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Member Materials

filing a form

All member materials, forms and links are available here.

Client Grievance and Appeal Process

Access documents

  • By phone – 800-704-0900 (voicemail #5)
  • In writing- Grievance and appeal forms, pre-paid and pre-addressed envelopes should be available at every clinic 
    • Quality Assurance Program, P.O. Box 28504, San Jose, CA 95159
    • Call the Quality Assurance Program at (800) 704-0900. 
  • Electronically – [email protected]
English // Español // Tiếng Việt // 中国 // Tagalog // Farsi // Russian

  • Contact Santa Clara County Ethics, Privacy & Compliance Office at 408-885-3794.
  • If your complaint is not resolved to your satisfaction, you may also file a complaint with either:

Federal Trade Commission (FTC) or Office for Civil Rights(OCR)

  • BHSD Quality Assurance
  • DHCS Office of Civil Rights

    • All people and organizations providing Medi-Cal assistance in California must respect a consumer’s rights and prohibit discrimination in the administration of Medi-Cal services (this includes the people and organizations determining Medi-Cal eligibility and Medi-Cal service providers). The Department of Health Care Services (DHCS) Office of Civil Rights (OCR) has established this complaint process for Medi-Cal consumers to voice complaints of alleged discrimination against any individual or organization that they believe has engaged in a prohibited discriminatory practice.

      DHCS 1044 Discrimination Complaint Form (Title VI and ADA)

  • US Department of Health and Human Services Office of Civil Rights
    • If you believe that you have been discriminated against because of your race, color, national origin, disability, age, sex, or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with OCR. You may file a complaint for yourself or for someone else.
    • If you believe that you have been discriminated against because of your disability by a State or local government health care or social services agency, you may file a complaint with the OCR. You may file a complaint for yourself or for someone else.

  • Electronic Information and Form: Filing a Complaint | HHS.gov

  • Mail to:
    Centralized Case Management Operations
    U.S. Department of Health and Human Services
    200 Independence Avenue, S.W.
    Room 509F HHH Bldg.
    Washington, D.C. 20201
  • Email to [email protected]
Access documents

Member Handbook

Access Handbooks page

Our Member Handbook has all the information you need to use our services. You can get this handbook and other materials for free in different languages. For help, call County of Santa Clara Behavioral Health Services at (800) 704-0900. The call is free. 

English | Español | 中​​文 | Tiếng Việt | Tagalog | فارسی | Русский

You can get this information in other formats, such as braille, 20-point font large print, audio, and accessible electronic formats at no cost to you. Call the county telephone number listed on the cover of this handbook (TTY: 711). The call is toll free. 

English | Español | 中​​文 | Tiếng Việt | Tagalog | فارسی | Русский

BHSD is required to notify member of any significant change to the Beneficiary Handbook at least 30 days in advance.  Check here to see if there are any current updates.

English | Español | 中​​文 | Tiếng Việt | Tagalog | فارسی | Русский

ATTENTION: If you need help in your language call 1-800-704-0900 (TTY: 711). Aids and services for people with disabilities, like documents in braille and large print, are also available. Call 1-800-704-0900 (TTY: 711). These services are free of charge.

English | Español | 中​​文 | Tiếng Việt | Tagalog | فارسی | Русский

Access Handbooks page

Client Support

The county provides oral interpretation services from a qualified interpreter, on a 24-hour basis, at no cost to you. You do not have to use a family member or friend as an interpreter. We discourage the use of minors as interpreters, unless it is an emergency. Interpreter, linguistic and cultural services are available at no cost to you. Help is available 24 hours a day, 7 days a week. For language help or to get this handbook in a different language, call the county telephone number listed on the cover of this handbook (TTY: 711). The call is toll free.

Language assistance services | Behavioral Health Services | County of Santa Clara

Discrimination is against the law. County of Santa Clara Behavioral Health Services Department follows State and Federal civil rights laws. County of Santa Clara Behavioral Health Services Department does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. County of Santa Clara Behavioral Health Services Department (BDSD) provides: 

  • Free aids and services to people with disabilities to help them communicate better, such as:
    • Qualified sign language interpreters
    • Written information in other formats (large print, braille, audio or accessible electronic formats)
  • Free language services to people whose primary language is not English, such as:
    • Qualified interpreters
    • Information written in other languages

English | Español | 中​​文 | Tiếng Việt | Tagalog | فارسی | Русский

To Access page: https://bhsd.santaclaracounty.gov/member-support/member-health-data
 
 
English // Spanish // Chinese Traditional// Chinese Simplified // Vietnamese // Tagalog // Punjabi // Russian // Farsi
Code of Conduct:

English // Spanish // Chinese // Vietnamese // Tagalog // Russian // Farsi

Provider Directory

View directories

An online provider directory is available to search mental health and substance use treatment providers in the network.

Provider Directories in other languages:

English | English (Large font) | 中文 | Español | Russian | Tagalog | Tiếng Việt | Farsi

Substance use provider directory in other languages:

English | English (Large font) | 中文 | Español | Russian | Tagalog | Tiếng Việt | Farsi

View directories

Each individual shall have rights that include, but are not limited to, the following: 

  • The right to confidentiality as provided for in HIPAA and Title 42, Code of Federal Regulations, Part 2.
  • The right to be accorded with dignity in contact with workforce members, volunteers, board members and other people.
  • The right to be accorded safe, healthful, and comfortable accommodations to meet his or her needs.
  • The right to be free from verbal, emotional, physical abuse and/or inappropriate sexual behavior.
  • The right to be informed by the program of the procedures to file a grievance or appeal discharge.
  • The right to be free from discrimination based on ethnic group identification, religion, age, gender, race, sexual orientation, or disability.
  • The right to be accorded access to his or her file.
  • The right to take medications prescribed by a licensed medical professional for medical, mental health, or substance use disorders. 

English // Chinese // Farsi // Spanish // Tagalog // Vietnamese // Russian

You should also receive and acknowledge receipt of a Patient Rights Handbook which can help answer other questions. Office of Patients' Rights

Patient's Rights Handbooks:

English // Arabic // Cantonese // Farsi // Korean // Russian // Spanish // Tagalog // Vietnamese

Patient's Rights Posters:

English // Cambodian // Chinese // Russian // Spanish // Tagalog // Vietnamese

Problem Resolution Process Posters:

English // Chinese // Farsi // Spanish // Tagalog // Vietnamese 

Additional Resources

For addictions services, DHCS requires participating providers to have specific resource materials available.  The County and the State sites maintain resource materials that are updated annually rand include required referrals for dental, social services and where to apply for state, federal, or county entitlement programs. The materials must be available for beneficiary use.