Chance Klasek, Jefferson Community Health & Life Chief Financial Officer, Civil Rights and Section 504 Coordinator
2200 H St., PO Box 277, Fairbury, NE
Discrimination is Against the Law
Jefferson Community Health & Life, JCH&L – Gardenside, JCH&L – Fairbury Clinic, & JCHL – Home Health (JCH&L) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2) JCH&L does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.
JCH&L:
If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact the Health Center’s CFO and Section 1557 coordinator at 402-729-6856.
If you believe that JCH&L 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: Chance Klasek, CFO and Civil Rights Coordinator, 2200 H Street, Fairbury, NE 68352, 402-729-6856, TTY: 1-800-833-7352, fax 402-729-2102, chance.klasek@jchealthandlife.org. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Chance Klasek, CFO and Civil Rights Coordinator 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, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 402.729.6856.
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 402.729.6856.
Chance Klasek, Jefferson Community Health & Life Chief Financial Officer, Civil Rights and Section 504 Coordinator
PO Box 277, Fairbury, NE 68352
402.729.3351, ext. 4427
U.S. Department of Health and Human Services, Office for Civil Rights
1.800.368.1019 or 1.800.537.7697 (TDD)
Includes taglines in the top 15 languages spoken in Nebraska
2200 H St., PO Box 277, Fairbury, NE