Mission Statement
To improve the health status of underserved segments of the population of the Los Angeles Area through the direct provision or coordination of health care, health education services, and research.
If you cannot afford to pay for services, JWCH Institute, Inc., and our Wesley Health Centers has a Sliding Fee Scale Discount Program to assist you.
JWCH Institute, Inc., and our Wesley Health Centers are not-for-profit health centers. We understand that many of our patients have limited means to pay for medical care. Therefore, we have developed a Sliding Fee Scale Discount Program to determine the appropriate fee to charge patients depending on their ability to pay. No one will be denied services due to inability to pay. Insurance coverage screening will be conducted to determine whether the services you require are covered by a public or private insurance source. Benefits assistance will be provided through our Eligibility staff to those who may be eligible for public benefits, including Medi-Cal, Medicare and Medi-Cal Managed Care benefits.
Sliding Fee Discounts
JWCH Institute, Inc., and our Wesley Health Centers provide a full discount to individuals and families with annual incomes at or below 100% of the Federal poverty guidelines. Individuals with incomes between 101% and 200% of poverty are charged fees in accordance with our Sliding Fee Discount schedule which is based on family size and income. These fee discounts apply to all JWCH Institute and our Wesley Health Centers Programs and Services. The Clinic Receptionist or Program Eligibility Specialist will help you with the proper paperwork to access services under the Sliding Fee Discount Program Schedule. You can also obtain a written copy of this Sliding Fee Discount Program Schedule and Policy from the Receptionist or Program Eligibility Specialist. If you need help understanding the Sliding Fee Discount Program Schedule and Policy or you have problems providing the necessary eligibility and documentation for the Sliding Fee Discount Program Schedule, please ask to speak with either the Eligibility staff or the Clinic Administrator. You can ask to speak with either of these JWCH Institute and our Wesley Health Centers staff members by asking the Clinic Receptionist.
Payment for Services Rendered
If you are determined to have a payment based on the Sliding Fee Discount Program Schedule, payment is requested at the time of services. If you are not able to pay for services at the time of your visit, the clinic will arrange for payment plans through our Billing Department. If you have questions, please contact our Billing Department at (323) 201-4516 or ask to speak with the Billing Supervisor.
Under special circumstances, patients may not be able to pay the discounted fee as a result of financial hardship. Waiving of fees will be determined on a case-by-case basis and can only be performed after receiving approval from the COO or CFO. Examples of financial hardships include, but are not limited to:
1. Sudden unemployment or significant reduction in income;
2. Bankruptcy;
3. Catastrophic situation, including death or disability of an immediate family member;
4. Loss of home/housing, increased/increasing housing costs;
5. Natural disaster resulting in a State of Emergency;
6. Other financial situations presented by patients on a case-by-case basis.
Public Health Service Employee Notice
The Health Resources and Services Administration (HRSA) considers JWCH Institute, Inc. and our Wesley Health Centers and its providers as Public Health Services employees, providing malpractice liability protection under the Federal Tort Claims Act (FTCA). This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).
Discrimination is Against the Law
JWCH Institute, Inc. and our Wesley Health Centers comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, sexual orientation or sex. JWCH Institute, Inc. and our Wesley Health Centers do not exclude people or treat them differently because of race, color, national origin, age, disability, sexual orientation, or sex. JWCH Institute, Inc., and our Wesley Health Centers:
• Provide free aids and services to people with disabilities to communicate effectively with us, such as:
– Qualified sign language interpreters.
– Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provide free language services to people whose primary language is not English, such as:
– Qualified interpreters
– Information written in other languages
If you need any of these language services, please ask for the Clinic Administrator or other supervisor who will assist you.
If you believe that JWCH Institute, Inc., and our Wesley Health Centers have failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, sexual orientation or sex, you can file a grievance with:
Andy Irie
Chief Administrative Officer
5650 Jillson Street, Commerce, CA 90040
Voice: (323) 201-4516 | TTY: 711 | Fax: (323) 215-0170
admin@jwch.org
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Mr. Andy Irie, Chief Administrative Officer is available to help you.
You may also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically, through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW, Room 509F, HHH Building
Washington, DC 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at:
http://www.hhs.gov/ocr/office/file/index.html
Grievance Procedure:
If you feel you have been discriminated against by a JWCH Institute, Inc. employee, please notify:
Andy Irie
Chief Administrative Officer JWCH Institute, Inc.
5650 Jillson Street, Commerce, CA 90040
Tel: (323) 201-4516
If your complaint is not resolved satisfactorily, please notify:
Al Ballesteros
Chief Executive Officer JWCH Institute, Inc.
5650 Jillson Street, Commerce, CA 90040
Tel: (323) 201-4516
Patient Rights & Responsibilities Policy
All patients seeking treatment or care at JWCH Institute, Inc., and our Wesley Health Centers have rights which are described below as the “Patient Bill of Rights.” Information on these rights is available to all patients upon request.
If patients have been judged to be incompetent in accordance with law, are found by their physicians to be incapable of understanding their rights, are unable to communicate, or are un-emancipated minors, these rights may be exercised by guardians, next-of-kin, or legally authorized persons on behalf of the patients. In accordance with section 70707 of the California Administrative Code, the JWCH Institute, Inc., and our Wesley Health Centers has adopted the following list of patient rights and responsibilities:
Patient Rights
1. A patient has the right to high quality, considerate, and respectful care given by competent personnel and to expect that high professional standards are continually maintained and reviewed. A patient has a right to medical and nursing services without discrimination based upon race, color, religion, sex, sexual orientation, national origin or source of payment. A patient has the right to participate in making care decisions.
