Client Right to Courteous, Fair & Dignified Treatment
Please review our grievance statement policy and submit the information required below should you wish to report a grievance.
Grievances and Appeals
Willamette Sky Counseling (WSky) is committed to providing quality services designed to meet our clients needs and to respect client rights. If you or any person acting on your behalf believes that your needs are not being met within the scope of treatment or that your rights have been violated, you may file a grievance with the provider, your coordinated care plan, or the Health Systems Division regarding any aspect of your treatment verbally or in written form.
If you have a concern or complaint, ask your therapist to help you resolve the problem. If your therapist is not available, ask administrative staff to help you. If you are not satisfied with the resolution, you may write a formal grievance. These grievances can be submitted to our Administrative Response Team and they are logged the day they are received. An investigation will be conducted within 30 calendar days or sooner, if possible.
Written Grievance
Clients may request our grievance form online via [email protected]. Request a from from their therapist. Or write their own document. The written grievance must include the following:
The Administrative Response Team will speak with you and all other appropriate parties in investigating your grievance within 30 calendar days. The Administrative Response Team will discuss with you possible resolutions, and will then take action to resolve all valid aspects of the grievance. The resolution will be pursued in a timely manner. The Administrative Response Team will place in your record a copy of the grievance, a summary of investigation results, and a description of actions taken. You have a right to review this information. Aspects of this information that could violate the privacy rights of staff or other patients may be withheld from your record.
You have the right to ask for a faster complaint or grievance process. This is if you feel that your life or health is in immediate and serious danger because of what’s happening with your complaint or grievance. Is this something you’d like us to consider? We will review your request for a faster process. We will decide within 48 hours if you need a faster complaint or grievance process.
If you are unsatisfied with the outcome, you can file an appeal in writing within 10 working days of the date of the Administrative Response Team’s notification.
Contact information for appeals:
PacificSource Community Solutions: 800-431-4135, TTY: dial 711
Oregon Health Plan: 503-947-5804
Disability Rights Oregon: Voice: 503-243-2081; TTY users: dial 711
Health Systems Division at the Oregon Health Authority: 503-945-5763
Governor’s Advocacy Office: 503-945-6904
If you have a concern or complaint, ask your therapist to help you resolve the problem. If your therapist is not available, ask administrative staff to help you. If you are not satisfied with the resolution, you may write a formal grievance. These grievances can be submitted to our Administrative Response Team and they are logged the day they are received. An investigation will be conducted within 30 calendar days or sooner, if possible.
Written Grievance
Clients may request our grievance form online via [email protected]. Request a from from their therapist. Or write their own document. The written grievance must include the following:
- Your Name (and if the grievance is on your behalf or another person)
- The date (s) of occurrence
- List of persons involved
- A statement of the problem and any details that will highlight the nature and circumstance of the grievance
- Your suggested resolutions
The Administrative Response Team will speak with you and all other appropriate parties in investigating your grievance within 30 calendar days. The Administrative Response Team will discuss with you possible resolutions, and will then take action to resolve all valid aspects of the grievance. The resolution will be pursued in a timely manner. The Administrative Response Team will place in your record a copy of the grievance, a summary of investigation results, and a description of actions taken. You have a right to review this information. Aspects of this information that could violate the privacy rights of staff or other patients may be withheld from your record.
You have the right to ask for a faster complaint or grievance process. This is if you feel that your life or health is in immediate and serious danger because of what’s happening with your complaint or grievance. Is this something you’d like us to consider? We will review your request for a faster process. We will decide within 48 hours if you need a faster complaint or grievance process.
If you are unsatisfied with the outcome, you can file an appeal in writing within 10 working days of the date of the Administrative Response Team’s notification.
- Send your appeal within ten (10) working days of the date of response to your complaint/grievance. Send to Oregon Health Authority (OHA) – Health Systems Division, 500 Summer St. NE Salem Or 97301-1079, Phone: 1-800-273-0557
- If your treatment is paid for by public or private insurance, you can also file an appeal with your insurance company. If you are covered by a CCO, such as PacificSource Community Solutions, you can appeal to PacificSource
- WSky representatives will be available to assist in responding to the appeal, if requested.
- Health Systems Division at the Oregon Health Authority must provide a written response within 10 working days of the receipt of the appeal.
- If the individual or guardian is not satisfied with the appeal decision, they may file a second appeal in writing within 10 working days of the date of the written response to the Health Systems Division Director at the Oregon Health Authority.
Contact information for appeals:
PacificSource Community Solutions: 800-431-4135, TTY: dial 711
Oregon Health Plan: 503-947-5804
Disability Rights Oregon: Voice: 503-243-2081; TTY users: dial 711
Health Systems Division at the Oregon Health Authority: 503-945-5763
Governor’s Advocacy Office: 503-945-6904