Non-Discrimination Notice

Discrimination is against the law. Carelon Palliative Care follows State and Federal civil rights laws. Carelon Palliative Care 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.

Carelon Palliative Care 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)
• 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 prior to your appointment or if you are hearing or speech impaired, you may call 844-232-0500. Upon request, this document can be made available to you in braille, large print, audio cassette, or electronic form.

If you believe that Carelon Palliative Care 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 Carelon's Non Discrimination Coordinator. You can file a grievance by phone, in writing, in person, or electronically:

• By phone: Contact Khateryn Perez, Compliance Director at (279) 206-8638
• In writing: Fill out a complaint form or write a letter and send to:
  
  MS-6170
  Carelon Palliative Care
  12900 Park Plaza Drive, Suite 150 Cerritos, CA 90703

Electronically: Please submit your compliant to Khateryn.Perez@Carelon.com

OFFICE OF CIVIL RIGHTS –California Department of Health Care Services-California Residents Only

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: http://www.dhcs.ca.gov/Pages/Language_Access.aspx 
  
  
• Electronically: Send an email to CivilRights@dhcs.ca.gov
  
  

OFFICE OF CIVIL RIGHTS – U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

If you believe you have been discriminated against on the basis of race, color, national origin, age, disability or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by phone, in writing, or electronically:

• By phone: Call 1-800-368-1019. If you cannot speak or hear well, call TTY/TDD 1-800-537-7697
• In writing: Fill out a complaint form or send a letter to:
  
  U.S. Department of Health and Human Services
  200 Independence Avenue, SW
  Room 509F, HHH Building
  Washington, D.C. 20201
  
  
• Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html 
• Electronically: Visit the Office for Civil Rights Complaint Portal at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf 

This notice is available at https://www.carelonhealth.com/palliative-care