Great Rivers Behavioral Health (the BHO) has a process in place to ensure that it complies with Federal and State laws such as the Civil Rights Act, the Age Discrimination Act, and the Americans with Disabilities Act.  The BHO communicates the enrollee rights to the enrollees.  The BHO has and follows a method of monitoring enrollee rights.  The BHO ensures that its staff and contracted/affiliated providers consistently follow the State and Federal laws pertaining to enrollee rights.

Enrollee rights are:

  • be treated with respect and dignity
  • have your privacy protected
  • help your provider to develop a plan of care with services to meet your needs
  • help make decisions about your mental health care
  • receive services in a barrier-free location (accessible)
  • receive the name, address, telephone number, and any languages offered other than English of providers in your BHO yearly or when you request it
  • receive the amount and duration of services you need
  • receive a written Notice of Adverse Benefit Determination from the BHO if services are denied, limited, reduced, suspended, or terminated or you disagree with the plan
  • receive information about the structure and operation of the BHO
  • receive emergent or urgent care or crisis services
  • receive post-stabilization services after you receive emergent or urgent care or crisis services that result in hospitalization
  • be free from use of seclusion or restraints
  • receive age and culturally appropriate services
  • be provided a certified interpreter and translated material at no cost to you
  • receive information you request and help in the language or format of your choice
  • have available treatment options and alternatives explained to you
  • refuse any proposed treatment
  • receive care that does not discriminate against you (e.g. age, race, type of illness)
  • be free of any sexual exploitation or harassment
  • receive an explanation of all medications prescribed and possible side effects
  • make a mental health advance directive that states your choices and preferences for mental health care
  • receive information about medical advance directives. For more information about Advance Directives use the links below:
  • receive quality services, which are medically necessary
  • Receive medically necessary services in accordance with the early periodic screening, diagnosis, and treatment (EPSDT) under WAC 182-534-0100, if you are twenty years of age or younger
  • receive a second opinion from a mental health or substance use professional in GRBHO area if you disagree with your provider
  • Receive medically necessary behavioral health services outside of the BHO if those services cannot be provided adequetly and timely within the BHO.
  • Choose a behavioral health provider for yourself and your child (if your child is under 13 years of age).
  • Change behavioral health providers during the first 90 days, or first 12 months of being approved for services.
  • Request and receive a copy of your behavioral health treatment records. You will be told the cost for copying.
  • be free from retaliation
  • Request and receive policies and procedures of GRBHO and Behavioral Health Agencies (BHAs) as they pertain to your rights.
  • File a grievance with the behavioral health agency or Great Rivers if you are not satisfied with a service.
  • Receive a notice of Adverse Benefit Determination so that you may appeal any decision by Great Rivers that denies or limits authorization of a requested service, that reduces, suspends, or terminates previously authorized service, or that denies payment for a service, in whole or in part.
  • File an appeal if Great Rivers fails to provide services in a timely manner as defined by the state.
  • Request an administrative (fair) hearing if your grievance or appeal is not resolved within the timelines as described in WAC 388-877-0660.
  • Request services by the behavioral health Ombuds office to help you file a grievance or appeal, or request and administrative hearing.
  • request and receive a copy of these Rights

Click here for a complete listing of your Medicaid Behavioral Health Benefits.
Other Languages