Non-Discrimination Notice

Discrimination is against the law. Contra Costa Health Plan (CCHP) follows State and Federal civil rights laws. CCHP 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.

CCHP 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, other 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, contact CCHP between 8 AM - 5 PM by calling 1-877-661-6230. If you cannot hear or speak well, please call TTY 711. Upon request, this document can be made available to you in braille, large print, audio cassette, or electronic form. To obtain a copy in one of these alternative formats, please call or write to:

• Contra Costa Health Plan
• 595 Center Ave Ste 100, Martinez, CA 94553
• 1-877-661-6230 (TTY 711)

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 AM - 5 PM by calling 1-877-661-6230. 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 Avenue, Suite 100, Martinez, CA 94553 or fax it to 1-925-313-6047
• In person: Visit your doctor's office or CCHP and say you want to file a grievance.
• Electronically: Visit CCHP's website at www.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 for 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 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 for Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

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