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The State of California was recently awarded a Federal grant from the Centers of Medicare and Medicaid Services (CMS) to support and establish a program to perform ombudsman services for Cal MediConnect. This program will be an important consumer protection for all Cal MediConnect enrollees, ensuring that individual issues can be addressed. These services will be in addition to existing appeals and grievances processes.
The program will be housed within the Department of Managed Health Care (DMHC). Its independence from the Department of Health Care Services (DHCS) during implementation is a critical element of its creation, ensuring that there is a third-party charged with assisting enrollees and providing feedback to DHCS on one of its programs.
From January to February 2014, DHCS and DMHC ran a rigorous RFP process to select a primary independent entity that would be responsible for administering ombudsman services specific to the needs of Cal MediConnect beneficiaries, their family members, and caretakers. The chosen primary entity is the Legal Aid Society of San Diego. The Legal Aid Society of San Diego, and a number of experienced subcontractors throughout the demonstration counties, will be available to provide ombudsman services to Cal MediConnect beneficiaries. The Legal Aid Society of San Diego, and all their subcontractors, are highly experienced in providing ombudsman services. The Cal MediConnect Ombudsman will be operational starting April 1, 2014.
Below are links to important information, policy documents, and additional reading to help in understanding the Cal MediConnect Ombuds Program.
For appointments at all Ombudsman offices, call HCA’s toll-free number, 1-888-804-3536. Business hours will vary by location.
Los Angeles County
Neighborhood Legal Services of Los Angeles County
- 13327 Van Nuys Boulevard
Pacoima, CA 91131
- 1104 E. Chevy Chase Drive
Glendale, CA 91205
- 9354 Telstar Avenue
El Monte, CA 91731
- Legal Aid Society of Orange County
- 2101 N. Tustin Avenue
- Santa Ana, CA 92705
San Diego County
- Legal Aid Society of San Diego
- Consumer Center for Health Education & Advocacy
- 1764 San Diego Avenue, Suite 200
- San Diego, CA 92110
San Mateo County
- Legal Aid Society of San Mateo County
- 330 Twin Dolphin Drive, Suite 123
- Redwood City, CA 94065
- *Appointments are to be made in advance
Santa Clara County
- Bay Area Legal Aid
- 4 N. Second Street, Suite 600
- San Jose, CA 95113
Ombudsman service locations available outside participating CCI counties
- 1735 Telegraph Avenue
- Oakland, CA 94612
Contra Costa County
- 1025 Macdonald Avenue
- Richmond, CA 94801
- 30 North San Pedro Road, Suite 170
- San Rafael, CA 94903
San Francisco County
- 1035 Market Street, 6th Floor
- San Francisco, CA 94103
- Cal MediConnect Ombuds Program Informational Guide (November 2013)
- Cal MediConnect Ombuds Program RFP (2013)
- Cal MediConnect Ombuds Program: Appendix 1 (2013)
- Cal MediConnect Ombudsman Services RFP (August 16, 2016)
- Medi-Cal Managed Care Office of the Ombudsman – Helpful information about the current Medi-Cal Managed Care Ombudsman program. Please use this information to get an idea of how an Ombudsman program functions.
- The Department of Managed Health Care’s Consumer Assistance Program – Learn about DMHC’s Consumer Assistance Program, the program that the Cal MediConnect Ombuds Program was modeled after.
Please join our email list to make sure you get the latest updates on the Cal MediConnect Ombuds Program, including updates when policy documents are released and opportunities to give feedback on the program.
Questions can be sent to firstname.lastname@example.org.