Nondiscrimination Notice
NONDISCRIMINATION NOTICE
Discrimination is against the law. Community Health Plan of Imperial Valley complies with applicable State and Federal civil rights laws and does not discriminate, exclude people or treat them differently because of race, color, national origin, age, mental disability, physical disability, sex (including pregnancy, sexual orientation, and gender identity), religion, ancestry, ethnic group identification, medical condition, genetic information, marital status, or gender.
Community Health Plan of Imperial Valley:
•Provides free aids and services to people with disabilities to communicate effectively with us, such as:
•Qualified sign language interpreters
•Written information in other formats (large print, audio, accessible electronic formats, and other formats)
•Provides 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 Community Health Plan of Imperial Valley (CHPIV) at 1-833-236-4141 (TTY: 711), 24 hours a day, 7 days a week.
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:
Community Health Plan of Imperial Valley (CHPIV)
Health Equity Department
P.O. Box 9103 Van Nuys, CA 91410-9103
1-833-236-4141 (TTY: 711)
HOW TO FILE A GRIEVANCE
If you believe that Community Health Plan of Imperial Valley has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, or sex (including pregnancy, sexual orientation, and gender identity), mental disability, physical disability, religion, ancestry, ethnic group identification, medical condition, genetic information, marital status, or gender you can file a grievance with CHPIV 1557 Coordinator. You can file a grievance by phone, in writing, in person, or electronically:
- By phone: Contact CHPIV 1557 Coordinator between 8:00 am and 8:00 pm (EST), Monday through Friday by calling 1-855-577-8234 (TTY: 711).
- In writing: Fill out a complaint form or write a letter and send it to:
- 1557 Coordinator, PO Box 31384, Tampa, FL 33631
- In person: Visit your doctor’s office or CHPIV and say you want to file a grievance.
- Electronically: Visit CHPIV’s website at https://chpiv.org.
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 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, please 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 of Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf.
This notice is available at Community Health Plan of Imperial Valley website: https://chpiv.org/non-discrimination-policy