HHS Non-discrimination During COVID-19 Guidelines

The Department of Health and Human Services (HHS) released guidance today intended to ensure that any healthcare provider who has received financial assistance, especially during the COVID-19 pandemic,  are compliant with the non-discrimination provisions of Title VI of the Civil Rights Act of 1964.  Consistent with the Affordable Care Act Section 1557’s non-discrimination provisions, Title VI ensures that no individual is denied access to benefits or otherwise discriminated against on the basis of race, color, national origin, disability, age, or sex.

HHS’ Office of Civil Rights (OCR) released this guidance to remind healthcare providers that Title VI prohibits both intentional and disproportionate or adverse impact discrimination.  Additionally, HHS is collecting nationwide data to identify the social, behavioral, and economic impacts on health disparities and vulnerable populations specific to the COVID-19 pandemic response.  The guidance specifically mentions ambulance service providers and suggests that they should:

• Adopt policies to prevent and address harassment or unlawful discrimination;
• Evaluate existing policies and procedures to ensure that their service delivery does not exclude or otherwise deny individuals based upon their belonging to a protected category;
• Ensure that individuals are not subject to excessive wait times based upon their racial or ethnic minority group;
• Provide services to all neighborhoods and individuals regardless of their race, color, or national origin;
• Appoint individuals to planning or advisory bodies without regard to race, color, or national origin;
• Provide culturally appropriate messaging to individuals with Limited English Proficiency (LEP)

Most EMS agencies already maintain an ACA Section 1557 Compliance Coordinator and have a Grievance Procedure for those who believe that they have been discriminated against in the provision of EMS mobile healthcare services.  It is recommended that EMS agencies review their current practices, as well as, their response coverage, times, and care provided in all the areas that they serve.  Further, I recommend that these efforts are documented and, if disparities are identified, a plan of correction is drafted, executed, and monitored, to ensure compliance.