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California Children’s Services Grievance, Appeal, and State Hearing Fact Sheet
Do you have a concern or disagree with a decision made by the
Department of Health Care Services’ (DHCS) California Children's Services (CCS) program?
You have the right to file a CCS program grievance, appeal, or request a state hearing.
You may file a grievance any time for concerns with:
»Coordination of your or your child’scare, services, equipment, orappointments»Poor customer service»Discrimination against you or your child»Health information privacy
»Quality of your or your child’s care»Referrals for services»Scheduling appointments»Timeliness of service authorizations orCCS program eligibility decisions
Grievances are resolved within 30 calendar days. If your grievance involves serious threat of harm, such as severe pain, or potential loss of life, limb, or major bodily function, they are resolved
within 3 business days.i
Email
Mail
Phone 711 for TTY
In Person
You may file an appeal with DHCS and/or the CCS program within 30 calendar days from the date you receive written notice of a decision you disagree with. You can file an appeal about:
»A reduction or change of services»Requested services not being covered»A decision to end your or your child’sCCS program eligibility
»An increase in the amount to be paid tothe CCS program
Grievance
Appeal
Ways to File a Grievance*
MTUGrievance@acgov.org
CCS Administrative Program:
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If the county CCS program needs more information to make a decision, it must respond within 21 calendar days of receiving the additional information. Appeal decisions will be sent to you within 21 calendar days in a First Level Appeal Response Notice of Action (NOA) and includes information about the denial (including the basis for the decision, related facts, and supporting law) as well as information for filing for a state hearing.
Continuation of Services: Families have the right to continue receiving CCS coverage and previously approved CCS services during the appeal process. Continuation of services is not available for pending CCS program applicants, as they have not previously received CCS services. If services are denied, reduced, or modified, members can receive the services previously approved for the rest of the appeal process or until there is a final decision on the matter. To continue your CCS services, submit a request to the county CCS program by phone, email, mail, or in person.
Note: A state hearing may be requested at any point in the denial process. A First Level Appeal is not required to file a state hearing request.
If you have Medi-Cal, you may ask the CCS program or Medi-Cal to continue your benefits or services until your appeal is resolved or you receive a decision after your state hearing. If you withdraw your request for an appeal, services will stop at that time. Your right to a state hearing is described below.
Email
Mail, In Person, or by Phone 711 for TTY
You have the right to request a state hearing to challenge the decision made by the CCS agency. The request for a state hearing may be made without filing a First Level Appeal. You do not need to wait to receive a decision on your First Level Appeal before requesting a
state hearing. You also have the right to request a state hearing within 120 calendar days of receiving written notice of your denial/appeal if your appeal is denied. A state hearing allows you to resolve your dispute in a fair and timely manner. You have the right to have your hearing by phone, video, or in person. You also have the right to disability accommodations. At least two days before the hearing, the county, or DHCS, will provide the family with a statement of position document explaining the reason for the decision. At the hearing, the administrative law judge will allow both sides to explain their position, and the family will have an opportunity to present evidence, including testimony or letters from treating doctors.
Continuation of Services: Families have the right to continue receiving CCS coverage and previously approved CCS services during the state hearing process. Continuation of services is not available for
Ways to File an Appeal*
State Hearing
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pending CCS program applicants, as they have not previously received CCS services. If services are denied, reduced, or modified, members can receive the services previously approved for the rest of the state hearing process or until there is a final decision on the matter. To continue your CCS services, submit a request to the county CCS program by phone, email, mail, or in person and email DHCS at ISCDHAU@dhcs.ca.gov.ii
DHCS received a federal waiver to extend the timeframe for members to request a state hearing, allowing up to 120 days from the date when the NOA was mailed. This benefit will expire on June 30, 2025. Beginning July 1, 2025, families will have 90 days from the date on the NOA to request a state hearing. In addition, the waiver provides for the automatic continuation of CCS services to all members who request a state hearing within 120 days of the NOA. This benefit will end on June 30, 2025.
If you have Medi-Cal, you may ask the CCS program or Medi-Cal to continue your benefits or services until your appeal is resolved or you receive a decision after your State Hearing. If you withdraw your request for a state hearing or if there is a final hearing decision against you, services will be stopped at that time. State hearing decisions will be sent to you after the hearing.
Phone
(800) 743-8525 (Voice)(800) 952-8349 (TDD)
Mail
California Department of Social Services State Hearings Division P.O. Box 944243, MS 21-37
Fax (833) 281-0905
Online
https://www.cdss.ca.gov/hearing-requests
CCS program, benefits, and other information are available on the DHCS website at https://www.dhcs.ca.gov/services/ccs/Pages/default.aspx.
i CCS families with Medi-Cal can file grievances and appeals through Medi-Cal. Please check with your local CCS county for more information.
ii Continuation of services is currently automatically approved. Automatic approval will end on June 30, 2025. *Translation assistance and reasonable accommodations are available for phone and in-person assistance.
Ways to Request a State Hearing*