Patient Non-Discrimination and Grievance Policy

Department: Administration Approved/Amended On: 10/1/17
Approved By: Company President Effective Date: 7/1/16
This policy/procedure supersedes all other policies/procedures of the same subject.


As a recipient of Federal monies through the Medicare program, Mohawk Ambulance does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of race, color, gender, religion, national origin, disability, age, genetic information, gender identity, sexual orientation, veteran’s status or any other basis protected by applicable federal, state or local law in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, and in staff and employee assignments to patients.

This is in accordance with Section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116), which provides that an individual shall not be excluded from participation in, be denied the benefits of, or be subjected to discrimination on the grounds:

  • Prohibited under Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d et seq. (race, color, national origin);
  • Title IX of the Education Amendments of 1972, 20 U.S.C. 1681 et seq. (sex);
  • The Age Discrimination Act of 1975, 42 U.S.C. 6101 et seq.(age); or
  • Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794 (disability); or
  • Under any health program or activity, any part of which is receiving federal financial assistance, or under any program or activity that is administered by an Executive Agency or any entity established under Title I of the Affordable Care Act or its amendments.


Protection against Sex Discrimination

  • Individuals will not be denied health care based on their sex, including their gender identity and sex stereotyping.
  • Women will be treated equally with men in the health care they receive and the insurance they obtain.
  • Individuals will be treated consistent with their gender identity.
  • Mohawk Ambulance will not deny or limit treatment for any health services that are ordinarily or exclusively available to individuals of one gender based on the fact that a person seeking such services identifies as belonging to another gender.

Protections for individuals with Limited English Proficiency

Mohawk Ambulance will take reasonable steps to provide meaningful access to each individual with limited English proficiency.

  • Mohawk Ambulance will provide language assistance service, when oral language assistance or written translation is not available.
  • Mohawk Ambulance will post taglines in written information and on Mohawk Ambulance’s website at the top fifteen (15) languages spoken by individuals in the State of New York with limited English proficiency that indicate the availability of language assistance.

The tagline will provide information that the language services, free of charge are available to them by calling 1-888-808-9008 Client ID# 70069226.

Protections for individuals with Disabilities

  • Mohawk Ambulance will take steps to ensure communications with individuals with disabilities are appropriate and will provide necessary auxiliary aides and services in the form of alternative formats, sign language or interpreters.
  • Any community program Mohawk Ambulance offers, when applicable, will provide it in electronic and information technology to be accessible to individuals with a disability.

Non-Discrimination Notice:

For the purposes of complying with the rules and regulations set forth and enforced by the Office for Civil Rights, Mohawk Ambulance will inform the public, patients, and employees that the company does not discriminate on the basis of race, color, national origin, disability, or age.

  • Mohawk Ambulance will post a notice of nondiscrimination on their website at of individuals’ rights providing information about communication assistance with individuals with limited English proficiency, and regarding available information for individuals with a disability needing communication assistance.
  • The notice will provide information regarding filing a grievance with Mohawk Ambulance and with the Office for Civil Rights.
  • A copy of the notice is available upon request.
  • The notice will be included in the employee handbook and distributed during orientation; and;
  • The notice will be posted in employee break rooms or work areas.

Grievance Procedures

  1. 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. It is against the law for Mohawk Ambulance to retaliate against anyone who opposes discrimination, files a grievance or participates in the investigation of a grievance.
    1. Grievances must be submitted to Mohawk Ambulance’s Compliance Coordinator or designee within sixty (60) days of the date the person filing the grievance becomes aware of the alleged discriminatory action. Written complaints should be sent to: Mohawk Ambulance, 357 Kings Rd, Schenectady, NY. Attn: Compliance Coordinator.
    2. A complaint must be in writing, containing the name and address of the person filing it.
    3. The complaint must state the problem or action alleged to be discriminatory and the remedy or relief sought.
    4. Mohawk Ambulance’s Compliance Coordinator 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.
    5. Mohawk Ambulance’s Compliance Coordinator will maintain the files and records of Mohawk Ambulance relating to such grievances.
    6. To the extent possible, and in accordance with applicable law, Mohawk Ambulance’s Compliance 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.
    7. Mohawk Ambulance’s Compliance Coordinator will issue a written decision on the grievance, based on a preponderance of the evidence, no later than thirty (30) days after its filing, including a notice to the complainant of their right to pursue further administrative or legal remedies.
    8. The person filing the grievance may appeal the decision of Mohawk Ambulance’s Compliance Coordinator by writing to the company President, at 357 Kings Rd, Schenectady, NY 12304 within fifteen (15) days of receiving the decision of Mohawk Ambulance’s Compliance Coordinator.
    9. The President shall issue a written decision in response to the appeal no later than thirty (30) days after its filing.
  1. 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.
  1. A person can file a complaint of discrimination electronically through the Office for Civil Rights Complaint Portal, which is available at: 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.
  1. Complaint forms are available at: Such complaints must be filed within 180 days of the date of the alleged discrimination.
  1. Mohawk Ambulance’s Compliance Coordinator 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.