Txoj Haujlwm Pabcuam Txhua Tus Pabcuam Rau Cov Neeg Laus (PACE)
Qhov kev pab cuam PACE pab saib xyuas txhua tus neeg koom nrog hauv qhov kev zov me nyuam raws li nws tus kheej xav tau nrog lub hom phiaj ua kom cov neeg laus nyob hauv lawv lub zej zog.
Yuav ua ntawv tsis txaus siab li cas?
Ib tus neeg koom nrog PACE thiab/lossis nws tus neeg sawv cev, tuaj yeem hais lus tsis txaus siab rau PACE lub koom haum (PO) cov neeg ua haujlwm ntawm tus kheej, hauv xov tooj lossis sau ntawv mus rau lub chaw PACE.
Kev tsis txaus siab txhais tau tias yog kev tsis txaus siab, hais lus los yog sau ntawv, qhia qhov tsis txaus siab rau kev xa khoom lossis kev saib xyuas zoo, txawm hais tias yuav thov kev kho mob li cas. Kev tsis txaus siab yuav nyob nruab nrab ntawm cov neeg koom nrog PO lossis lwm lub koom haum lossis ib tus neeg uas PO muab kev pabcuam rau tus neeg koom.
Kev tsis txaus siab yuav suav nrog, tab sis tsis txwv rau:
- Qhov zoo ntawm cov kev pab cuam uas tus neeg koom nrog PACE tau txais hauv tsev, ntawm PACE Center lossis nyob rau hauv ib qho chaw pw hauv tsev kho mob (tsev kho mob, chaw kho mob, chaw tu neeg mob, chaw tu neeg mob nruab nrab lossis chaw kho mob hauv tsev)
- Lub sijhawm tos hauv xov tooj, hauv chav tos lossis chav kuaj
- Tus cwj pwm ntawm ib tus kws kho mob lossis cov neeg ua haujlwm pabcuam
- Kev tsim nyog ntawm cov chaw nruab nrab
- Qhov zoo ntawm cov zaub mov muab
- Kev pabcuam tsheb thauj mus los; thiab
- A violation of a participant’s rights
Note: The PACE Program as administered by DHCS and PO delivering PACE services in specified ZIP codes throughout the state are committed to assuring that PACE participants are satisfied with the service delivery or quality of care they receive. PO must establish grievance processes to address participants’ concerns or dissatisfaction about services provided, provision of care, or any aspect of the PACE program.
Yuav nrhiav tau koj lub koom haum PACE hauv zos li cas los ntawm Lub Nroog:
Kev Pabcuam Cheeb Tsam Lub Nroog thiab Zip Codes
PACE Lub Koom Haum Tiv Thaiv Cov Ntaub Ntawv
Sijhawm Sijhawm: Tsis pub dhau tsib hnub tom qab tau txais qhov kev tsis txaus siab, PO yuav lees paub qhov tau txais qhov kev tsis txaus siab thiab txheeb xyuas tus neeg lossis lub koomhaum uas yuav raug hu rau lawv qhov kev tsis txaus siab. POs ua hauj lwm los daws cov kev tsis txaus siab txog kev kho mob thiab tsis yog kev kho mob tsis pub dhau peb caug (30) hnub nyob rau hauv lub sij hawm tuav tswj tsis pub lwm tus paub, raws li kev cai thiab kev cog lus yuav tsum.
Yuav ua ntawv thov kom rov hais dua li cas?
Kev thov kom rov hais dua tuaj yeem hais lus, tsis hais tus kheej lossis hauv xov tooj lossis sau ntawv. Cov txheej txheem thov rov hais dua yog muaj rau txhua tus neeg koom nrog, nws tus neeg sawv cev lossis tus kws kho mob uas tsis lees paub qhov kev them nyiaj rau ib qho kev pabcuam lossis kev tsis lees paub, ncua lossis hloov kho qhov kev pabcuam los ntawm tus kws kho mob thawj zaug (PCP) lossis ib tus tswvcuab ntawm pab pawg kws kho mob (IDT) uas tsim nyog tau txais kev xa mus.
An appeal is defined as a participant’s action taken with respect to the POs noncoverage of, or nonpayment for, a service including denials, reductions or termination of services.
Cov txheej txheem rov hais dua yuav siv ib qho ntawm ob daim ntawv hauv qab no:
- A standard appeal means review process for response to, and resolution of, appeals as expeditiously as the participant’s health requires, but no later than 30 calendar days after the PO receives an appeal.
