Resources / Nondiscrimination

Non discrimination & Equal Access

Our commitment, your rights, and what both look
like in practice.

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If you came here from the footer of our website, you've probably seen the standard nondiscrimination statement on dozens of healthcare sites.

They mostly read the same way — a paragraph of federal language naming the categories that can't be discriminated against, followed by contact information for the Office for Civil Rights in case you need to complain.

That language is required. We follow it. But it's also the bare minimum, and reading it doesn't tell you what care actually looks like for a patient who speaks Arabic, or who uses a wheelchair, or whose chosen family doesn't match the labels on a form.

This page does something different. It names the federal commitments. It explains what they look like operationally. And it tells you what you're entitled to as a patient or family — and how to claim it.

Our Legal Foundation

The Federal Commitments We
Operate Under

As a Medicare-certified hospice, St. Marie's operates under federal civil rights law. These aren't just prohibitions on what we can't do — each statute creates concrete patient rights enforceable through HHS, federal courts, and state agencies. The key provisions:

§

Section 1557 of the Affordable Care Act

prohibits discrimination on the basis of race, color, national origin, sex (including sexual orientation and gender identity), age, and disability in any health program or activity receiving federal financial assistance.

§

Title VI of the Civil Rights Act of 1964

prohibits discrimination on the basis of race, color, and national origin.

§

Section 504 of the Rehabilitation Act of 1973

prohibits disability-based discrimination by federally funded entities.

§

The Americans with Disabilities Act (ADA)

requires accessibility and reasonable accommodations.

§

The Age Discrimination Act of 1975

prohibits discrimination on the basis of age.

§

Compliance & What It Means

Compliance isn't optional. But compliance isn't really the point of this page. The point is what these protections mean in your day-to-day experience with us — as a patient, or as a family member.

"A nondiscrimination statement says what an organization won't do. Equal access describes what it actually does. The two aren't the same."

St. Marie's Hospice
Equal Access in Practice

What Equal Access Looks Like in Practice

A nondiscrimination statement says what an organization won’t do. Equal access describes what it actually does. The two aren’t the same.

At St. Marie’s, equal access means:

The rest of this page goes through these in more detail.

01

Care plans built around the patient's actual life — their language, their values, their family structure, their faith tradition, their abilities

02

Communication in the patient's preferred language, in the format that works for them

03

Religious and cultural practices around dying honored, not worked around

04

The people the patient considers family treated as family — regardless of legal status or biological relationship

05

Cost never being the reason a Medicare-eligible patient is turned away

Language Access

Language Access Services

If you or your loved one are more comfortable in a language other than English, we provide professional interpretation services free of charge. This is required by Section 1557, and we take it seriously.

What this means in practice:

01

Phone interpretation in over 200 languages, including Arabic, Spanish, Mandarin, Bengali, Vietnamese, Polish, Russian, and Tagalog — among others spoken across the Detroit and Michigan tri-county area

02

In-person interpretation arranged when phone interpretation isn't appropriate for the conversation

03

American Sign Language (ASL) interpretation available for deaf and hard-of-hearing patients and family members

04

Written materials — admission documents, care instructions, consent forms — provided in your preferred language

One detail families often ask about: we don't use family members as substitute medical interpreters, except in emergencies. The federal definition of a qualified interpreter excludes family and friends in most cases — not because the family isn't trying to help, but because medical interpretation requires neutral, trained handling. A son interpreting for his mother through a difficult conversation about pain medication is also processing his own grief. That filter rarely serves the patient well, even when it's well-intentioned.

You don't need to request interpretation services in advance, and you don't pay for them. Tell us at admission — or anytime after — and we arrange it.

Disability Accommodations

Patients and family members with disabilities are entitled to accommodations that make care fully accessible — at no cost. These aren’t extras. They’re rights.

Standard accommodations we provide:

Sign language interpretation for deaf patients and family members
Large print versions of any written materials
Accessible electronic formats for patients who use screen readers
Alternative communication methods for patients with speech or cognitive disabilities
Physical accessibility considerations in how care is delivered in the home

In real situations, this comes up more often than families expect. A deaf spouse needs ASL during family education on medication administration. A patient with low vision needs care instructions read aloud or printed large. A family member with cognitive challenges needs visual aids alongside spoken explanations. None of these require special permission. Federal law requires us to provide auxiliary aids and services that ensure effective communication and meaningful access — at no cost to you. That’s not a favor we extend. It’s an obligation we honor.

How Care Actually Happens

Cultural, Chosen Family, and Cost

Cultural and Religious Accommodation

End-of-life care looks different across faith traditions and cultures. A Muslim family preparing for death has specific practices around the dying person, the body after death, and family presence. A Hindu family may have specific rituals. Jewish, Catholic, Protestant, Buddhist, Sikh, and other traditions all carry deep practices around the final stage of life. Secular families have their own values.

