Nondiscrimination Notice
Discrimination is Against the Law
Draft for review by Newstart and its legal/compliance advisor. This page is not final. Items in [yellow brackets] must be filled in or confirmed before this page is published.
Free Language Help and Aids
ATTENTION: If you speak a language other than English, free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call 818-459-3676 [TTY number, if any] or speak to your provider.
[Add the same notice in at least the 15 languages most commonly spoken by people with limited English proficiency in California, using HHS’s translated sample notices (resources for covered entities page). Replace “a language other than English” with each language name.]
Discrimination is Against the Law
Reliacare Home Health Inc DBA Newstart Home Health Inc complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)). Reliacare Home Health Inc DBA Newstart Home Health Inc does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.
We do not condition the provision of care or otherwise discriminate against anyone based on whether they have executed an advance directive.
[Legal review: the earlier version of this notice also listed religion and said it covered employment. Decide whether to keep a sentence such as “We also do not discriminate on the basis of religion,” and whether employment should be covered here or in a separate notice. Add the optional HHS wording on the scope of sex discrimination only if counsel approves.]
Free Help to Communicate With Us
Reliacare Home Health Inc DBA Newstart Home Health Inc:
- Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language assistance services to people whose primary language is not English, which may include:
- Qualified interpreters
- Information written in other languages
If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact [Name and title of Section 1557 Coordinator] at 818-459-3676.
How to File a Grievance
If you believe that Reliacare Home Health Inc DBA Newstart Home Health Inc has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
[Name and title of Section 1557 Coordinator]
Reliacare Home Health Inc DBA Newstart Home Health Inc
6262 Glade Ave #26, Woodland Hills, CA 91367
Phone: 818-459-3676
TTY: [TTY number, if any]
Fax: 818 459 3675
Email: [Email address for grievances — confirm]
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, [Name and title of Section 1557 Coordinator] is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at www.hhs.gov/ocr/office/file/index.html.
This notice is available on our website at newstarthomehealth.com.