Non-Discrimination Notice and Complaint Forms

This page has been automatically translated from English. MSDH has not reviewed this translation and is not responsible for any inaccuracies.

The Mississippi State Department of Health (MSDH) is committed to serving all people equally. MSDH does not discriminate on the basis of race, color, national origin (including limited English proficiency), disability, age, or sex (including pregnancy, gender identity, sex characteristics and sexual orientation) in administration of its programs, services, and activities. MSDH supports your legally protected rights against discrimination and takes no action to interfere with them, or to retaliate against anyone because of exercising these rights.

Civil Rights Complaint Form

File a Civil Rights Complaint

If you believe that MSDH has failed to provide services or discriminated in another way on the basis of race, color, national origin, age, disability or sex (including pregnancy, gender identity, sex characteristics and sexual orientation) or has retaliated against you for engaging in a protected Civil Rights activity in its programs or activities, you can file a complaint by contacting our Civil Rights Coordinator.

You can file a complaint in person or by mail or e-mail. If you need help filing a grievance, or have questions about our non-discrimination policy, the MSDH Civil Rights Coordinator is available to help you.

Charles Lee
Civil Rights Coordinator
Mississippi State Department of Health
P. O. Box 1700
Jackson, MS 39215-1700
(601) 576-7847

The Civil Rights Coordinator is the individual designated by the MSDH to receive and monitor inquiries concerning non-discrimination requirements implemented by federal laws and regulations. The Civil Rights Coordinator is also responsible for informing all persons that the agency does not discriminate by posting and updating the Non-discrimination Notice, tracking all complaints filed under federal non-discrimination laws, ensuring services are provided to individuals with limited English Proficiency, and ensuring no intimidation or retaliation against anyone who has exercised their rights under 40 CFR Section 7. Before filing a complaint, you can discuss your concerns with the Civil Rights Coordinator listed above.

You may also file a discrimination complaint directly with the appropriate federal agency. For assistance with filing a civil rights complaint, you can call, write, or e-mail the contacts below.

File a complaint by mail:

U.S. Department of Health and Human Services
Centralized Case Management Operations
200 Independence Avenue, SW., Room 509F, HHH Building
Washington, D.C. 20201

File a complaint by phone or fax:

  • Toll-free: 800-368-1019
  • Fax: (202) 619-3818
  • TDD: 800-537-7697

You may also file a civil rights complaint directly with the U.S. Department of Justice, Civil Rights Division, electronically through their Complaints Portal or by mail or phone at:

U.S. Department of Justice
Office for Civil Rights
810 Seventh Street NW
Washington, DC 20531
Toll-free: 1-855-856-1247

You may also make a complaint by filling in both this Complaint Verification Form and this Identity Release Statement and submitting them to

If you are filing a complaint related to the Mississippi WIC Program, you may file the complaint with the U.S. Department of Agriculture. Mail or e-mail the complaint form below to the USDA:

Mail complaint form to:

Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410

Your rights against discrimination are protected under these federal laws:

  • Title VI of the Civil Rights Act of 1964
  • Title IX of the Education Amendments of 1972
  • Section 504 of the Rehabilitation Act of 1973
  • the Age Discrimination Act of 1975
  • Americans with Disabilities Act of 1990 (ADA), as amended by the ADA Amendments Act of 2008
  • 40 C.F.R. Parts 5 and 7, including Title VI of the Civil Rights Act of 1964, as amended
  • Section 13 of the Federal Water Pollution Control Act Amendments of 1972

Grievance Procedure

This Grievance Procedure is intended to satisfy Title VI requirements by ensuring that no person is excluded from participation in, denied the benefits of, or subjected to discrimination under any Mississippi State Department of Health (MSDH) program, activity, or service, or is subjected to intimidation, threats, coercion, or discrimination for exercising their rights under federal or State law. This policy establishes procedures for receiving, investigating, and responding to allegations of discrimination.


The policies, procedures, and responsibilities of this Grievance Procedure apply to all MSDH programs, activities, and services.

Complaint Forms

Complaint forms can be found in the section above.

