Step 5: File a Discrimination Complaint with the Federal Office of Civil Rights
The link to file a complaint can be found here. The specific questions that will be asked can be found below. Please save a copy of your story to share with the BD SUMHAC advocates at the National Hemophilia Foundation and the Hemophilia Federation of America so that they can follow-up with the Office of Civil Rights on your behalf. You will have the option of printing a copy of your complaint before submitting it, however, they will not send you a copy of your complaint.
Questions asked by the Office of Civil Rights
Once you complete the screening questions, you will be able to submit the details of your complaint:
Your first and last name
Your phone number
Your address
Your email address
Note: If you are filing the complaint on behalf of someone else, the first and last name of the person whose civil rights were violated (the person who received a denial to a mental health and/or substance use disorder treatment facility because of their BD)
The reason that you have been (or someone else has been) discriminated against on the basis of: [select disability].
Who or what agency or organization do you believe discriminated against you (or someone else)
Person or Agency/Organization: [select agency/organization]
Name of Agency/Organization
Agency/Organization’s address
Agency/Organization’s phone number (optional)
When do you believe that the discrimination occurred?
Insert specific dates (Please submit the date of the first denial and the length of time that you waited for placement or until discharge).
Describe briefly what happened. How and why you believe that you(or someone else) have been has been discriminated against. Please be as specific as possible. Be prepared to submit a succinct summary of the incident that describes the context, the specific reason(s) that they gave for denying access, etc. Possible reasons include:
o Bleeding disorders are too medically complex.
o They can’t manage the infusions/injections.
o They don’t allow needles in our facility.
o An insurance issue related to BD medication.
o An issue related to accessing medication at the specialty pharmacy.
Only 4,000 characters are allowed in the text box. However, they do allow you to upload additional files if you need to include more details.
9. Documentation of discrimination
10. Optional demographic information
11. How did you learn about the Office of Civil Rights: (please insert BD SUMHAC)
12. You will be asked to sign this form
13. And give your consent by signing this form
You will have an option to print or PDF a copy of the complaint before you submit.
When the complaint has been submitted, you will receive a confirmation form that looks like this