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Alpine County Behavioral Health Services Mental Health Services Act (MHSA) Issue Resolution Process (IRP) Alpine County Behavioral Health 032619 (Please note: If you want a response about your concern, please complete the contact information; otherwise this information is optional.) Date: Name Phone (optional): Address (optional): Issue(s) to be resolved: Inconsistency between the approved MHSA Plan and the implementation of the Plan Concerns about the Local Community Program Planning Process Inappropriate use of MHSA funds Describe Issue (Summarize your concern with as much detail as possible): What would you like to see happen to resolve the issue? Signature (optional): Date: ****FOR OFFICE USE ONLY**** To be completed by MHSA Coordinator Investigation/Resolution: Please complete form and mail, drop off, or fax to ACBHS: Address: 75 C Diamond Valley Road, Markleeville, CA 96120 FAX: [PHONE REDACTED]