Notice Informing Individuals About Nondiscrimination and Accessibility Requirements

Northland PACE Program complies with applicable Federal civil rights laws and does not discriminate on the basis of race, ethnicity, national origin, religion, sex, age, sexual orientation, mental or physical disability, or source of payment.  Northland PACE Program does not exclude people or treat them differently because of race, ethnicity, national origin, religion, sex, age, sexual orientation, mental or physical disability, or source of payment. 

Northland PACE Program:

• Provides free aids and services to people with disabilities to communicate effectively with us, 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, call the number for the appropriate Northland PACE Program:

Bismarck         701-751-3050

Dickinson         701-456-7387

Minot              701-857-8045

Toll Free          888-883-8959

TTY:                 800-366-6888

If you believe that Northland PACE Program 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 the Northland PACE Program Compliance Manager, 2223 East Rosser Avenue, Bismarck, ND 58501, Phone: 888-883-8959, TTY: 800-366-6888 or Fax: 701-751-3053.

You can file a grievance in person or by mail, fax, or phone. If you need help filing a grievance, the Northland PACE Program Compliance Manager 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.

H7195­_20161216-30030-1
12/2016 DM