How do I raise a complaint about a program?

Start with safety

If someone is in immediate danger, has been assaulted or needs urgent medical care, call 911. A complaint process is not an emergency service. If you are worried about the abuse or neglect of a vulnerable adult or a child, the police or your state's protective services may also need to know.

Raising it with the program

For many concerns, the program itself is the first place to go. Ask for its grievance or complaint policy and who handles complaints. Put the concern in writing if you can, with dates and what happened, and keep a copy.

Some states require programs to explain how complaints work. Texas's client bill of rights, for example, says clients have the right to make a complaint and receive a fair response from the facility within a reasonable time.

You do not have to go through the program first if you are afraid of retaliation, if the concern is serious, or if the program is the problem. You can go straight to the state agency.

Complaining to the state

State licensing agencies investigate complaints about programs they license, and in some states about programs that should be licensed but are not. Here is how four states describe their processes on their official pages.

In California, the Department of Health Care Services investigates complaints against the state's alcohol and other drug recovery and treatment programs, and violations of the code of conduct by registered or certified counselors. DHCS says complaints can be made by mail, fax or an online form. It says complainants are not automatically told the outcome, but can request it once the investigation closes. DHCS does not investigate sober living homes, unless a home is providing services that require a license.

In Pennsylvania, the Department of Drug and Alcohol Programs describes how to file a complaint about licensed treatment facilities and recovery houses, including a recovery house that should be licensed but is not. It says clients, family members, staff, community members and others can file. It says staying anonymous may hinder or prevent an investigation. After investigating, DDAP says it sends a letter with the outcome to both the person who complained and the facility.

In Texas, the Health and Human Services Commission lists its channels for complaints about chemical dependency treatment facilities, including an online portal and a hotline. It says it keeps complainants' names confidential unless the law requires release, and that if you choose to stay anonymous, it will not be able to give you the results.

In Arizona, the Department of Health Services explains in its FAQ for sober living homes that complaints go through its online complaint portal, that complainants can ask to stay anonymous, and that it reviews and triages complaints within two business days of receiving them.

In other states, look for the state agency that licenses substance use treatment programs, and check its website for a complaint process.

What to include

A complaint is easier to investigate when it is specific. Include the program's name and address, the dates of what happened, where it happened, who was involved, if you know, and a clear description of what you saw or experienced. Say whether you raised it with the program first and what happened. Keep copies of anything you send.

You do not need to prove your complaint or know which rule was broken. Describe what happened and why it concerned you. The agency decides what to investigate.

What happens next

Processes differ. Pennsylvania's DDAP says it decides how quickly to start an investigation based on the risk involved, and may investigate through an unannounced visit, a routine inspection or by phone. It classes findings as substantiated, unsubstantiated or inconclusive. Arizona says most investigations of sober living homes happen within 45 days.

An investigation may take time, and you may not hear much while it is underway. If you have been given a reference or intake number, keep it and use it when you follow up.

Other kinds of concerns

Some problems belong somewhere else as well. Concerns about billing or insurance fraud can go to your insurer. Concerns about how your health information was shared can go to the program's privacy officer, and HHS describes how to file a complaint about health information privacy. A concern about an individual clinician may also go to the board that licenses that profession.

If you are still in the program

Raising a concern while you are receiving care can feel risky. If you fear being treated differently, you can go directly to the state agency, and you can ask a trusted person outside the program to help. If you want to leave because of what happened, tell a clinician about any medical risks first if you can, and make sure you have somewhere safe to go.