HOW TO FILE A GRIEVANCE If you believe that CCHP 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 CCHP’s Civil Rights Coordinator. You can file a grievance by phone, in writing, in person, or electronically: ● By phone: Contact CCHP between 8 a.m. and 5 p.m. by calling 877-661-6230. Or, if you cannot hear or speak well, please call TTY/TDD: 711. ● In writing: Fill out a complaint form or write a letter and send it to: CCHP Civil Rights Coordinator, Member Grievance Unit, 595 Center Ave., Suite 100, Martinez, CA 94553 or fax it to 925-313-6047. ● In person: Visit your provider’s office or CCHP and say you want to file a grievance. ● Electronically: Visit CCHP’s website at contracostahealthplan.org. OFFICE OF CIVIL RIGHTS–CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES If you have Medi-Cal, 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 TTY/TDD: 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 FOR 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 800-368-1019. If you cannot speak or hear well, please call TTY/TDD: 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 Ave., 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.
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