As a recipient of Federal financial assistance, Islands Hospice does not exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, disability, or age in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by Islands Hospice directly or through a contractor or any other entity with which Islands Hospice arranges to carry out its programs and activities.
This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Regulations of the U.S. Department of Health and Human Services issued pursuant to these statutes at Title 45 Code of Federal Regulations Parts 80, 84, and 91.
Additionally, Section 1557 of the Affordable Care Act:
Islands Hospice complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Islands Hospice does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
• 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, 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 Claudia Fristoe, Islands Hospice Compliance Officer.
If you believe that Islands Hospice 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: Claudia Fristoe, Compliance Officer, 1301 Young Street, Honolulu, HI 96814, Telephone number-(808) 550-2552, Fax-(808) 550-2551, Emailemail@example.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Claudia Fristoe, Compliance Officer, 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 http://www.hhs.gov/ocr/office/file/index.html.
In case of questions, please contact:
Provider Name: Islands Hospice
Section 504 Coordinator: Quality Assurance and Performance Improvement
Telephone number: 808 550-2552