: Clinic ServicesNumber
: 02-04Effective Date
: 6/6/2011Revision Date
: 6/6/2011 Functional Area
: Member ServicesApproved by
Inez Leonard, Health Program Manager
Susmit Mishra, MD, Medical DirectorDefinitions
Clinic Services does not exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, age, or disability (including but not limited to HIV disease), in admission to, participation in, or receipt of services or benefits under any of its programs or activities.
Clinic Services does not deny admission to any of its programs or activities, or medical/dental treatment (as determined by reasonable medical/dental judgment given the current state of medical/dental knowledge) on the basis of an applicant’s or program participant’s HIV status.Details
If Clinic Services staff have a question of whether program admission or a medical/dental procedure would benefit the applicant or program participant with HIV disease, and if the program admission or medical/dental procedure would be indicated in the absence of HIV disease, Clinic Services staff shall conduct an individualized assessment of the applicant or program participant and consult with an infectious disease specialist or other appropriate specialist, as time and circumstances permit, before making a final decision regarding program admission, medical/dental treatment by Clinic Services staff, or referral to other providers with medical/dental specialties not available at Clinic Services.
Clinic Services shall make reasonable modifications in policies, practices, or procedures when the modifications are necessary to avoid discrimination on the basis of disability (including but not limited to HIV disease), unless Clinic Services can demonstrate that making the modifications would fundamentally alter the nature of the service, program or activity, or would result in undue financial and administrative burdens.Complaint Measures
Applicants and program participants may file internal grievances with Clinic Services Problem Resolution Nurse by filling out internal complaint form.
Applicants and program participants may file internal grievances with the Department of Health and Human Services by contacting the department Ombudsman at 7001-A East Parkway, Sacramento, CA. 95823 or (916) 875-2000.
Participants may also file discrimination complaints with the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), at www.hhs.gov/ocr/civilrights/complaints
, by email at firstname.lastname@example.org or by contacting DHHS/OCR/Region 9, 90 7th St., #4-100, San Francisco, CA 94103, or call: (415) 437-8310; (415) 437-8311 (TDD); (415) 437-8329 FAX.