Non-discrimination grievance process

Section 1557 of the Affordable Care Act prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. It is the policy of Children’s Wisconsin to comply with Section 1557 and not to discriminate on the basis of race, color, national origin, sex, age or disability.

Children’s Wisconsin has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 and its implementing regulations, issued by the U.S. Department of Health and Human Services. Section 1557 and its implementing regulations may be obtained from our Patient Representatives, who have been designated to coordinate the efforts of Children’s Wisconsin to comply with Section 1557 (Section 1557 Coordinator). Our Patient Representatives can be reached at:

Children’s Wisconsin
c/o Patient Relations
Mail Station 939
P.O. Box 1997
Milwaukee, WI 53201-1997
Phone: (414) 266-7848 or (800) 556-8090
Fax: (414) 266-6669
Email: PatientRelations@childrenswi.org

Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age or disability may file a grievance under this procedure. It is against the law for Children’s Wisconsin to retaliate against anyone who 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 Patient Relations Department will conduct an investigation of the complaint. This investigation will ensure all interested persons an opportunity to submit evidence relevant to the complaint.
• The Patient Relations Department will maintain the files and records relating to all grievances. To the extent possible, and in accordance with applicable law, the Corporate Compliance Department 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.
• Our Patient Representatives will issue a written decision on the grievance within 30 days after the filing of the grievance, 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 contacting our Vice President and General Counsel within 15 days of receiving the grievance decision. This individual can be reached at:
  

  Children’s Wisconsin
  c/o Vice President and General Counsel
  Mail Station C760
  P.O. Box 1997
  Milwaukee, WI 53201-1997
  Phone: (414) 266-3460
  Fax: (414) 266-6409
  Email: LegalDept@childrenswi.org



• The Vice President and General Counsel 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 pursuing 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 at:

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
• Complaints must be filed within 180 days of the date of the alleged discrimination
• Children’s Wisconsin will make appropriate arrangements to ensure that individuals with disabilities and individuals with limited English proficiency are provided language assistance services, respectively, if needed to participate in this grievance process. Such arrangements may include, but are not limited to providing qualified interpreters or other aids. Our Patient Representatives will help facilitate such arrangements.