OCR NOTICE OF NONDISCRIMINATION
SOURCE: HHS Office for Civil Rights
RECKER DENTAL CARE complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age or sex.
RECKER DENTAL CARE does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
RECKER DENTAL CARE
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)
Provide 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 Eric Recker, DDS, or Lori Van Dusseldorp.
If you believe that RECKER DENTAL CARE has failed to provide these services to discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:Eric Recker, DDS
2114 Washingtion Street
Pella, Iowa 50219
You can file a grievance in person, by fax or by email. If you need help filing a grievance, Eric Recker DDS 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, DC 20201
Toll Free: 1-800-868-1019, 1-800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
RECKER DENTAL CARE GRIEVANCE PROCEDURE
FOR COVERED PRACTICES WITH 15 OR MORE EMPLOYEES
RECKER DENTAL CARE SECTION 1557 ACA GRIEVANCE PROCEDURE
It is the policy of Recker Dental Care not to discriminate on the basis of race, color, national origin, sex, age, or disability. Recker Dental Care has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 of the Affordable Care Act (42 U.S.C. 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S.Department of Health and Human Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. Section 1557 and its implementing regulations may be examined in the office of Eric R Recker, DDS, 2114 Washington Street, Pella, Iowa 50219, 641-628-1604, Fax: 641-628-2705, and email of smile@reckerdental care.com, who has been designated to coordinate the efforts of Recker Dental Care to comply with section 1557.
Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age or disability my file a grievance under this procedure. It is against the law for Recker Dental Care to retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance.
- Grievances must be submitted to the Section 1557 Coordinator within (60 days) of the date the person filing the grievance becomes aware of the alleged discriminatory action.
- A complaint must be in writing, containing the name and address of the person filing it. The complaint must state the problem or action alleged to be discriminatory and the remedy or relief sought.
- The Section 1557 Coordinator (or her/his designee) shall conduct an investigation of the complaint. This investigation may be informal, but it will be thorough, affording all interested persons an opportunity to submit evidence relevant to the complaint. The Section 1557 Coordinator will maintain the files and records of Recker Dental Care relating to such grievances. To the extent possible, and in accordance with applicable law, the Section 1557 Coordinator will take appropriate steps to preserve the confidentiality of files and records relating to grievances and will share them only with those who have a need to know.
- The Section 1557 Coordinator will issue a written decision on the grievance, based on a preponderance of the evidence, no later than 30 days after its filing, including a notice to the complainant of their right to pursue further administrative or legal remedies.
- The person filing the grievance may appeal the decision of the Section 1557 Coordinator by writing to the Aministrator/Chief Executive Officer/Board of Directors/etc.) within 15 days of receiving the Section 1557 Coordinator’s decision. The (Administrator/Chief Executive Officer/Board of Directors/etc.) shall issue a written decision in response to the appeal no later than 30 days after its filing.
The availability and use of this grievance procedure does not prevent a person from pursing other legal or administrative remedies, including filing a complaint of discrimination on the basis of race, color, national origin, sex, age or disability in court or with the U.S. Department of Health and Human Services, Office for Civil Rights. A person can file a complaint of discrimination electronically through the Office for Civil Rights Complaint Portal, which is 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, DC 20201.
Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html. Such complaints must be filed within 180 days of the date of the alleged discrimination.
Recker Dental Care will make appropriate arrangements to ensure that individuals with disabilities and individuals with limited English proficiency are provided auxiliary aids and services or language assistance services, respectively, if needed to participate in the grievance process. Such arrangements may include, but are not limited to, providing qualified interpreters, providing taped cassettes of material for individuals with low vision, or assuring barrier-free location for the procedures. The Section 1557 Coordinator will be responsible for such arrangements.
We will take reasonable steps to provide free-of-charge language assistance services to people who speak language we are likely to hear in our practice and who don’t speak English well enough to talk to us about the dental care we are providing.
ATTENTION: If you speak English, language assistance services, free of charge are available to you. Call 800-838-4337 or 800-765-6003.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 800-838-4337 / 800-765-6003.
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 800-838-4337 / 800-765-6003。
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 800-838-4337 / 800-765-6003.
OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 800-838-4337 / 800-765-6003.
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 800-838-4337 / 800-765-6003.
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 1-800-838-4337 / 1-800-765-6003
ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 800-838-4337 / 800-765-6003.
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 800-838-4337 / 800-765-6003 번으로 전화해 주십시오.
ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 800-838-4337 / 800-765-6003 पर कॉल करें।
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 800-838-4337 / 800-765-6003.
Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 800-838-4337 / 800-765-6003.
เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 800-838-4337 / 800-765-6003.
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 800-838-4337 / 800-765-6003.
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 800-838-4337 / 800-765-6003.