Grievance Procedures and Complaints Processing

  1. If a person believes they have suffered from prohibited discrimination under a MSDH program, activity, or service they may contact the MSDH's Title VI Coordinator (Coordinator) to seek informal resolution. The Coordinator may schedule an interview with the complainant.
  2. If a complaint about a MSDH program, activity, or service cannot be resolved informally, the complainant may file a formal complaint with the Coordinator. A written complaint must be filed within 180 days after the alleged discriminatory action, event, or occurrence unless the MSDH waives the time limit for good cause. Complaints must include the complainant's or their representative's name and contact information; a description of the nature of the complaint, the date(s) of the alleged discriminatory action, event, or occurrence; the requested remedy; and complainant's or representative's signature. Complaint forms are available in English and Spanish. Complaints filed in the MSDH Women, Infants and Children (WIC) program can be taken orally.
  3. The complaint does not need to be written or signed if it is submitted in an alternate format to accommodate the complaint filing needs of a person who has an LEP, a disability, or other special need.
  4. MSDH staff are required to provide complainants with disabilities the appropriate auxiliary aid or service and complainants with limited English proficiency language assistance services when necessary to file a complaint.
  5. The Civil Rights Coordinator will ensure that complaints filed in the WIC program are referred to the USDA Food and Nutrition Service (FNS), Civil Rights Division’s Regional Civil Rights Officer within five (5) calendar days of receipt in accordance with the FNS State Agency Complaints Processing Memorandum of Understanding (October 16, 2016) and the FNS Instruction 113-1: Civil Rights Compliance and Enforcement.  The Civil Rights Coordinator (or their designee) will not investigate WIC complaints.
  6. The MSDH will notify the complainant of the MSDH's receipt of the complaint within five business days.
  7. The Coordinator will maintain a complaint log containing the name and address of the complainant or their representative, date(s) of the alleged prohibited discrimination, nature of the complaint, date of submission of the complaint, date of the Coordinator's request for additional information necessary to evaluate the complaint and date of its receipt, results of the investigation, and disposition of the complaint.
  8. As part of the investigation, the Coordinator may request that the complainant provide additional documentation and information supporting the complaint. The complainant must respond to the Coordinator's request within 30 days after it is sent to the physical or email address provided on the complaint, or the case may be closed.
  9. The Coordinator will issue a written decision on the grievance no later than 45 days after its filing. The preponderance of the evidence standard will be applied during analysis of the complaint. (Under the preponderance standard, the burden of proof is met when the party with the burden convinces the fact finder that there is a greater than 50% chance that the claim is true.)
  10. The Grievant may appeal the decision of the Civil Rights Coordinator by filing an appeal in writing to the State Health Officer within 15 days of receiving the Civil Rights Coordinator’s decision.
  11. The State Health Officer or his designee will issue a written decision in response to the appeal no later than 30 days after its filing.
  12. Complaints filed with MSDH will go to MSDH Civil Rights Coordinator, Post Office Box 1700, Jackson, MS 39215-1700 or by email to

The availability and use of this grievance procedure does not preclude a person from filing a complaint of discrimination on the basis of race, color, national origin, sex, age, disability, or retaliation/reprisal with the applicable federal funding entity.

Language Assistance

The Mississippi State Department of Health:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
  • Qualified sign language interpreters, and
  • Written information in other formats (large print, audio, accessible electronic formats, other formats).
  • Provides free language services to people whose primary language is not English, such as:
  • Qualified interpreters, and
  • Information written in other languages.

If you need any of these services, contact the Civil Rights Coordinator by e-mail at It is advised that you do not e-mail protected health information or personally identifiable information, in order to protect your confidentiality in accordance with the Health Insurance Portability and Accountability Act of 1996.

If you have difficulty understanding English or have a disability, free language assistance or other aids and services are available. MSDH provides free interpretation services, translation of materials, or other assistance available upon request: call 601-206-1720.

Español (Spanish)

Si tiene dificultades para entender inglés o tiene una discapacidad, háganoslo saber. La asistencia lingüística gratuita u otros servicios de ayuda están disponibles a pedido en su departamento de salud local sin cargo. Llame al 601-206-1720.

