Lake Chelan Health – Nondiscrimination

PURPOSE

The purpose of this policy is to ensure that all patients and visitors of Lake Chelan Health (LCH) are treated with equality, in a welcoming, nondiscriminatory manner, consistent with applicable state and federal law.

POLICY STATEMENT

It is the policy of Lake Chelan Health (LCH) to provide equal access to its facilities and services without discrimination on the basis of age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability, veteran or military status, or any other basis prohibited by federal, state, or local law. Equal access includes physical accommodations for disabled persons, nondiscriminatory delivery of benefits, and reasonable aid in accessing electronic health programs.

SCOPE

The policy applies to all members of the Lake Chelan Health (LCH) workforce, including employees, medical staff members, contracted service providers, and volunteers, and to all vendors, representatives, and any other individuals providing services to or on behalf of LCH.

ROLES & RESPONSIBILITIES

It is the role and responsibility of all staff, vendors and representatives to abide by and uphold this policy.

DEFINITIONS

1. Nondiscrimination – The practice of treating people equally and fairly, without regard to certain characteristics. People should not be treated less favorably than others in similar situations because of their race, color, sex, language, religion, political or other opinion, national or social origin, property, birth, disability, age, sexual orientation, and more.
2. Reasonable accommodation – A change or adjustment that allows people with specific needs to have equal opportunities. An accommodation is considered reasonable if it doesn’t create an undue hardship for the employer. Reasonable accommodations are not considered “special treatment” and can often benefit all employees.

PROCEDURE

1. Nondiscrimination – Hospital Personnel will treat all patients and visitors receiving services from or participating in other programs of LCH and its affiliated clinics with equality in a welcoming manner that is free from discrimination based on age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability, association, veteran or military status, or any other basis prohibited by federal, state, or local law.
2. Notice – Hospital Personnel will provide notices to patients regarding this Nondiscrimination Policy and LCH’s commitment to providing access to and the provision of services in a welcoming, nondiscriminatory manner. LCH will provide notices pursuant to Section 1557 of the Patient Protection and Affordable Care Act.
3. Reasonable Accommodations – Hospital Personnel will inform patients of the availability of and make reasonable accommodations for patients consistent with federal and state requirements. This includes, for example, informing patients of their right to appropriate auxiliary aids and services such as qualified language interpreters for non-English speaking patients and sign language interpreters for hearing-impaired patients and how to obtain these aids and services. Aids and services will be provided free of charge and in a timely manner when such aids and services are necessary to ensure an equal opportunity to participate to individuals with disabilities or to provide meaningful access to individuals with limited English proficiency.
4. Visitation Rights – Hospital Personnel will afford visitation rights to patients free from discrimination based on age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability, association, veteran or military status, or any other basis prohibited by federal, state, or local law and will ensure that visitors receive equal visitation privileges consistent with patient preferences. At the time patients are notified of their patient rights, Hospital Personnel will also inform each patient, or the patient’s support person, including the patient’s attorney in fact, when appropriate, of the patient’s visitation rights, including any clinical restriction on those rights, and the patient’s right, subject to the patient’s consent, to receive visitors whom the patient designates, free of discrimination based upon age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability, association, veteran or military status, or any other basis prohibited by federal, state, or local law. Such visitors include a spouse, registered domestic partner (including same-sex registered domestic partner), another family member, friend, or a legal representative of the patient, such as an attorney in fact. Hospital Personnel will also notify patients of their right to withdraw or deny such consent at any time. Hospital Personnel will afford such visitors equal visitation privileges consistent with the patient’s preferences.
5. Provision of Services – Hospital Personnel will determine eligibility for and provide services, financial aid, and other benefits to all patients in a similar manner, without subjecting any individual to separate or different treatment on the basis of age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability, association, veteran or military status, or any other basis prohibited by federal, state, or local law.
6. Complaints: 
   1. Any person who believes that they, or another person has been subjected to discrimination which is not permitted by this policy, may file a complaint using LCH’s complaint and grievance procedure, which will provide prompt and equitable resolutions of grievances.
   2. Any Hospital Personnel receiving a patient or visitor discrimination complaint will advise the complaining individual that he or she may report the report to the Executive Director of Quality, Safety and Risk Management at 509-682-3300, extension 8900, and file a complaint without fear of retaliation.
   3. Hospital Personnel are prohibited from retaliating against any person who opposes, complaints about, or report discrimination, files a complaint, or cooperates in an investigation or other proceeding under federal, state, or local anti-discrimination law.
7. Compliance – LCH’s Compliance Officer is responsible for coordinating compliance with this Policy, including giving notice to and training all Hospital Personnel on this Policy. LCH will designate at least one employee to coordinate its efforts to comply with and carry out its responsibilities under this policy and under Section 1557 of the Patient Protection and Affordable Care Act, including the investigation of any grievance.

REFERENCES

1. Patient Protection and Affordable Care Act, Section 1557
2. WA DOH
3. WA State Hospital Association

ATTACHMENTS 

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*This policy may be revised at any time without prior notice. All revisions supersede prior policy and are effective immediately upon approval.
*Any printed policy is not valid past the print date and should not be relied on for official purposes. Current versions of all policies can be found in PolicyStat.