SMALL SMILES OF RENO GRIEVANCE PROCEDURE

Source: HHS Office for Civil Rights

Section 1557 of the Affordable Care Act Grievance Procedure


It is the policy of Small Smiles of Reno not to discriminate on the basis of race, color, national origin, sex, age or disability. Small Smiles of Reno 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 Small Smiles of Reno, 3362 S McCarran Blvd, Reno, NV 89502, 775-329-5437, 775-829-1553, jose@smallsmilesreno.com, who has been designated to coordinate the efforts of Small Smiles of Reno 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 may file a grievance under this procedure. It is against the law for Small Smiles of Reno to retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance.

Procedure:

      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 Small Smiles of Reno 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 (Administrator/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 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 Page 1 of 2
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.


Small Smiles of Reno 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 this 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 a barrier-free location for the proceedings. The Section 1557 Coordinator will be responsible for such arrangements.

Sliding Fee SCALE


Discounts for essential services are offered based on family size and income.  Applications can be obtained from the office manager during normal business hours and in order to be processed must be accompanied by the previous year's tax return, three most recent paystubs, and/or other means of income verification.  Discounts extend all the way to zero for those living below the federal poverty levels.  Please allow 2 weeks for application processing.  Income must be re-verified annually to keep discounts active.  

Nevada LANGUAGE ASSISTANCE


We will take reasonable steps to provide free-of-charge language assistance services to people who speak languages 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.


Spanish: Tomaremos acciones razonables para proporcionar servicios de asistencia lingüística gratuitos a aquellas personas cuyo lenguaje escuchemos frecuentemente en nuestro consultorio y que no hablen un inglés lo suficientemente bueno como para hablar con nosotros sobre el servicio odontológico que suministramos.


Tagalog: Gagawin namin ang mga makatwirang hakbang para maibigay namin ng walang bayad ang mga tulong na serbisyo sa wika para sa mga taong nagsasalita ng mga wikang karaniwan naming naririnig sa aming pagsasagawa at sa mga hindi bihasa sa pagsasalita ng Ingles na sasangguni sa amin tungkol sa pangangalaga ng ngipin na ibinibigay namin.


Chinese: 我们将有序地做到提供免费的语言服务使我们能听懂英语不好的人向我们咨询有关牙齿护理


Korean: 저희는 적절한 조치를 통하여 언어 지원 서비스를 무료로 제공할 것입니다. 다만, 실제로 저희에게 관심이 있는 언어를 쓰지만 저희 치아 관리 서비스에 대해 의견을 줄 수 있을 만큼 영어로 의사소통이 원활하지 않는 경우로 한정합니다


Vietnamese: Chúng tôi sẽ thực hiện các bước cần thiết để cung cấp dịch vụ hỗ trợ ngôn ngữ miễn phí cho những người giao tiếp bằng những ngôn ngữ mà chúng tôi có thể nghe thấy tại phòng khám của mình và cho những người không có đủ trình độ tiếng Anh để thảo luận về dịch vụ chăm sóc nha khoa mà chúng tôi đang cung cấp.


Amharic: አገልግሎት በምንሰጥበት ወቅት ልንሰማቸው የምንችል የተለያዩ ቋንቋዎችን ለሚናገሩና ስለምንሰጠው የጥርስ ሕክምና ለመነጋገር የሚያስችል በቂ የእንግሊዝኛ ቋንቋ ችሎታ ለሌላቸው ሰዎች የቋንቋ ድጋፍ አገልግሎት ከክፍያ ነጻ ለመስጠት ተገቢ የሆኑ እርምጃዎችን እንወስዳለን፡፡


Thai: เราได ้ก ้าวไปอีกขั้นด ้วยการให ้บริการผู้ชวยด ้านภาษาโดยไม่มีค่าบริการ ่ ให ้กับผู้ที่ไม่สามารถสอสารด ้วยภาษาอังกฤษเกี่ยวกับการดูแลทันตกรรมที่เราให ้บริการได ้ดีพอและใช ื่ ภาษ ้ าที่เรามักจะได ้ยินบ่อยในศูนย์ทันตกรรมของเรา


Japanese: 実際に練習の中で耳にするく可能性がある言語を話す人々で、弊社が提供している歯科治療について、英語がそ れほど上手でない人々に、無償の言語支援サービスを提供するために合理的な措置を講じるつもりです。


Arabic: سوف نقوم باتخاذ خطوات معقولة من أجل توفیر خدمات المساعدة اللغویة بدون تكلفة للأشخاص الذین یتحدثون لغات أخرى من المرجح أن نستمع إلیھا خلال ممارستنا والذین لا یتقنون تحدث الإنجلیزیة بشكل جید یمكنھم من التحدث إلینا فیما یتعلق برعایة الأسنان التي نقدمھا.


Russian: Мы принимаем необходимые меры, чтобы предоставить бесплатные услуги переводчика для общения на языках, с которыми мы сталкиваемся в нашей практике с клиентами, которые не владеют английским языком достаточно, чтобы обсудить с нами стоматологическое обслуживание, которое мы предоставляем.


French: Nous prendrons les mesures raisonnables pour fournir des services d'assistance linguistique gratuits pour les individus qui parlent des langues que nous sommes susceptibles d'entendre durant nos séances et qui ne parlent pas suffisamment bien l'anglais pour discuter avec nous concernant les soins dentaires que nous fournissons.


Persian (Farsi): ما برای ارائھ خدمات ترجمھ رایگان بھ افرادی کھ زبان انگلیسی آنھا برای صحبت با ما درباره خدمات مراقب از دندان ارایھ شده ما در حد کافی نبوده و بھ زبان ھای صحبت می کنند کھ ما بھ احتمال زیاد در ھنگام کار با آنھا سر و کار پیدا می کنیم گام ھایی منطقی را بر خواھیم داشت.


Samoan: Ole a matou taumafai ise auala e maua ai fesoasoani fai-fua-ele-totogia, i auaunaga ile gagana mo tagata e tautatala i isi gagana ia matou te faalogo ai i totonu ole fale fai nifo, ae le lelei le tautala ile Igilisi ina ia faafaigofie ai ona talanoa mai e uiga i auaunaga fai nifo o loo matou faia.


German: Wir werden angemessene Schritte unternehmen, um denen eine gebührenfreie Sprachunterstützung zu bieten, die Sprachen sprechen, die wir möglicherweise in unserer Praxis hören, die aber kein Englisch sprechen, das gut genug ist, um mit uns über die Zahnpflege zu sprechen, die wir anbieten.


Ilocano: Aramidenmi dagiti maiparbeng nga addang tapno maitedmi nga awan bayadna dagiti tulong a serbisyo iti pagsasao a para kadagiti tattao nga agsasao kadagiti lengguahe a masansan a mangngeg iti trabahomi ken kadagiti saan a nalaing nga agsao iti Ingles tapno makisarita kadakami maipapan iti panangaywan iti ngipen nga ipapaaymi. 

Limited to Pediatric Dentistry

SMALL SMILES OF RENO NOTICE OF NONDISCRIMINATION

Source: HHS Office for Civil Rights


Small Smiles of Reno complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.


Small Smiles of Reno does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.


Small Smiles of Reno:

• 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)

• 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 Jose Espana.


If you believe that Small Smiles of Reno 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:

Jose Espana

3362 South McCarran Blvd, Reno, NV 89502

Phone (775) 329-5437

Fax (775) 829-1553

jose@smallsmilesreno.com


You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Jose Espana 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:/Iocrportal.hhs.gov/ocr/portai/iobby.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, 800-537-7697 (TDD).


Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.