The agency said organizations in federal programs cannot limit care access on the basis of race, color, or national origin.
The Office for Civil Rights (OCR) within the Department of Health & Human Services (HHS) has posted a reminder of Title VI of the Civil Rights Act of 1964, which mandates that healthcare organizations cannot discriminate or limit care access on the basis of race, color, or national origin.
This guidance comes in the context of considerable racial health disparities and health equity issues seen during the COVID-19 pandemic.
“HHS is committed to helping populations hardest hit by COVID-19, including African-American, Native American, and Hispanic communities,” said Roger Severino, OCR director. “This guidance reminds providers that unlawful racial discrimination in healthcare will not be tolerated, especially during a pandemic.”
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The guidance reiterates that any healthcare organization that receives federal funding must comply with Title VI of the Civil Rights Act. This means that healthcare organizations enrolled in federal programs during the COVID-19 pandemic may not discriminate on the grounds of race, color, or national origin.
The guidance went beyond reviewing overt denial of care based on race, color, or national origin. It also provided recommendations for how hospitals, organizations, and public health municipalities can create inclusive care access options.
For instance, care delivery sites should be accessible for all patient populations. Existing policies should not inadvertently exclude racial or ethnic minorities. This means racial or ethnic minority patients should be not be disproportionately subjected to long wait times, care access barriers, or intensive care unit denials when compared to non-minority patients.
The agency also recommended organizations ensure resources spanning from non-emergency medical treatment to healthcare provider personnel be made available to patients regardless of a patient’s race or ethnic background.
This guidance comes as the nation sees racial health disparities come to bear as part of the coronavirus pandemic. People of color, particularly Black individuals, are contracting COVID-19 at a higher rate than their white peers. People of color are also more likely to suffer a more aggressive form of the disease.
These adverse outcomes are likely because traditionally marginalized and underserved communities are more likely to have comorbidities that complicate COVID-19.
Traditionally marginalized populations are not more likely to become sick; instead, most experts agree these populations are subjected to institutional racism that has sowed mistrust in the medical field, leaving patients with less access to care and more risk for chronic illness. At the same time, traditionally marginalized communities are more likely to encounter other social risk factors that can cause chronic illness.
“Minorities have long experienced disparities related to the medical and social determinants of health – all of the things that contribute to your health and wellbeing. The COVID-19 pandemic has magnified those disparities, but it has also given us the opportunity to acknowledge their existence and impact, and deepen our resolve to address them,” said Vice Admiral Jerome M. Adams, Surgeon General, MD, MPH, said in relation to the OCR guidance.
“This timely guidance reinforces that goal and I look forward to working across HHS and with our states and communities to ensure it is implemented.”
These guidelines seek to address some of the systemic issues that have led to poorer health and outcomes among racial or ethnic minorities even before the COVID-19 pandemic.
This is not the first action on civil rights OCR and HHS have taken in recent months.
In June, HHS and OCR finalized changes to Section 1557 of the Affordable Care Act (ACA), which protects civil rights for patients. The changes altered a 2016 definition of sex, which by and large protected the rights of transgender individuals and members of the LGBTQ community. The 2016 administration defined gender identity as “one’s internal sense of gender, which may be male, female, neither, or a combination of male and female.”
Since then, a series of courts have ruled that redefinition as unlawful, the current HHS administration reported. Specifically, courts ruled the redefinition as “contrary to civil rights law,” including the Religious Freedom Restoration Act and the Administrative Procedure Act.
This latest rule change represents HHS acting on those court rulings, which the agency said were binding.
“HHS will enforce Section 1557 by returning to the government’s interpretation of sex discrimination according to the plain meaning of the word ‘sex’ as male or female and as determined by biology,” HHS said in its announcement of the finalized rule. “The 2016 Rule declined to recognize sexual orientation as a protected category under the ACA, and HHS will leave that judgment undisturbed.”
The finalized changes also rolled back ACA requirements that covered health entities to provide certain language services. Although the rule still requires translation services in medical facilities and works to limit the use of family members as medical interpreters, language advocates still said the rule was a hit to non-English speakers.
The rule eliminates language that requires regulated entities to provide mailed notice to patients in 15 or more languages. Including that printed material amounted to some $2.9 billion in costs, HHS said, which the agency stated is passed onto patients and consumers.
HHS did outline areas Section 1557 would still provide civil rights protections. HHS still stands for access to care regardless of race, color, national origin, disability, age, and sex.
This much has been made evident from this most recent review of Title VI of the Civil Rights Act issued by HHS and OCR.
Source: Patientengagement Hit