Office of the Ombudsman

Helps solve problems from a neutral standpoint to ensure that 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 Office of the Ombudsman:

• Helps solve problems between Medi-Cal managed care members and managed care plans
• Helps solve problems between Medi-Cal members and county mental health plans
• Helps members with urgent enrollment and disenrollment problems
• Helps Medi-Cal members access Medi-Cal specialty mental health services
• Offers information and referrals
• Identifies ways to make the Medi-Cal managed care program more effective
• Educates members on how to navigate the Medi-Cal managed care and specialty mental health system
• Connect you with the right person or department to help solve a problem
• Connect you with local resources in your county who can help you
• Connect you with patients' rights services

The office of the Ombudsman does not conduct formal investigations; does not change rules, policies, or procedures, nor does it participate in any formal hearing or grievance process