Medical Assistance

AHCCCS and DES are committed to delivering health care services and determining eligibility without discriminating on any basis protected by law. For instance, households with different immigration statuses may apply for benefits on behalf of U.S. Citizen children and other family members.

If you believe you’ve been subjected to discrimination in an AHCCCS or DES program or activity, you can file a complaint with the AHCCCS Administration, the Department of Economic Security, or the U.S. Department of Health and Human Services, Office for Civil Rights.

How to file a complaint with AHCCCS for Medical Assistance Claims of Discrimination

You can send a discrimination complaint to AHCCCS at:

General Counsel
AHCCCS Administration,
Office of the General Counsel,
MD 6200
801 E Jefferson,
Phoenix, AZ 85034

Fax: (602) 253-9115
Email: EqualAccess@azahcccs.gov

For details on the AHCCCS complaint process, you can review AHCCCS Administrative Policy 117 on Discrimination Complaints here:
http://www.azahcccs.gov/shared/Downloads/Policy117OnDiscriminationComplaints.docx

Medical Assistance, Cash Assistance, and Nutrition Assistance

How to file a complaint with DES for Medical Assistance, Cash Assistance, and Nutrition Assistance Claims of Discrimination

You can send a discrimination complaint to the Arizona Department of Economic Security to:

Office of Equal Opportunity
P. O. Box 6123
Mail Drop 1119
Phoenix, AZ 85005-6123

By Fax: (602) 364-3982
By Email:OfficeofEqualOpportunity@azdes.gov

For details on the DES discrimination complaint process, you can review DES Director’s Office of Equal Opportunity Procedures: Client Complaint Process DES 1-01-14-01 here:
https://des.az.gov/digital-library/directors-office-equal-opportunity-procedures-client-complaint-process

How to file a complaint with DHHS for Medical Assistance and Cash Assistance Claims of Discrimination

You can send a discrimination complaint with the United States Department of Health and Human Services, Office for Civil Rights to:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
Voice Phone (202) 368-1019
Fax (202) 619-3818
TTY (800) 537-7697
Toll-free (800) 368-1019
Form:https://www.hhs.gov/civil-rights/filing-a-complaint/complaint-process/index.html
Email: OCRComplaint@hhs.gov

Nutrition Assistance

How to file a complaint with the U.S. Department of Agriculture for Nutrition Assistance Claims of Discrimination

In accordance with the federal civil rights law and U.S. Department of Agriculture (USDA) this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), religious creed , disability, age, political beliefs, reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the agency (state or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form, which can be obtained online at https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, by calling (833) 620-1071, or by writing a letter addressed to the USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of the alleged civil rights violation. The completed AD-3027 form or letter must be submitted to:

1. Mail:

   Food and Nutrition Service, USDA
   1320 Braddock Place, Room 334
   Alexandria, VA 22314; or
   

2. Fax:

   (833) 256-1665 or (202) 690-7442; or
   

3. Email:
   

   FNSCIVILRIGHTSCOMPLAINTS@usda.gov

This institution is an equal opportunity provider.