2. A patient has the right to designate a surrogate decision maker when the patient is unable to make decisions regarding health care. Alternatively, the patient has the right to exclude family members from participating in his or her health care decisions.
3. A patient has the right to know what health center rules and regulations apply to his or her conduct. A patient has the right to expect good management techniques to be implemented within the health center to effectively utilize his or her time and to avoid personal discomfort. Please see the list of patient responsibilities at the end of this document.
4. A patient has the right to refuse any drug, treatment, or procedure offered by the health center to the extent permitted by law. A physician shall inform the patient of the medical consequences of his or her refusal of any drug, treatment, or procedure.
5. A patient has the right to formulate an advance directive (Living Will or Durable Power of Attorney for Healthcare). Provision of care is not conditioned upon whether or not the patient has an Advance Directive. The patient also has the right to receive information about the health center’s policies and procedures relating to Advance Directives.
6. A patient, next-of-kin, or legally responsible representative has the right to participate in the consideration of ethical issues.
7. A patient has the right, upon request, to be given the name of his or her attending physician, the names of all other physicians directly participating in his or her care, and the names and functions of other health care personnel having direct contact with him or her.
8. A patient has the right to have all records pertaining to his or her medical care treated as confidential except as otherwise provided by law or third-party contractual arrangements. The health center shall provide the patient, upon request, access to all information contained in his or her medical records in accordance with applicable regulations (unless access is specifically restricted by the attending physician for medical reasons or is prohibited by law).
9. A patient has the right to full information in layman’s terms concerning diagnosis, treatment and prognosis, including information about advantages/disadvantages, alternative treatments and possible complications. When it is not medically advisable to give such information to the patient, the information shall be given to the patient’s next of kin or other appropriate persons. Except in emergencies, a patient has the right to expect that his or her physician will obtain the necessary informed consent prior to the start of any procedure or treatment.
10. A patient has the right to every consideration of his or her privacy and security concerning his or her own medical care program. Consultation, examination, and treatment are confidential and should be conducted discreetly, making every attempt to maintain the patient’s verbal and visual privacy. A patient has the right to be free from all forms of abuse and harassment and to have his/her care provided in a safe environment.
11. A patient has the right to expect emergency procedures to be implemented without unnecessary delay.
12. A patient has the right to assistance in obtaining consultation with a physician other than the attending physician.
13. When medically permissible, a patient may be transferred to another facility, only after the patient or next- of-kin or other legally responsible representative has received complete information and an explanation concerning the needs for and alternatives to such a transfer. The institution to which the patient is to be transferred must accept the patient for transfer in advance.
14. A patient has the right to expect that the health center will provide a mechanism whereby he or she is informed upon discharge of his or her continuing health care requirements, and the means for meeting them.
15. A patient who cannot communicate with health center staff because he or she does not speak English or because of hearing or speech impairment shall have access, where possible, to an interpreter and/or technology that will facilitate communication.
16. A patient has the right to examine and receive a detailed explanation of health center bills. He or she has a right to full information and counseling on the availability of financial resources for health care.
17. A patient has the right to communicate complaints regarding his or her care to his or her physician, clinic administrator, or JWCH administration (323) 201-4516. Complaints may also be communicated to the County of Los Angeles, Department of Public Health, Health Facilities Inspection Division, 3400 Aerojet Avenue, #323, El Monte, CA 91731, (800) 228-1019. If a patient is an HMO member, complaints may be communicated to Health Care LA, IPA at (818) 702-0100.
18. A patient has the right to be informed of these rights at the earliest possible time during the course of service.
Patient Responsibilities
1. A patient should provide, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalization, medications and other matters relating to his or her health. Unexpected changes in condition are also to be reported to the appropriate individual.
2. A patient should make it known to the appropriate people whether or not he or she clearly understands a contemplated course of action and what is expected.
3. A patient should follow the treatment plan recommended by the practitioner primarily responsible for his or her care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the responsible practitioner’s orders, and as they enforce the applicable rules and regulations. The patient is responsible for resulting outcomes if he or she refuses treatment or does not follow the practitioner’s instructions.
4. A patient should assure either personally or through a legally responsible party that the financial obligations of his or her treatment/services are fulfilled as promptly as possible.
5. A patient should be considerate of the rights of other patients and personnel and for assisting in the control of noise and number of visitors. This includes being respectful of the property of other patients, visitors, staff and the health center.
After-Hours and Emergency Assistance
If you feel you have a life threatening emergency, call 911 or go to the nearest emergency room. To reach a health center medical provider after hours or when JWCH Institute, Inc., and our Wesley Health Centers are closed, please call either (562) 867-7999 or (866) 733-5924.
Have questions or need assistance?
If you have any questions about our services, costs or availability, please call our Appointment Center hotline at:
(866) 733-5924
For a life threatening emergency
call 9-1-1 or go to the closest Emergency Department.
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No one is turned away due to lack of ability to pay for services or due to being uninsured.
We also offer a sliding fee schedule for persons at or below 200% of Federal Poverty Income Guidelines.
The Health Resources and Services Administration (HRSA) consider JWCH Institute, Inc. / Wesley Health Centers and its providers as Public Health Services employees, providing malpractice liability protection under the Federal Tort Claims Act (FTCA). This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).
