Civil Rights Corner

Mandatory Civil Rights Trainings

ICF – Mandatory Civil Rights Training for Service Providers, Contractors and Vendors

Module 1
Module 2
Module 3

Mandatory Notices

Mandatory and Public Meeting Notices–Alternate Format

Should you need this or any mandatory or public meeting notice in an alternate format,
please e-mail [email protected] or call 586-4955.

The Hawaii Relay Service (dial 711) is available to hearing impaired and deaf individuals.


Training and Development Presentations

For alternate formats, e-mail [email protected]


DHS 2016 – 2020 Self Evaluation and Compliance Plan

Table of Contents

Executive Summary


Appendix A 
Acts, Acronyms, and Definitions

Appendix B
DHS Policies and Procedures (4.10.1, 2, 3, and 4)

Appendix C
Sample Mission, Vision, Pledge, and Service Standards

Appendix D
Sample Publication and Form (Access Hawaii; Request for Auxiliary Aid)

Appendix E
Sample Translation (Tagalog; Chinese)

Appendix F 
Sample Notifications and Description of Data Sources
Program Accessibility for Persons with Disabilities Notice
The Americans with Disabilities Act Prohibits Discrimination Notice
Nondiscrimination Notice
Notice of Due Process Standards

Appendix G
Discrimination Complaint Procedure (DHS 6000 and 6006)

Appendix H 
Title VI Civil Rights compliance Checklist (Sample)

Appendix I
Title VI Coordinator Description

Appendix J
Related Resources and Sample Data Source Descriptions
HHS Finalizes Rule to Improve Health Equity Under the Affordable Care Act
(Section 1557 – Sex Discrimination) May 13, 2016
Sample Business Associate Agreement Provisions
Sample Data Source Descriptions

Affirmative Action Plan

DHS Policies and Procedures

Language Access Plan

Forms and Brochures

DHS 5000 – Offer and Acceptance or Waiver of Free Interpreter Services

DHS 5050 – Interpreter Form and Code of Ethics

DHS 6000 – Discrimination Complaint with Instructions

DHS 6006 – Consent Release Form

DHS 6007 – Complaint Withdrawal Form

DHS 6008 – Auxiliary Aid Request Form

DHS 6009 Request for Accommodation under ADAAA (Employees and Applicants for Employment at DHS) with Instructions