- An expedited appeal occurs when a participant believes that his or her life, health, or ability to regain maximum function would be seriously jeopardized, absent provision of the service in dispute. The PO will respond to the appeal as expeditiously as that participant’s health condition requires, but no later than 72 hours after it receives the appeal. The 72-hour timeframe may be extended by up to 14 calendar days for either of the following reasons:
- Tus neeg koom nrog thov qhov txuas ntxiv.
- Lub PO ua pov thawj rau Lub Chaw Tswj Xyuas Lub Xeev qhov xav tau cov ntaub ntawv ntxiv thiab qhov kev ncua sij hawm yog qhov txaus siab rau cov neeg koom nrog.
Lub Rooj Sib Hais Hauv Xeev yog dab tsi?
Lub Rooj Sib Hais Hauv Xeev yog cov rooj sib tham raug cai lossis rooj sib hais rau cov tsev neeg lossis cov neeg tau txais txiaj ntsig los tawm tsam qhov kev txiav txim siab ntawm cov neeg tau txais txiaj ntsig thiab cov kev pabcuam lossis lub koomhaum uas tsis lees paub, lossis hloov kho cov kev pabcuam hauv kev ncaj ncees, ywj pheej, ncaj ncees, thiab raws sijhawm, kom ntseeg tau tias cov txheej txheem raug ua tiav raws li tsoomfwv thiab lub xeev cov cai.
Koj Txoj Cai Hnov Lus yog dab tsi
Koj muaj cai thov lub xeev lub rooj sib hais los tawm tsam qhov kev txiav txim siab lossis kev txiav txim. Koj yuav tsum thov lub rooj sib hais tsis pub dhau 90 hnub txij hnub ntawm Daim Ntawv Ceeb Toom Ua Haujlwm (NOA). Lub 90 hnub pib hnub tom qab koj raug xa mus rau NOA.
Tej zaum koj tuaj yeem xa koj daim ntawv thov tom qab 90 hnub yog tias koj muaj qhov laj thawj zoo vim li cas koj tsis tuaj yeem foob rau lub rooj sib hais hauv 90 hnub.
Koj tuaj yeem thov Lub Xeev Lub Rooj Sib Hais Li Cas?
- On-Line: Thov Kev Sib Hais Hauv Online
- Los ntawm Xov Tooj: Hu rau California Department of Social Services, State Hearings Division tus xov tooj hu dawb ntawm (800) 743-8525 (Suab) lossis (800) 952-8349 (TDD)
- In Writing (Mail): Submit your request to the county welfare department at the address shown on the NOA or by mail to:
California Department of Social Services
State Hearings Division
P.O. Box 944243, Mail Station 21-37
Sacramento, California 94244-2430
Tiv tauj peb
For PACE program, please direct comments, questions, or suggestions to PACE@dhcs.ca.gov or visit Program of All-Inclusive Care for the Elderly.
For more information, please visit All Inclusive Care for the Elderly DHCS webpage.
Ua Daim Ntawv Tsis Txaus Siab Tsis Txaus Siab
Yog tias koj xav tias kev ntxub ntxaug tau cuam tshuam rau koj cov txiaj ntsig lossis kev pabcuam, koj tuaj yeem xa daim ntawv tsis txaus siab txog kev ntxub ntxaug rau DHCS Office of Civil Rights hauv qab no:
Office of Civil Rights
Department of Health Care Services
PO Box 997413, MS 0009
Sacramento, CA 95899-7413
Xov tooj: (916) 440-7370
Email: CivilRights@dh.cs.
Koj tuaj yeem siv daim ntawv tsis txaus siab txog kev ntxub ntxaug ADA Title VI los xa koj qhov kev tsis txaus siab mus rau DHCS Office of Civil Rights. Daim ntawv no tseem muaj cov ntaub ntawv ntxiv txog koj cov cai. Yuav tsum xa tsab ntawv tsis txaus siab kom sai li sai tau lossis tsis pub dhau 180 hnub ntawm qhov kawg ntawm kev ntxub ntxaug. Yog tias koj qhov kev tsis txaus siab cuam tshuam txog cov teeb meem uas tau tshwm sim ntev dua li qhov no thiab koj tab tom thov zam lub sijhawm txwv, koj yuav raug nug kom qhia qhov laj thawj zoo vim li cas koj tsis ua koj qhov kev tsis txaus siab hauv lub sijhawm 180-hnub.
You may also submit a discrimination complaint to United States Department of Health and Human Services, Office of Civil Rights. Additional information on filing discrimination complaints is available on the Non-Discrimination Policy and Language Access webpage.