On July 20, 2020, the Office for Civil Rights (OCR) at the US Department of Health and Human Services (HHS) issued guidance focused on federal financial assistance recipients’ compliance with Title VI of the Civil Rights Act of 1964. Title VI prohibits discrimination on the basis of race, color or national origin. The bulletin also highlights initiatives and funding opportunities by OCR and HHS focused on removing discriminatory barriers that impede equal access to quality healthcare. 

IN DEPTH

As the novel Coronavirus (COVID-19) pandemic continues to affect the United States, current data from the Centers for Disease Control and Prevention (CDC) suggests that the virus disproportionately affects racial and ethnic minority groups. To help ensure that these disparities are addressed, the Office for Civil Rights (OCR) at the US Department of Health and Human Services (HHS) issued a bulletin guidance document on July 20, 2020, titled “Civil Rights Protections Prohibiting Race, Color and National Origin Discrimination During COVID-19.”

The bulletin focuses on federal financial assistance recipients’ compliance with Title VI of the Civil Rights Act of 1964. Title VI prohibits discrimination on the basis of race, color or national origin by recipients of federal financial assistance. Title VI prohibits “both intentional discrimination and methods of administration that have a disproportionate and adverse impact on the basis of race, color, or national origin.”

The bulletin provides specific guidance points to help ensure Title VI compliance by funding recipients, including:

• Adopting policies to prevent and address harassment or other unlawful discrimination

• Confirming that existing policies and procedures do not exclude or otherwise deny persons on the basis of race, color or national origin

• Ensuring that community-based testing sites and alternate care sites are accessible to racial and ethnic minority populations

• Ensuring that individuals from racial and ethnic minority groups are not subjected to excessive wait times, rejected for hospital admissions or denied access to intensive care units compared to similarly situated non-minority individuals

• Providing ambulance service, non-emergency medical transportation and home health services (if part of the recipient’s offered services) to all neighborhoods within the recipient’s service area, without regard to race, color or national origin

• Appointing or selecting individuals to participate as members of a planning or advisory body as part of the funding recipient’s program, without exclusions on the basis of race, color or national origin

• Assigning staff, including physicians, nurses and volunteer caregivers, without regard to race, color or national origin

• Assigning beds and rooms without regard to race, color or national origin

• Making available to patients, beneficiaries and customers information on how the funding recipient does not discriminate on the basis of race, color or national origin in accordance with applicable laws and regulations.

In addition to providing guidance on how to comply with Title VI, the bulletin highlights several OCR and HHS initiatives to “identify the populations most vulnerable to COVID-19 and to improve prevention, testing, and treatment in these populations.” These initiatives include:

• The appointment of a COVID-19 chief health equity officer by the CDC

• Funding opportunities for public health research from the National Institutes of Health (NIH) and the National Institute on Minority Health and Health Disparities

• Funding opportunities for implementation of science projects focused on providing access to diagnostic testing in underserved communities by the NIH Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) Initiative

• Establishment of the National Infrastructure for Mitigating the Impact of COVID-19 within Racial and Ethnic Minority Communities Initiative, led by the Morehouse School of Medicine

• Allocations and awards to thousands of rural health clinics; community health centers; community-based testing sites; and Indian Health Service (IHS), Tribal and Urban Indian Health programs by the Health Resources and Services Administration and IHS.

Key Takeaways

As federal funding recipients, including state and local agencies, hospitals and other healthcare providers, continue to take steps to serve their communities and address the COVID-19 public health emergency, the OCR bulletin reminds these recipients of federal funds to ensure that they are adequately and appropriately serving their entire community. Undertaking additional compliance efforts in a time of limited resources and amid the unique demands of the pandemic may be challenging for providers, but OCR continues to place a priority on taking active steps to address health inequities affecting minority communities and to remove discriminatory barriers that impede equal access to quality healthcare.