0 TOTAL 2 N/A N/A 2 0 0 GRAND TOTALS 36 1 0 37 0 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 VENTURA

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 0 0 0 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 0 0 0 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 0 0 0 0 0 ACCESS SERVICE NOT AVAILABLE 0 0 0 0 SERVICE NOT ACCESSIBLE 5 4 1 0 TIMELINESS OF SERVICES 0 0 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 5 N/A N/A 4 1 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 13 13 0 0 TREATMENT ISSUES OR CONCERNS 0 0 0 0 MEDICATION CONCERN 6 6 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 19 N/A N/A 19 0 0 CHANGE OF PROVIDER 8 N/A N/A 8 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 2 1 1 0 LOST PROPERTY 1 0 1 0 OPERATIONAL 2 2 0 0 PATIENTS' RIGHTS 1 1 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 3 2 1 0 TOTAL 9 N/A N/A 6 3 0 GRAND TOTALS 41 0 0 37 4 0

Mental Health Services Division Annual Medi-Cal Beneficiary Grievance and Appeal Report

Fiscal Year: 2016-17 YOLO

CATEGORY PROCESS DISPOSITION

GRIEVANCE APPEAL EXPEDITED

APPEAL COMPLETED

REFERRED OUT

PENDING as of June 30

ACTIONS (Appeals on Actions) NOTICE OF ACTION - A 2 0 2 0 0 NOTICE OF ACTION - B 0 0 0 0 0 NOTICE OF ACTION - C 18 0 18 0 0 NOTICE OF ACTION - D 0 0 0 0 0 NOTICE OF ACTION - E 0 0 0 0 0 ALL OTHER ACTIONS 0 0 0 0 0 TOTAL N/A 20 0 20 0 0 ACCESS SERVICE NOT AVAILABLE 2 2 0 0 SERVICE NOT ACCESSIBLE 0 0 0 0 TIMELINESS OF SERVICES 3 3 0 0 24/7 TOLL-FREE ACCESS LINE 0 0 0 0 LINGUISTIC SERVICES 0 0 0 0 OTHER ACCESS ISSUES 0 0 0 0 TOTAL 5 N/A N/A 5 0 0 QUALITY OF CARE STAFF BEHAVIOR CONCERNS 23 21 0 2 TREATMENT ISSUES OR CONCERNS 13 12 0 1 MEDICATION CONCERN 0 0 0 0 CULTURAL APPROPRIATENESS 0 0 0 0 OTHER QUALITY OF CARE ISSUES 0 0 0 0 TOTAL 36 N/A N/A 33 0 3 CHANGE OF PROVIDER 5 N/A N/A 5 0 0 CONFIDENTIALITY CONCERN 0 N/A N/A 0 0 0 OTHER FINANCIAL 0 0 0 0 LOST PROPERTY 0 0 0 0 OPERATIONAL 4 4 0 0 PATIENTS' RIGHTS 0 0 0 0 PEER BEHAVIORS 0 0 0 0 PHYSICAL ENVIRONMENT 0 0 0 0 OTHER GRIEVANCE NOT LISTED ABOVE 3 3 0 0 TOTAL 7 N/A N/A 7 0 0 GRAND TOTALS 53 20 0 70 0 3