Springfield Clinic’s mission is to provide the highest quality health care to the people of central Illinois, without regard to disability. Springfield Clinic is equipped to meet the needs of our patients with disabilities.
Nondiscrimination and Accessibility Information
Springfield Clinic provides free aids and services to people with disabilities to communicate effectively with us, such as:
Springfield Clinic provides free language services to people whose primary language is not English, such as:
To request an accommodation, please complete and submit the online Request for Healthcare Access Accommodation form.
If you do not believe you have received the accommodations you need to enable your access to health, let’s work together to make it right! Please contact the Quality Management Department and speak with any member of our staff to let them know what you need or what has happened. We will work with you to find a reasonable accommodation to ensure you have equal access to Springfield Clinic’s quality health care services.
Springfield Clinic Quality Management Department
1025 South 6th Street, Springfield, IL 62794
Phone: 217.528.7541 or 800.444.7541
If you believe we have not been able to assist you, then you may submit a grievance to let us know what the problem is by following the Discrimination Grievance Procedure (see below) and submitting a Grievance Regarding Lack of Health Care Access Based on Disability Form.
It is the policy of Springfield Clinic not to discriminate on the basis of race, color, national origin, sex, age, or disability. Springfield Clinic has an internal grievance procedure providing for prompt and equitable resolution of grievances alleging any action prohibited by the Rehabilitation Act of 1973, the U. S. Department of Human Services regulations implementing the Act; or the Affordable Care Act of 2010, or the Americans with Disabilities Act of 1991, all as amended from time to time.
Any person believing that they, a family member, or someone to whom they provide care (referred to as “you” from here on) has been subjected to discrimination may file a grievance under this procedure. A failure to reasonably accommodate an individual with a disability to provide access to healthcare may constitute discrimination based on disability. It is against the law for Springfield Clinic to retaliate against you for filing a grievance or against anyone who cooperates in the investigation of a grievance.
The Quality Management (“QM”) Director acts as the Section 504 Coordinator as well as the Section 1557 Coordinator (“Coordinator”) and is responsible for processing grievances.
You must submit the grievance to the QM Department within 7 days of the date you become aware of the alleged discriminatory action. All grievances will be forwarded promptly to the Coordinator.
You must put your grievance in writing and you must include your name, the patient’s name (if you are not the patient), your address, and telephone number or email address, whichever you prefer. You must state the event or action alleged to be discriminatory and the accommodation, remedy or relief sought. You are encouraged to use Springfield Clinic’s Grievance Regarding Lack of Health Care Access Based on Disability Form.
Complete and submit the online form.
The Coordinator will investigate the grievance. This investigation may be informal, but it will be thorough. It will allow you, and/or others you believe would have information, to submit evidence related to the grievance. The Coordinator will give you the results of the investigation in writing no later than 30 days after the grievance was filed.
You may appeal the Coordinator’s decision by writing to the Chief Executive Officer within 15 days of receiving the decision. The Chief Executive Officer shall issue a written decision in response to the appeal no later than 30 days after its filing at:
Springfield Clinic, LLP
Chief Executive Officer
Section 504/1557 Appeals
P.O. Box 19248
Springfield, IL 62794-9248
Grievance Submission Online Form
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