Notice Informing Individuals About Nondiscrimination and Accessibility Requirements – Discrimination is Against the Law
Women’s Health Center of Lebanon, Ltd. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Women’s Health Center of Lebanon, Ltd. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Women’s Health Center of Lebanon, Ltd.:
• 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 the Practice Administrator, Trudi Noppenberger.
Since you have services through the MA program, you will need to ask your doctor to help you get an interpreter. If you have problems getting an interpreter, you or someone helping you can contact the Office of Medical Assistance, Bureau of Fee-for-Service Programs and leave a voicemail message. Messages are checked daily. If a message is left after normal working hours, they will call you the next day with an interpreter to help you. If you use a Medical Assistance Managed Care Organization (MCO), call the Special Needs unit of your MCO for help.
Bureau of Fee-for-Service Programs:
Use one of the following methods to request a language interpreter.
* Telephone 1-866-872-8969 – choose Option #1 for English, Option #2 for Spanish, Option #3 for Vietnamese, Option #4 for Cambodian, Option #5 for Russian, Option #6 for Mandarin Chinese, or Option #7 for a sign language interpreter and leave a detailed voice mail message.
* TDD/TTY – PA Relay 711 – give the operator the 1-866-872-8969 phone number to call, choose Option #7 for a sign language interpreter, and leave a detailed voicemail message. * E-mail: MA-Interpreter@pa.gov
* You or someone helping you will need to know the information below when calling:
o Person’s name
o Person’s ten digit Medical Assistance ID number
o Doctor’s name, address and telephone number
o Date and time of appointment
o Language needed
o Reason why the doctor did not provide an interpreter (if known)
If you need their help, please call two weeks before your doctor’s appointment. Calling will give them enough time to have an interpreter for your appointment.
If you believe that Women’s Health Center of Lebanon Ltd. 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: Trudi Noppenberger, Practice Administrator, 300 Willow St., Lebanon, PA 17046, (717) 273-8835 x 2310, (717) 273-0728, firstname.lastname@example.org. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Trudi Noppenberger 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.