Tiếng Việt (Vietnamese)

Nếu quý vị gặp khó khăn trong việc hiểu tiếng Anh hoặc bị khuyết tật, vui lòng cho chúng tôi biết. Hỗ trợ ngôn ngữ miễn phí hoặc các dịch vụ trợ giúp khác được cung cấp miễn phí theo yêu cầu tại Sở Y Tế địa phương của quý vị: 601-206-1720.

中文 (Chinese)


اللغة العربی (Arabic)

إذا كنت تواجھ صعوبة في فھم اللغة الإنجلیزیة أو تعاني من إعاقة، فیرجى إخبارنا بذلك. إذ تتوفر المساعدة اللغویة مجانًا أو خدمات المساعدة الأخرى مجانًا عند طلبھا من الإدارة المحلیة للشؤون الصحیة: 601-206-1720.

Français (French)

Si vous éprouvez de la difficulté à comprendre l'anglais ou si vous souffrez d'un handicap, veuillez nous en informer. Une assistance linguistique gratuite et d'autres services d'aide sont disponibles sur demande auprès de votre service de santé local. Veuillez appeler: 601-206-1720.

Kreyol (Haitian)

Si w gen difikilte pou w konprann Angle oswa si w gen yon andikap, tanpri fè nou konnen. Asistans lang gratis oswa lòt sèvis èd disponib sou demann nan Depatman Sante lokal ou a gratis. Tanpri rele: 601-206-1720.

Italiano (Italian)

Se non capisce bene l’inglese o ha una disabilità, ce lo comunichi. Presso il locale Dipartimento della salute sono disponibili a titolo gratuito un servizio di assistenza linguistica o altri servizi di assistenza su richiesta. Contattare: 601-206-1720.

Deutsch (German)

Wenn Sie kein Englisch verstehen oder eine Behinderung haben, teilen Sie es uns bitte mit. Kostenlose Sprachunterstützung oder andere Hilfsdienste sind auf Wunsch bei Ihrem lokalen Gesundheitsamt kostenlos verfügbar: 601-206-1720.


यदि आपको अंग्रेजी समझने में कठिनाई होती है या आप अक्षम हैं, तो अनुरोध करने पर मुफ्त भाषा सहायता या अन्य मदद और सेवाएं उपलब्ध हैं। कृपया कॉल करें: 601-206-1720

فارس ی (Farsi)

اگر زبان انگلیسی را درک نمیکنید یا دارای معلولیت ھستید، لطفاً بھ ما اطلاع دھید. خدمات رایگان زبانی یا سایر خدمات امدادی، در صورت نیاز بھ صورت رایگان در اداره بھداشت محلی شما قابل دریافت است : 601-206-1720.

한국어 (Korean)

영어를 이해하는 데 어려움이 있거나, 장애가 있는 경우 저희에게 알려주십시오. 무료 언어 지원 또는 기타 지원 서비스는 요청 시 지역 보건부에서 무료로 제공됩니다: 601-206-1720.


Tí o bá ní ìṣòro mípa òye Gẹ̀ẹ́sì tàbí o ní àìlera, jọ̀wọ́ jẹ́ kí a mọ̀. Àǹfàní ètò ìrànlọ́wọ́ èdè àti àwọn ètò ìràlọ́wọ́ mìíràn wà tí o bá bèèrè fun ní ẹ̀ka Ìtọ́jú ìlera àdùúgbò lọ́fẹ̀ẹ́: 601-206-1720.


Ọ bụrụ na ọ na-esiri gị ike ịghọta Bekee ma ọ bụ na i nwere nkwarụ, biko mee ka anyị mara. Enyemaka asụsụ efu ma ọ bụ ọrụ enyemaka ndị ọzọ dị mgbe a chọrọ ha na Ngalaba Mpaghara Ahụike gị n'efu: 601-206-1720.

Last reviewed on Feb 14, 2024 request edits

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Mississippi State Department of Health 570 East Woodrow Wilson Dr Jackson, MS 39216 866‑HLTHY4U Contact and information

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