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HHS Finalizes Rule Strengthening Protections Against Disability Discrimination

May 7, 2024

Final Rule advances equity and bolsters protections for people with disabilities under Section 504 of the Rehabilitation Act

The U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), finalized a rule that prohibits discrimination on the basis of disability. This rule, titled Discrimination on the Basis of Disability in Health and Human Service Programs or Activities, advances equity and bolsters protections for people with disabilities under Section 504 of the Rehabilitation Act (Section 504). This important Final Rule is HHS’s latest action in furtherance of Executive Order 14091, entitled Further Advancing Racial Equity and Support for Underserved Communities Through the Federal Government.

Reflecting over fifty years of advocacy by the disability community, the Section 504 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 rule advances the promise of the Rehabilitation Act and helps protect people with disabilities from experiencing discrimination in any program or activity receiving funding from HHS because of their disability.

“This rule strengthens the protections afforded by Section 504, a landmark civil rights law, and furthers the Department’s commitment to ensuring equal access to this nation’s health care system and its social service programs for people with disabilities and their families,” said Secretary Xavier Becerra. “It is 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.”

“Today’s rule is long overdue. My office heard from thousands in overwhelming support of this rule and the need to update this rule now for people with disabilities,” said HHS OCR Director Melanie Fontes Rainer. “By removing barriers to health care and social services, this rule advances justice for people with disabilities who have for too long been subject to discrimination. No diagnosis should be missed because of an inaccessible mammogram, no patient should be left with questions about test results due to inaccessible websites, and no life should be valued less due to disability. This is the promise of Section 504 of the Rehabilitation Act and through this action the Biden-Harris Administration is, once again, making clear its commitment to equality and civil rights.”

“Section 504 makes a fundamental promise that disabled people will be treated as full and equal members of the community,” said HHS General Counsel Samuel Bagenstos. “In health and social services programs, keeping that promise can mean the difference between life and death for people with disabilities. Today’s final rule implements critical updates to ensure that HHS continues to make good on that promise.”

“The direct result of decades of advocacy by people with disabilities, the updated 504 rule is one of strongest tools we have ever had to combat the discrimination and inequities faced by disabled people,” said Alison Barkoff, who leads the Administration for Community Living. “ACL was proud to work with OCR to develop the new regulations, and we are committed to supporting OCR in implementing them. We also are looking forward to partnering with the disability community to educate people with disabilities of all ages about the rule’s powerful protections of their civil rights.”

Section 504 prohibits discrimination on the basis of disability in programs and activities that receive funding from HHS. Since the law was enacted, major legislative and judicial developments have shifted the legal landscape of disability discrimination under Section 504.

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.

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

This rule takes effect 60 days after publication. The current rule remains in effect until that time. If you believe that you or another party has been discriminated against on the basis of race, color, national origin, sex, age, or disability, visit the OCR complaint portal to file a complaint online at: https://www.hhs.gov/ocr/complaints/index.html

The final rule may be viewed or downloaded at: https://www.federalregister.gov/public-inspection/2024-09237/nondiscrimination-on-the-basis-of-disability-in-programs-or-activities-receiving-federal-financial

A fact sheet on the rule is available here: https://www.hhs.gov/civil-rights/for-individuals/disability/section-504-rehabilitation-act-of-1973/part-84-final-rule-fact-sheet/index.html

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