FREQUENTLY ASKED QUESTIONS

What is the Office of Behavioral Health Advocate?

The Office of Behavioral Health Advocacy (OBHA) is an independent body protecting the interests of Washingtonians engaged in behavioral health services and their support by providing consulting, resources, advocacy, and mediation for complaints against behavioral health services by individual providers and facilities.

• OBHA provides the oversight of the services and operations of the Behavioral Health Advocate (formerly Behavioral Health Ombuds)

• Provides recommendations to local, regional, and statewide community and governmental entities to bring about changes in laws, rules, regulations, policies, and procedures that will improve to the quality of behavioral health services for Washington's residents.

• Educates the community and service providers about the services of the Behavioral Health Advocates.

• Ensures there is Behavioral Health Advocate services in each of the ten managed care regions.

 

 

What is a behavioral health advocate?

​They are peers with lived experience with receiving behavioral health services and navigating the system. Assist individuals, families, and communities across WA State with behavioral health needs and concerns.

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How can the Behavioral Health Advocate help me?

• Will assist by working with you and/or designated representative to resolve your complaint with the BH Provider/Agency/Facility. We will identify next steps and work with you to ensure these take place as quickly as possible.

• Assist with the navigation of the behavioral health system. Provide information, referral, and resources. 

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What services does a Behavioral Health Advocate provide?

• Listen to your concern

• Research the situation

• Provide you with consultation

• Serve as your advocate

• Investigate and resolve grievances at the lowest possible level;

• Educate clients and families about the behavioral health system;

• Assist with the completion of a Mental Health Advanced Directive

• Are available to advocate and assist a client through a complaint, grievance, appeal, or state fair hearing process;

• Coordinate and collaborate with allied systems’ and other OMBUDS SERVICES

• Check back with you to ensure you haven't experienced retaliation

• Ombuds are also available to help you connect to provider agencies in your area and answer questions about how the behavioral health system works in the state of Washington

 

Is there a fee for OBHA or BHA services?

No, services are free and confidential.

 

What is a complaint?

An expression of dissatisfaction with the behavioral health services you are receiving and handled at the provider level or filed with a WA State Agency

 

Department of Health

https://doh.wa.gov/about-us/file-complaint

 

Office of the insurance

https://www.insurance.wa.gov/complaints-appeals

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What is a grievance? (WAC 182-538-110) https://app.leg.wa.gov/WAC/default.aspx?cite=182-538-110

An expression of dissatisfaction with the behavioral health services with a (service provider or) funder of the service.

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What is an appeal? (WAC 182-538-110) https://app.leg.wa.gov/WAC/default.aspx?cite=182-538-110

An Adverse benefit determination received by the funder of the service you are seeking or receiving. Must be filed within 60 calendar days from the date of the notice.

 

What is an agency administrative hearing? (WAC 182-538-110) https://app.leg.wa.gov/WAC/default.aspx?cite=182-538-110

• A formal process when you disagree with the decision of the appeal.

• If the funder did not act within the timeframe of the appeal

• Must be filed no later than one hundred twenty calendar days from the date of the written notice of resolution of appeal from the MCO

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What is a Mental Health Advanced Directive?

• Is a written form to: Note what treatment you want or don't want, if you are unable to communicate or make decisions. Identify a person you trust to make decisions on your behalf.

 

What do we need from you?

• Details about the issue

• Explain what the resolution would look like

• Maintain contact with the behavioral health advocate

• Complete the Release of Information and authorization to represent form if someone will be representing you.

• If calling from an inpatient facility, we will need your Access/Patient ID number.

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Can I file a grievance and a complaint at the same time?

No, a grievance and complaint cannot be filed at the same time if the content of the complaint is the same. If a client is not satisfied with the outcome of the complaint, a grievance can be filed.