Discrimination is against the law. Central California Alliance for Health (the Alliance) follows State and Federal civil rights laws. The Alliance does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. The Alliance provides: ■ Free aids and services to people with disabilities to help them communicate better, such as: ■ Qualified sign language interpreters ■ Written information in other formats (large print, audio, accessible electronic formats, other formats) ■ Free language services to people whose primary language is not English, such as: ■ Qualified interpreters ■ Information written in other languages If you need these services, contact the Alliance between 8 a.m. and 5:30 p.m., Monday through Friday, by calling 800-700-3874. If you cannot hear or speak well, please call 800-735-2929 (TTY: Dial 711). Upon request, this document can be made available to you in braille, large print, audiocassette, or electronic form. To obtain a copy in one of these alternative formats, please call or write to: Central California Alliance for Health 1600 Green Hills Road, Suite 101 Scotts Valley, CA 95066 800-700-3874 800-735-2929 (TTY: Dial 711) HOW TO FILE A GRIEVANCE If you believe that the Alliance has failed to provide these services or unlawfully discriminated in another way on the basis of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation, you can file a grievance with the Alliance’s Civil Rights Coordinator, also known as the Senior Grievance Specialist. You can file a grievance by phone, in writing, in person, or electronically: ■ By phone: Contact the Alliance’s Senior Grievance Specialist between 8 a.m. and 5:30 p.m., Monday through Friday, by calling 800-700-3874. Or, if you cannot hear or speak well, please call 800-735-2929 (TTY: Dial 711). ■ In writing: Fill out a complaint form or write a letter and send it to: Central California Alliance for Health Attn: Senior Grievance Specialist 1600 Green Hills Road, Suite 101 Scotts Valley, CA 95066 ■ In person: Visit your doctor’s office or the Alliance and say you want to file a grievance. ■ Electronically: Visit the Alliance’s website at www.thealliance.health. OFFICE OF CIVIL RIGHTS – CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES You can also file a civil rights complaint with the California Department of Health Care Services, Office of Civil Rights by phone, in writing, or electronically: ■ By phone: Call 916-440-7370. If you cannot speak or hear well, please call 711 (Telecommunications Relay Service). ■ In writing: Fill out a complaint form or send a letter to: Deputy Director, Office of Civil Rights Department of Health Care Services Office of Civil Rights P.O. Box 997413, MS 0009 Sacramento, CA 95899-7413 Complaint forms are available at www.dhcs.ca.gov/Pages/Language_Access.aspx. ■ Electronically: Send an email to CivilRights@dhcs.ca.gov. This newsletter is also available in large print and audio formats at www.thealliance.health/otherformats. Nondiscrimination Notice Living Healthy
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