Bella Vita complies with all applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, familial status, disability (whether it be mental or physical), or sex (including gender identity and sexual orientation). Bella Vita:
If you need these services or have a grievance based on Bella Vita’s failure to provide these services or discrimination on the basis of race, color, national origin, age, disability, or sex, you can contact Bella Vita’s Civil Rights and Section 1557 Coordinator: Shawn Paulsen, Executive Director, 1470 S. Havana Street, Aurora, CO 80012 Phone: (303)-500-7002 Email: email@example.com.
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, your local 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 (OCR) electronically through the OCR Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, phone (800) 868-1019, or TDD (800) 537-7697.
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Language Assistance Services are Available to Individuals with Limited English Proficiency
ATTENTION: If you speak Spanish, Vietnamese, Chinese, Korean, Russian, Arabic, German, French, Tagalog, Japanese, Persian, Italian, Polish, Miao-Hmong, Navajo or another language, language assistance services, free of charge, are available to you.
Call: (877) 280-1622. TTY: Dial 711 and request a call be made to (877) 280-1622 to request language assistance.
Section 1557 Grievance Procedure
It is the policy of Bella Vita not to discriminate on the basis of race, color, national origin, sex, age or disability. Bella Vita has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 of the Affordable Care Act (42 U.S.C. 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S. Department of Health and Human Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. Section 1557 and its implementing regulations may be examined at Bella Vita, 1470 S. Havana Street, Aurora, CO 80012.
Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age or disability may file a grievance under this procedure. It is against the law for Bella Vita to retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance. Procedure:
The availability and use of this grievance procedure does not prevent a person from pursuing other legal or administrative remedies, including filing a complaint of discrimination on the basis of race, color, national origin, sex, age or disability in court or with the U.S. Department of Health and Human Services, Office for Civil Rights.
A person can file a complaint of discrimination electronically through the Office for Civil Rights Complaint Portal, which is available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201 or by phone at: (877) 696-6775.
Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html. Such complaints must be filed within 180 days of the date of the alleged discrimination.
Bella Vita will make appropriate arrangements to ensure that individuals with disabilities and individuals with limited English proficiency are provided auxiliary aids and services or language assistance services, respectively, if needed to participate in this grievance process. Such arrangements may include, but are not limited to, providing qualified interpreters, providing audio recordings of material for individuals with low vision, or assuring a barrier-free location for the proceedings. The Section 1557 Coordinator will be responsible for such arrangements.