On May 1, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), finalized a rule that prohibits discrimination based on disability. This ruling is an important landmark in the disability rights movement because it is the first comprehensive update to Section 504 of the Rehabilitation Act in 47 years.

The rule, titled Discrimination based on Disability in Health and Human Service Programs or Activities, provides a comprehensive set of regulations to protect people with disabilities against discrimination for activities or programs receiving funding from HHS.

“Our rules ensure that the medical treatment decisions are not based on biases or stereotypes about individuals with disabilities, judgments that an individual with a disability will be a burden on others, or beliefs that [the] life of an individual with a disability has less value than the life of a person without a disability,” said Melanie Fontes Rainer, Office for Civil Rights U.S. Department of Health & Human Services Director. “It also, for the first time, implements a legally enforceable standard to ensure non-discrimination in the use of technologies that are routinely used in healthcare, including web content and mobile app and kiosks.”

Since its inception, Section 504 of the Rehabilitation Act acted as a civil rights law to prohibit discrimination on the basis of disability. The new ruling continues to recognize the purpose of Section 504 but also ensures that the rule is enforced and promotes health equity by clarifying the obligations of entities providing healthcare services to people with disabilities. 

In detail, the rule:                                                   

• Guarantees that medical treatment decisions are not based on negative biases or stereotypes about individuals with disabilities, judgments that an individual with a disability will be a burden on others, or dehumanizing beliefs that the life of an individual with a disability has less value than the life of a person without a disability.
• Prohibits the use of any measure, assessment, or tool that discounts the value of a life extension based on disability to deny, limit, or otherwise condition access to aid, benefit, or service.
• States what accessibility means for websites and mobile applications and sets forth a specific technical standard to ensure that health care and human service activities delivered through these platforms are readily accessible to and usable by individuals with disabilities.
• Adopts the U.S. Access Board’s standards for accessible medical diagnostic equipment such as exam tables and mammography machines.
• Details requirement to ensure that children, parents, caregivers, foster parents, and prospective parents are not discriminated against in the services provided by HHS-funded child welfare agencies, including, but not limited to, reasonable efforts to prevent foster care placement, parent-child visitation, reunification services, child placement, parenting skills programs, and in- and out-of-home services.
• Clarifies obligations to provide services in the most integrated setting, like receiving services in one’s own home, appropriate to the needs of individuals with disabilities.

Xavier Becerra, Secretary of the Department of Health and Human Services, recognized that one of the major challenges in adopting this ruling is informing the disabled population that they have rights and that this ruling makes those rights more powerful. He believes that a solution to overcome this challenge is by encouraging individuals to help communicate to Americans with disabilities that they have enforceable rights.

Additionally, the Final Rule updates existing requirements to make them consistent with the Americans with Disabilities Act (ADA), as many HHS recipients are also covered by the ADA this consistency will improve and simplify compliance.

Here at NCHPAD, we are grateful and excited for the new ruling but acknowledge the additional effort in upholding and enforcing the rights and regulations.  

“This important new rule from the U.S. Department of Health and Human Services strengthens protections against disability discrimination, ensuring healthcare decisions are fair and that people with disabilities get equal treatment in all health and human service programs,” said Zoe Young, PhD, NCHPAD Associate Director. “This is an exciting step forward for those of us in the disability and health field. There is still much more work to be done on the frontline to ensure all healthcare facilitates are properly equipped and personnel are trained to implement these protections effectively.”