The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) implements statutes that are critical to health equity, including federal civil rights laws, conscience and religious freedom laws, the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Breach Notification Rules, and the Patient Safety Act and Rule, which together protect fundamental rights of non-discrimination, conscience, religious freedom, and health information privacy. OCR’s Strategic Plan provides a framework for how compliance work, partnerships, and operations can implement the Biden-Harris Administration’s commitment to advancing health equity, as described in President Biden’s Executive Orders 14076, 13985, 14091 and 14110.
OCR adopts the definition of health equity articulated in Executive Order 14091 of consistent and systematic treatment of all individuals in a fair, just, and impartial manner, including individuals who belong to communities that often have been denied such treatment, such as Black, Latino, Indigenous and Native American, Asian American, Native Hawaiian, and Pacific Islander persons and other persons of color; members of religious minorities; women and girls; LGBTQI+ persons; persons with disabilities; persons who live in rural areas; persons who live in United States Territories; persons otherwise adversely affected by persistent poverty or inequality; and individuals who belong to multiple such communities.
OCR is working to advance health equity through its rulemaking and enforcement activities, both of which allow OCR to effectuate and enforce standards of the law to prevent non-discrimination and advance fair, just and equal treatment in Federally funded health care programs and activities.
Disability and Aging
Health Equity Goal: Ensure non-discrimination and increase access to services in the community for persons with disabilities who want to return to their communities from institutional settings or are at risk of institutionalization.
Health Equity Goal: Combat and prevent discrimination and advance opportunities for individuals with disabilities through rulemaking.
Impact: Will help protect the general health and wellbeing of individuals with disabilities by clarifying what counts as discriminatory medical treatment and improving patients’ ability to have meaningful access to necessary medical equipment and health and human service programs.
Impact: Improves protections for people with disabilities during public health disasters and emergencies.
Impact: Helps educate the public on how disability rights laws apply to conditions related to the COVID-19 pandemic.
Non-discrimination in Health Care
Health Equity Goal: Ensure non-discriminatory access to health care services and supporting persons with disabilities seeking access to medication.
Health Equity Goal: Advance non-discrimination in health and human services programs through rulemaking.
Impact: Improves non-discrimination protections for marginalized communities, including gender diverse individuals, LGBTQI+ individuals, pregnant people, individuals with limited English proficiency, and individuals with disabilities. The proposed Section 1557 Rule would expand the applicability of non-discrimination standards in health care to health coverage, including limited-duration health plans, and to the Department’s activities related to health programs such as the Medicare and Medicaid programs and the Indian Health Service.
Impact: Clarifies non-discrimination protections in specific HHS grant programs including services and grants that provide aid to refugees, assistance to people experiencing homelessness, substance use treatment and prevention, community mental health services, maternal and child health services, and community services.
Operations and Outreach
Health Equity Goal: Provide outreach and technical assistance to the public to advance our health equity activities in civil rights and HIPAA.
Impact: OCR connects with the public by regularly responding to inquiries on subjects such as civil rights, religious conscience, and health information privacy through providing technical assistance, information on rulemaking, and, at times, speaking directly with staff.
Impact: Increase the accessibility of OCR services for people with different language access needs and gender identities.
Impact: Improves ability to provide individuals information more efficiently, re-route their calls to other agencies, and start to identify trends from data received from callers.
Language Access
Health Equity Goal: Advance meaningful access for individuals with limited English proficiency and effective communication for individuals with disabilities by issuing guidance to states and health care providers and by ensuring the Department delivers linguistically appropriate and accessible programs and services
Impact: The Language Access Plan helps Departmental agencies ensure access to timely, quality language assistance services including translation and effective communication services that will have a disproportionately greater impact on individuals with disabilities and individuals with limited English proficiency. The data collection component of the Language Access Plan also helps agencies identify and address communication barriers to equal opportunity that underserved communities face.
Impact: Improves compliance with civil rights requirements by requiring states to meet individuals’ communication needs. This letter helped to improve states’ understanding of their responsibility to provide effective communication in the Medicaid Unwinding process and addresses communication needs for individuals identified in EO 14091, Further Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. OCR’s letter reminded states of their obligations to ensure non-discrimination on the basis of race, color, national origin, and disability, and anticipates that this work will bolster state efforts to retain children and families on Medicaid programs, reducing the medical and financial risks caused by coverage gaps.
Impact: Helps health care providers better understand their non-discrimination obligations and helps patients better understand their rights under federal law.
Environmental Justice
Health Equity Goal: Address health disparities and reduce environmental risks for underserved communities by ensuring compliance with federal civil rights laws.
Impact: Helps residents of Lowndes County access clean water and public health resources. The Settlement Agreement requires the Alabama Department of Public Health to take a number of measures, including launching a public health campaign, providing educational materials on the impacts of sewage to health care providers, and creating a sustainable and equitable public health infrastructure improvement plan. This action also creates a model for future actions under Title VI and Section 1557.
Substance Use Disorder and Related Conditions
Health Equity Goal: Increase awareness of non-discrimination laws that protect individuals involved in child welfare who are in recovery from substance use disorder.
Health Equity Goal: Increase Health Care Coordination and Confidentiality for Patients with Substance Use Challenges
Impact: Increases coordination among providers in any setting, including those who treat individuals with substance use disorder and clarifies protections surrounding records disclosure to help address concerns that discrimination and fear of prosecution may deter individuals with substance use disorder from seeking health care. Such protections include civil enforcement and requiring reporting of breaches of substance use disorder treatment records.
Impact: Provides clear and accessible guidance on disability protections for individuals in recovery for opioid use disorder.
Health Information Privacy
Health Equity Goal: Advance health equity and the attainment of the highest level of health for all people by supporting the privacy and security of individuals’ health information.
Impact: Helps improve privacy protections for patients seeking reproductive health care. Infringements on reproductive health privacy are likely to have a disproportionate impact on women and communities that have been historically underserved.
Impact: Supports patients’ privacy rights and expectations and advances confidence in the confidentiality of patient communications with their health care provider and the privacy of their health records. The guidance will help provide accessible information on health information privacy, including to individuals who may be reliant on telehealth services and those who may have not been previously exposed to information on data privacy.
Impact: Advances trust in the patient-provider relationship and ensures that patients’ private medical records will not be disclosed and used against people for merely seeking, obtaining, providing, or facilitating lawful reproductive health care. Infringements on health information privacy related to reproductive health care are likely to have a disproportionately greater effect on women, individuals of reproductive age, and individuals from communities that have been historically underserved.