A local appeal is your right to request a review of your service provider’s decision or action to reduce, terminate, suspend or deny services. Your service provider is required to inform you when a decision is made to change or deny services you receive or request. If you do not agree with the decision you may request a local appeal from DWIHN. An appeal may be initiated as either an oral or written request. Medicaid enrollees and MI Health Link enrollees have sixty (60) calendar days to request a local appeal. Underinsured and uninsured enrollees have thirty (30) calendar days to request a local dispute resolution. In every case, DWIHN customer service appeal staff have thirty (30) calendar days to provide a resolution.
A local appeal or a local dispute resolution request must be filed first with DWIHN before seeking a second decision from a higher authority. For Medicaid and MI Health Link members seeking a second decision on a Medicaid covered service, a State Fair Hearing must be filed within one hundred and twenty days (120) calendar days from the date on the notice of adverse benefit determination. For uninsured or underinsured enrollees, there is a ten (10) calendar day timeframe in which an alternative dispute resolution can be requested.
Your satisfaction is very important to us. We are here to help you with any problems or questions you might have regarding your behavioral health care services. Just give us a call, we can assist you with:
- State Fair Hearing
- Local Dispute Resolution
- Alternative Dispute Resolution
Have a question about any enrollee/member appeals, please give us a call at (313) 344-9099 and ask for the Appeals Coordinator: Pam Oehmke at ext. 3207 or the Appeals Specialist: Dorian Johnson at ext. 3345.
Family Support Subsidy Program
The Family Support Subsidy Program (FSSP) is a Michigan program to help families who care for their children with severe disabilities at home. The program can assist with paying for special expenses the family may incur while caring for their child. The financial support may help prevent or delay placements outside the home. Supporting families of children with severe disabilities with this program allow families to stay together and gives families flexibility in purchasing special services.
Families may be eligible for this program if they have a child under age 18 who has been recommended by a local or intermediate school district’s multidisciplinary evaluation team with an eligibility category of:
- Cognitive impairment (CI)
- Severe multiple impairments (SXI)
- Autism spectrum disorder (ASD)
Families in Wayne County may get and turn in applications for the subsidy program at the Detroit Wayne Integrated Health Network by calling (313) 344-9099 ext 3212 for Tia Davis or Dayna Phillips at ext. 3214 between the hours of 8:30a – 5:00p Monday through Friday.
A grievance is a due process right which allows for an expression of dissatisfaction about any aspect of care or service provided to you by DWIHN and Service Providers with whom we have direct or indirect contracts. You have the right to say you are unhappy with the services and supports you are receiving, the staff providing the services and or the manner services are being rendered. You can file a grievance orally or in writing at any time. If you need help in filing a grievance, our Customer Service Grievance staff is available to help you. Some examples of grievances are:
- Wait time to get an appointment with or to be seen by your doctor, therapist or case manager;
- Quality of the care you received
- Not being treated in a welcoming manner
- Poor customer service
We take all member complaints seriously and are committed to responding to them in an appropriate and timely manner. You will receive an acknowledgment letter within three (3) to five (5) calendar days of receipt of your grievance. Grievances are investigated and will be resolved within 30 to 90 calendar days. However, you can request an expedited resolution and you have the right to have your grievance resolved as quickly as possible should your condition warrant immediate attention. DWIHN staff will assist you with these determinations.
Should you wish to have someone else to file a grievance on your behalf, you may do so. However, written authorization is required to have a representative to speak on your behalf. Therefore, should a grievance be submitted by a representative without written authorization, it will not be processed until receipt of proper documentation.
Assistance is available in the filing process by contacting:
You will be given detailed information about grievances and other due process rights when you initially start services and annually or upon request. You may also ask for this information at any time by contacting the DWIHN Customer Service office.