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What is a grievance?

Grievance means an expression of dissatisfaction about any matter other than an adverse benefit determination. Grievances can be filed with the network behavioral health agency or the SBHO office.

How do I file a grievance?

A grievance may be filed orally or in writing. You can file your concern in person, by telephone, or in writing. You may file the concern or an authorized representative may file the concern for you if you give written permission for them to do so in writing. Typically, grievances about direct services are filed with your behavioral health agency. These are referred to as agency level grievances. If you are not satisfied with the offered resolution, you can file a BHO level grievance with the SBHO office. You also have the option of initially filing your concern directly with the SBHO office:

360-337-7050 or 800-525-5637
614 Division Street, MS-23
Port Orchard, WA 98367

What happens after I file a grievance?

Every agency and SBHO grievance is acknowledged in writing within five (5) business days of receipt of the grievance. The letter explains what actions will be taken to resolve your concern.

A written resolution must be provided no longer than 90 calendar days from the date the agency or SBHO receives the grievance.

Can I continue to receive services while my grievance is in process?

Yes, your behavioral health services may continue through your authorization period. Contact the SBHO immediately if you feel your services have been affected as a result of sharing your concern.

What if I am not satisfied with the offered resolution?

If you are not satisfied with the offered resolution to your provider level grievance, you may file a BHO level grievance.

The BHO’s written decision on the grievance is the final decision. The grievance cannot progress to a Fair Hearing unless the BHO does not act within the grievance process time frames (above).

What is a Fair Hearing?

A Fair (or Administrative) Hearing is a proceeding in front of an administrative law judge (ALJ).

Fair Hearings are filed with the Department of Social & Health Services (DSHS) Office of Administrative Hearings: 1-800-583-8271.

Resources

Grievance Brochure

Ombuds Services