Common use of County of Orange Grievance Appeal Process Clause in Contracts

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Orange County County Executive Office Office of Care Coordination 000 X. Xxxx Street,5th Floor Santa Ana, CA, 92701 Attachment 4 County of Orange County Executive Office Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess:

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Grievance Specialist XXxxxxxxxxxxxxxxx@xxxxx.xxx Orange County County Executive Office Health Care Agency Office of Care Coordination 000 X. Xxxx Street,5th Floor Santa Ana0xx Xxxxxx, CAXxxxx 000 Xxxxx Xxx, 92701 Attachment 4 XX, 00000 County of Orange County Executive Office Health Care Agency Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess:

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Grievance Specialist XXxxxxxxxxxxxxxxx@xxxxx.xxx Orange County County Executive Office Health Care Agency Office of Care Coordination 000 X. Xxxx Street,5th Floor Santa Ana0xx Xxxxxx, CAXxxxx 000 Xxxxx Xxx, 92701 XX, 00000 #:4257 Attachment 4 County of Orange County Executive Office Health Care Agency Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess:

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Grievance Specialist XXxxxxxxxxxxxxxxx@xxxxx.xxx Orange County County Executive Office Health Care Agency Office of Care Coordination 000 X. Xxxx Street,5th Floor 0xx Xxxxxx, Xxxxx 000 Santa Ana, CA, 92701 Attachment 4 DocuSign Envelope ID: 34D2C0D8-17A6-4D6E-922C-77E8D580EEC8 County of Orange County Executive Office Health Care Agency Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess:

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Grievance Specialist XXxxxxxxxxxxxxxxx@xxxxx.xxx Orange County County Executive Office Health Care Agency Office of Care Coordination 000 X. Xxxx Street,5th Floor 0xx Xxxxxx, Xxxxx 000 Santa Ana, CA, 92701 Attachment A Attachment 4 County of Orange County Executive Office Health Care Agency Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess:

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Orange County County Executive Office Office of Care Coordination 000 X. Xxxx Street,5th Floor Santa Ana, CA, 92701 Attachment A Attachment 4 County of Orange County Executive Office Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess:

County of Orange Grievance Appeal Process. Participants have a right to contact the County for an additional appeal process, once participants have completed the shelter provider’s grievance AND appeal process. The County’s grievance appeal process is designed to review the shelter’s grievance and appeal process as well as review the Shelter Operator’s written responses, and ensure that the Shelter Operator is adhering to their grievance policies, as well as their operations are in compliance with the County Standards of Care. In order to begin this process please contact the County: By Telephone: Xxxxxxx Xxxx Grievance Specialist (000) 000-0000 By Email: XXxxxxxxxxxxxxxxx@xxxxx.xxx By mail: Grievance Specialist XXxxxxxxxxxxxxxxx@xxxxx.xxx Orange County County Executive Office Health Care Agency Office of Care Coordination 000 X. Xxxx Street,5th Floor Santa Ana0xx Xxxxxx, CAXxxxx 000 Xxxxx Xxx, 92701 Attachment 4 XX, 00000 DocuSign Envelope ID: 34D2C0D8-17A6-4D6E-922C-77E8D580EEC8 County of Orange County Executive Office Health Care Agency Office of Care Coordination Grievance Appeal Form The County of Orange (County) is committed to supporting resolutions for participants that have grievances with County-funded shelter operators. The Grievance Appeal Form is designed for Participants that are looking to appeal a shelter operator’s grievance and/or appeals determination and requesting the County’s review to assess: