Washington DC

File a Complaint Against a Health Professional or Facility

DC Health FACILITY (Hospital, Nursing Home, etc.): Select this link.

DC Health PROFESSIONAL (Physician, Dentist, etc.): To file a complaint against a licensed DC health professional, please complete fillable PDF complaint form. Type information into fillable PDF form or printout and handwrite your information), and sign and mail to one of the addresses below:

For complaints against a health care professional, mail to:

DC Board of [the Board that regulates the licensed professional about whom you are complaining, e.g. Medicine, Nursing, Dentistry, etc.]

899 North Capitol Street, NE

Second Floor

Washington, DC 20002

If your complaint alleges unlicensed activity, you should address your complaint to:

Supervisory Investigator

899 North Capitol Street, NE

Second Floor

Washington, DC 20002

You can also fax your complaint form about unlicensed activity to (202) 442-4924.

PLEASE NOTE: Please be advised that the health professional licensing boards do not have jurisdiction over fee disputes, except for billing for services that were not provided. If you have a fee dispute with a health professional, you can seek redress through the civil courts. If you have been billed for services you were not provided, please also provide your information to The FBI Washington Field Office at HealthCareFraud.VA@ic.fbi.gov.

Contact Phone: (877) 672-2174

Contact Fax: (202) 727-8471

Contact TTY: 711

Office Hours: 8:15am - 4:45pm

Service Location: GIS Address: 899 North Capitol Street, NE City: Washington State: DC Zip: 20002

Substance Abuse Treatment Facilities

To file a complaint about a substance abuse treatment program certified by APRA, you must complete the Substance Abuse Complaint Form [PDF]. The form must be filled out completely and it must be signed and dated. APRA will investigate your concerns based on the information you provide. So it is important to provide detailed information. You can talk to the APRA Risk Manager for more information about submitting a complaint.

MENTAL HEALTH PROVIDERS

304.1 A grievance is the expression by any individual of his or her dissatisfaction with either DMH or a MH provider, including the denial or abuse of any consumer right or protection provided by applicable federal and District laws and regulations. A grievance will not be entertained if it complains of a specific action that occurred more than six (6) months prior to the filing of the grievance, absent extenuating circumstances.
304.2 DMH shall establish a grievance procedure (Grievance Procedure) that complies with applicable federal and District laws and regulations and that is available to all consumers and other interested parties. As part of the Grievance Procedure, each MH provider shall establish and adhere to an internal grievance procedure for its consumers (MH Provider Grievance Procedure) that has been approved by DMH according to § 301.2.
304.3 Consumers are not required to utilize the Grievance Procedure. Consumers may pursue other legal, administrative, or informal relief in lieu of or concurrently with filing a grievance.
304.4 Any consumer who believes he or she has been denied a service for which the consumer is eligible under Medicaid may file a grievance with the Office of Fair Hearings at the Department of Human Services, pursuant to D.C. and federal law. A Medicaid consumer who has a grievance regarding the receipt, termination, amount, kind, or conditions of Medicaid services is not required to go through DMH or MH Provider Grievance Procedures before filing a grievance with the Office of Administrative Review and Appeals, which is part of the Department of Human Services.
304.5 A MH provider's continuing obligations to safeguard the welfare of consumers, including the filing of Unusual Incident reports and other reports of allegations of abuse or neglect, are not affected by the Grievance Procedure.
304.6 Mental health services and mental health supports shall continue without limitation, reduction, or termination pending resolution of grievances regarding such mental health services and mental health supports.
304.7 Neither DMH nor a MH provider shall retaliate against the consumer or his or her representative in any way because the consumer filed a grievance. An allegation of retaliation shall be treated and filed as a new grievance against the MH provider or DMH.

