Healthcare providers would be required to make greater accommodations for patients with disabilities under a proposed rule the Health and Human Services Department announced Thursday.
Primarily, the draft regulation seeks to prevent providers from turning away patients with disabilities based on an inability or an unwillingness to accommodate their needs.
The proposed rule from the Office for Civil Rights would apply to all HHS programs and all organizations that do business with the department. HHS aims to update regulations in Section 504 of the Rehabilitation Act of 1973 to establish standards for healthcare organizations and other entities that provide medical treatment through federal programs or manage federal health and human services activities.
“Too many people are unable to equally access effective medical care,” Office for Civil Rights Director Melanie Fontes Rainer said at a news conference Thursday. “This lack of healthcare, this lack of meaningful preventative care, can lead to worse health outcomes. This rule means that a woman who’s never had a mammogram or a pap smear will be able to for the first time.”
The draft regulation would compel providers to make structural adjustments to ensure facilities are accessible to people with disabilities. Construction and renovation projects would have to adhere to federal standards, such as a requirement that elevators and ramps be fully operational. Healthcare organizations would also be required to offer effective communication methods for people with impairments, such as interpreters, text captioning and Braille materials.
Significantly, providers would need to modify medical equipment to accommodate patients with disabilities and revise biases found in clinical support tools. For example, Items such as examination tables and mammography machines would have to be adaptable for use by patients in wheelchairs.
In addition, clinical tools would be prohibited from using disability status as a determining factor for medical interventions. For instance, the Office for Civil Rights reported in 2020 that some state emergency triage guidelines for hospitals recommended cutting off care for people with disabilities sooner than other patients. These guidelines were subsequently revised to eliminate disability status as a criterion for triage decisions.“
"It’s 2023, yet for many Americans accessing basic health needs is still challenging. Some persons with disabilities may have to drive hours to get an accessible mammogram or receive the benefit and advancements of our healthcare system,” HHS Secretary Xavier Becerra said in a news release. “This historic proposed rule will advance justice for people with disabilities and help ensure they are not subjected to discrimination under any program or activity receiving funding from HHS just because they have a disability.”
The proposal aligns with the Americans with Disabilities Act of 1990 and other nondiscrimination laws and addresses issues the Office for Civil Rights has encountered during enforcement actions, according to HHS.
The Office for Civil Rights received 51,000 complaints last year—an all-time high—but employs fewer investigators than in the past, Fontes Rainer said. “We have people all the time that have to call my office before they can get something that’s accessible or an accommodation made. That’s not acceptable,” she said. The office is hiring to cover the backlog but needs additional funding, Becerra said.
The American Association of People with Disabilities welcomed the proposed rule. “The chilling effects created by the rampant ableism in healthcare caused and continues to cause disabled people across the country to forego the needed health management and prevention activities,” President and CEO Maria Town said at the news conference. “Systemic problems call for systemic solutions.”