HHS Rule: Strengthening Protections Against Disability Discrimination

The final rule provides robust civil rights protections for people with disabilities in federally funded health and human services programs, such as hospitals, healthcare providers participating in CHIP and Medicaid programs, state and local human or social service agencies, and nursing homes.

The new regulations ensure 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. The agency said the new rule advances equity and bolsters protections for people with disabilities under Section 504 of the Rehabilitation Act (Section 504).

Secretary of Health and Human Services (HHS) Xavier Becerra described the regulations as “comprehensive in scope, advancing justice for people with disabilities and helping to ensure they are not discriminated against under any program or activity receiving funding from HHS just because they have a disability.”

HHS argues in the rule that value assessment methods can play an important role in determining whether a particular intervention, such as a medicine or treatment, will be provided and under what circumstances.  They are an increasingly significant tool for cost containment and quality improvement efforts. However, value assessment methods may lead to discrimination against individuals with disabilities when they place a lower value on life-extension for individuals with disabilities or when that method is used to limit access or deny aids, benefits, or services.  The final rule prohibits the discriminatory use of such methods.

HHS has updated the regulations to clarify obligations in several critical areas. Specifically, the rule:

• Ensures 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 on the basis of disability to deny, limit, or otherwise condition access to an aid, benefit or service.
• Defines 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, like exam tables and mammography machines.
• Details requirements to ensure nondiscrimination 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.

Read the HHS fact sheet on the final rule: Discrimination on the Basis of Disability in Health and Human Service Programs or Activities. This rule takes effect 60 days after publication.