HHS, Illinois reach agreement on disability rights laws

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The U.S. Department of Health and Human Services' Office for Civil Rights (OCR) has reached an agreement with the State of Illinois Department of Human Services to enforce federal disability rights laws after a complaint alleged that a person with disabilities was unjustly institutionalized.

This, HHS said, potentially violated disability civil rights laws under Section 504 of the Rehabilitation Act, Section 1557 of the Affordable Care Act, and Title II of the Americans with Disabilities Act.

Each of these laws requires that services are provided in the most integrated setting appropriate to the needs of a person with a disability – including within their own home and community. Because of the agreement, the individual in question, simply referred to by HHS as "A.C.," has left an institution and is now living in the community.

WHAT'S THE IMPACT

Section 504 prohibits discrimination based on disability in any program or activity receiving federal financial assistance from HHS, while Section 1557 does the same with respect to certain health programs and activities. Title II of the ADA prohibits discrimination on the basis of disability by states and local governments in their services, including all healthcare and social service programs.

According to HHS, these laws require that regulated entities provide services in the most integrated setting appropriate to the needs of people with disabilities.

After receiving complaints alleging that A.C. was being institutionalized against his will, OCR initiated the Expedited Complaint Resolution (ECR) process, in which Illinois agreed to participate, working with A.C. and OCR to take the needed steps to support his move to the community.

Illinois DHS took several specific actions, including expanding its search for community providers; locating a provider who purchased and modified a home to accommodate the needs of A.C. and a roommate; supporting A.C. in moving to the residence, including adding additional direct care staff and staff training to support A.C. and his individual needs; and ensuring he received needed medical and dental care.

OCR said it would continue to monitor these corrective actions.

THE LARGER TREND

A new rule prohibiting discrimination on the basis of disability was finalized by HHS in May through the OCR, and seeks to advance equity and boost protections for people with disabilities under Section 504 of the Rehabilitation Act.

According to HHS, the final rule clarifies and strengthens civil rights protections for people with disabilities, addresses discrimination in medical treatment, adds enforceable standards for accessible medical diagnostic equipment, and ensures accessible web content and mobile apps.

The goal is to protect people with disabilities from experiencing discrimination in any program or activity receiving funding from HHS, the agency said.

More than 61 million Americans had a disability as of 2016, according to a 2022 Health Affairs analysis. Disparities in healthcare access and quality have been observed across many groups of people with disabilities in a variety of clinical environments. Such people also have been found to be less likely to report satisfaction with their care compared with people without disabilities.

Disparities in access to healthcare, and the quality of that care, have been associated with worse physical health and greater burden of chronic disease for people with disabilities compared with their nondisabled peers, research found.

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.