Martin County Health Care Facility complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex in admission, treatment, or participation in its programs, services and activities, or in employment. This facility does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

This facility:

• Provides free aids and services to people with disabilities to communicate effectively, such as:

○ Qualified sign language interpreters

○ Written information in other formats (large print, audio, accessible electronic

formats, other 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 the facility Administrator. If you believe that this facility 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:

Administrator

Martin County Health Care Facility

62 Maude Road, Inez, KY 41224

1-606-298-0091

You can file a grievance in person or by mail. If you need help filing a grievance, the facility Administrator 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.

ATTENTION: Language assistance services, free of charge, are available to you. Call 1-606-298-0091

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-606-298-0091

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-606-298-0091

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-606-298-0091

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(رقم 606-298-0091-1 ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم

606-298-0091-1 هاتف الصم والبكم

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ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-606-298-0091

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