What Is an Ombudsman?

Education

In regard to special education services, an ombudsman helps in resolving disagreements and complaints from families about how a school or district is addressing a student’s needs. An educational ombudsman can assist parents with an Individualized Education Program (IEP), an Individualized Family Service Plan (IFSP), 504 Plan meetings, and the Alternative Dispute Resolution (ADR) process. As stated by San Diego Unified School District, special education ombudspersons are “not parent advocates nor district decision-makers” but impartial members who typically help with the resolution of concerns at the school or district level.

The U.S. Department of Education has a list of all state ombudsman offices for non-public schools. California’s contact info is as follows:

Sylvia Hanna
[Ombudsman, California Department of Education] (http://www.cde.ca.gov/sp/sw/t1/ombudsmaneqservices.asp)
SHanna@cde.ca.gov
(916) 319-0948

As for public schools, some school districts have their own ombudsman. In California, those districts include San Diego, Oakland, Stockton, San Francisco, and Fresno Unified School Districts. Visit your school district website to find contact information for the ombuds connected to your school.

Public Benefits

Each state will have a different contact point for resolving conflict with the specific public benefits. To find your state’s public benefits ombuds offices, go to your state website and search for complaints about public programs. The California Department of Social Services (CDSS) will handle complaints about any public assistance programs. You can also file a formal complaint by writing or calling the department:

California Department of Social Services
Public Inquiry and Response
P.O. Box 944243
Sacramento, CA 94244-2430
(916) 651-8848
PIAR@dss.ca.gov

State that you want your problem to be handled as a "complaint" and give the reason for the complaint.

Regional Center and Self-Determination Program

According to the Department of Developmental Services (DDS), the Office of the Self-Determination Program Ombudsperson helps Regional Center clients and Self-Determination participants. As described on their website, their goal is to “increase the number of people in the Self-Determination Program (SDP), reduce the amount of time it takes to enter SDP, and recommend policy change at Regional Centers and DDS.” Their contact info is as follows:

Office of the Self-Determination Program Ombudsperson
Online contact form SDP.Ombudsperson@dds.ca.gov
(877) 658-9731

Insurance

Each state will have a different contact for complaints, questions, or disputes specific to insurance. If you’re in need of ensuring a fair appeal process, the California Department of Insurance Office of Ombudsman can be contacted here:

California Department of Insurance
Office of the Ombudsman
300 Capitol Mall, Suite 1600
Sacramento, CA 95814
ombudsman@insurance.ca.gov
(916) 492-3545

Medi-Cal

If Medi-Cal denies coverage for something your child needs, you are entitled to an appeal. The appeal process changes depending on whether you are enrolled in a managed care plan or fee-for-service (or “straight”) Medi-Cal:

• For straight Medi-Cal, the notice of action will typically include information on how to appeal. You can also contact your county office to file a formal complaint and request a Medi-Cal Fair Hearing. Remember: filing a complaint is different from requesting a third party to ensure a fair hearing.
• If you’re on a managed care plan, contact your plan’s customer service number. If this does not resolve the problem, you can file an appeal with your care plan. For assistance with this process, you can contact the Medi-Cal Managed Care and Mental Health Office of the Ombudsman.

IHSS

The IHSS Ombuds offers help to families with issues that cannot be resolved by the Department of Public Social Services. The IHSS Ombuds differ in each county. You can find your specific IHSS County Ombuds by searching for the IHSS or Long-Term Care Ombudsman on your official county website.

Los Angeles County IHSS Ombudsman: (888) 678-4477
Hotline hours are Monday through Friday, 8 a.m.—5 p.m., and assistance is available in both English and Spanish.

Long-Term Care Ombudsman: (800) 231-4024
This hotline is for issues regarding adults age 18 and older who live in board and care facilities and nursing facilities. There are no geographic restrictions.

Foster Care

The Foster Care Ombudsman offers an “independent forum for the review and resolution of complaints made by or on behalf of children in foster care regarding their care, placement, and services; it provides children and youth with information on their rights when placed in foster care.” To submit a concern or complaint, a child or adult can email or call the toll-free helpline at 1-877-846-1602 or email fosteryouthhelp@dss.ca.gov.

An ombuds office can help by:

• ​​Responding to inquiries
• Informing and clarifying rights
• Investigating complaints
• Explaining policies and procedures
• Advocating for the fairness of the process (not an advocate for an individual party)
• Developing options and suggesting appropriate referrals

As stated by the California Department of Corrections and Rehabilitation, the Office of Ombuds “may recommend changes in policies and procedures.” Note: recommending does not mean changing the rules, policies, or procedures. The Office “does not conduct formal investigations [and] does not change rules, policies, or procedures.”

The Center for Appropriate Dispute Resolution in Special Education (CADRE) Continuum offers a description of the processes that occur throughout the stages of conflict. An ombudsperson becomes involved in conflict after prevention and disagreement. If the dispute cannot be solved after disagreement, individuals have the options of facilitation, mediation, and the Office of Ombudsman. If the conflict continues, an ombudsperson can be present throughout procedural safeguards and legal review to ensure that both parties are equally understood.

Have any questions? Reach out and let us know!