We don't claim to know every tradition's practices by heart. What we do, consistently, is ask the family what matters at this stage of life — and follow their lead. That tends to be a more reliable approach than assuming we already understand.

In practice, this includes scheduling and staffing that accommodates religious observances, coordination with the patient's own clergy or spiritual leader, attention to cultural practices around food and prayer, and respect for traditions around the body after death. Our spiritual care team is trained to serve patients of any faith and patients of no faith — there to support whatever the patient already believes, not to impose or convert.

Care for LGBTQ+ Patients and Chosen Families

Same-sex partners are recognized as partners. Chosen family is recognized as family. Transgender patients are addressed by their correct name and pronouns. These aren’t policies that shift depending on a staff member’s personal beliefs — they’re how care is delivered.

In healthcare contexts, the legal default for “next of kin” has historically excluded chosen family — partners not legally married, friends who functioned as family, the people the patient actually built a life with. We don’t follow the legal default. We follow the patient’s lead. Whoever the patient names as family is treated as family in their care plan.

End-of-life care has not always been good to LGBTQ+ patients and families. Partners excluded from rooms and decisions. Chosen family kept out. The patient’s identity erased on records and in conversations. We’ve heard about these experiences from families who came to us after they happened elsewhere, and we built our practices to be different.

Specifically:

  • Chosen family is included in care planning and communication, regardless of legal status
  • Partners are treated as partners — present, informed, consulted
  • Correct names, pronouns, and identity are documented and used consistently
  • Religious or cultural objections from individual staff members do not affect a patient's care plan

Care Regardless of Ability to Pay

Hospice services for Medicare-eligible patients are covered 100% by the Medicare Hospice Benefit — no deductible, with a small copay only for respite care, and even that is capped.

A worry we hear often: "I don't want to start hospice if my family is going to be stuck with bills they can't pay."

Most families don't realize the Medicare Hospice Benefit means there are no bills to get stuck with for eligible patients. For patients who aren't Medicare-eligible, we work with Medicaid, private insurance, and other arrangements as needed. Cost shouldn't be the reason a patient who needs comfort care doesn't receive it.

If you're worried about cost — for yourself or someone you love — call. We'll talk through the options before any decisions get made, and we'll be straight about what's covered, what isn't, and what the realistic costs would actually be.

Being Honest

The Honest Reality of Hospice Disparities

It would be easier to leave this section out. We're including it because honesty is the point of this page.

Hospice access in the United States has been uneven. Black, Hispanic, and Asian American patients use hospice at lower rates than white Americans, despite often having equal or greater need. LGBTQ+ patients have documented concerns about discriminatory treatment in end-of-life care. Patients with disabilities, patients with limited English proficiency, and patients in low-income communities face systemic barriers that haven't been fully addressed by any provider — including ours.

We're not pretending those gaps don't exist. We work against them through staff training, partnership with community organizations across the tri-county area, language and accommodation services provided without making families ask repeatedly, and an open line when patients or families tell us we got something wrong. Equal access isn't a destination — it's something a hospice has to keep working at, in small and unglamorous ways, every week.

What You Can Do

Your Rights and How to Exercise Them

If you believe you or your loved one has experienced discrimination at St. Marie's — or has been denied a right described on this page — you have several options.

01

Talk to us directly.

Our Civil Rights Coordinator is available to discuss any concern. Concerns are documented, escalated to clinical leadership, and answered in writing. Most issues can be resolved at this level — and most families prefer to start here.

02

File a federal civil rights complaint.

The U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR) accepts complaints from any patient or family member who believes they experienced discrimination in a healthcare setting that receives federal funds. The complaint is free, and filing one doesn't require an attorney.

03

File a complaint with the State of Michigan.

The Michigan Department of Licensing and Regulatory Affairs (LARA) accepts complaints against state-licensed healthcare providers. We'll provide LARA's contact information on request.

  • Online: ocrportal.hhs.gov/ocr/smartscreen/main.jsf
  • Phone: 1-800-368-1019 (voice) / 1-800-537-7697 (TDD)
  • Mail: U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F HHH Building, Washington, D.C. 20201

We don’t retaliate against patients or families who raise concerns — internally or externally. That itself is a federal right under Section 1557, and it’s one we take seriously.

Talk to Us When You're
Ready

If you have a question about access, accommodations, or anything on this page, reach our Civil Rights Coordinator through our main office at (800) 489-7977, or through our contact page.

Equal access isn’t a statement we put in our footer. It’s what care looks like every day, in every home we enter.