FREE STANDING MENTAL HEALTH CLINICSS

22-A DCMR § 306

306.1 Consumers with grievances concerning a MH provider from whom they are receiving services shall file the grievances with their provider. Consumers with grievances concerning rules, policies, or actions of employees that are the sole responsibility of DMH may file them with their MH provider but are not required to do so.
306.2 Each MH Provider Grievance Procedure shall incorporate, at a minimum, the following elements:
- (a) Consumers shall have the opportunity to file a grievance at any time during the MH provider's normal hours of operation;
- (b) Consumers shall be protected against having to file or present a grievance to the person complained about in the grievance;
- (c) Consumers shall have access to peer advocates and shall have the right to representation during each stage of the grievance procedure by a peer advocate or personal representative;
- (d) The consumer or his or her designee shall receive written acknowledgment of a filed grievance;
- (e) Time limits shall be set the completion of each step of the Procedure, consistent with § 306.5;
- (f) Prompt steps shall be specified to insure the immediate physical safety of a consumer if the circumstances surrounding a grievance raise a reasonable belief that the consumer's safety is threatened;
- (g) If informal attempts to resolve a grievance are unsuccessful, the chief executive officer of the MH provider shall review the grievance and write a decision in response. The written decision shall be transmitted, with oral explanation, to the consumer or his or her designee along with a reminder of the consumer's right to appeal the grievance to DMH for external review.
306.3 Each MH provider shall establish a permanent group composed of equal numbers of consumers and staff members who shall be responsible for responding to inquiries regarding the grievance process, for attempting to resolve grievances consensually, and for assisting the chief executive officer of the MH provider in providing a response to grievances.
- (a) The group or individual group members may look into individual grievances and work with the consumer filing the grievance and other parties to resolve the grievance consensually, using mediation or other dispute resolution techniques.
- (b) If the grievance cannot be resolved informally, the group or individual group members may fact-find or make advisory recommendations to the chief executive officer of the MH provider.
- (c) Grievances containing allegations of physical or sexual abuse may be forwarded directly to the chief executive officer of the MH provider without action by the group.
306.4 Each MH Provider shall demonstrate that consumers have played a meaningful role in the final design of the Grievance Procedure, and that consumers will be meaningfully consulted in future efforts to monitor and evaluate its effectiveness and decide upon needed modifications. The consumer/staff group required by § 306.3 may be utilized for these functions, or the MH Provider may use other means.
306.5 The chief executive officer of each MH provider shall review, investigate, and provide a substantive response to grievances within the following time frames:
- (a)Within five (5) business days of the date the grievance is filed if it alleges abuse or neglect of a consumer or a denial of service to a consumer; or
- (b)Within ten (10) business days of the date the grievance is filed for all other grievances. The chief executive officer of a MH provider may request an extension of the time set by paragraph (b) above for a specific number of days. The consumer filing the grievance shall have the option to grant or deny such a request.
306.6 If a consumer is dissatisfied with the response to a grievance by the chief executive officer of the MH provider or his or her designee, the consumer shall have ten (10) business days from the date of verbal notification and explanation of the response within which to appeal the grievance to DMH for external review in accordance with §§ 308 and 309.
306.7 Each MH provider shall submit a copy of each grievance to DMH on the day it is filed and shall submit a copy of any subsequent action concerning the grievance within 24 hours of the action's occurrence. Providers shall submit the information in a manner to be specified by DMH.
306.8 Each MH provider shall ensure that every staff person, including administrative, clerical, and support staff, has a clearly understood responsibility to immediately advise any consumer or other person who is articulating a grievance on behalf of a consumer, of the right to file a grievance and of the means of contacting the peer advocate program.
306.9 Each MH provider may accomplish its responsibilities with regard to implementing the MH Provider Grievance Procedure through utilization of its own staff or board members, as appropriate, or through agreement with outside staff, agencies, or organizations. The utilization of outside persons in the MH Provider Grievance Procedure shall be clearly explained to each consumer filing a grievance and to other parties filing a grievance on behalf of a consumer.

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