As we celebrate Black History Month, we reflect on the role of my office, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), in advancing racial equity and remaining committed to the enforcement of federal civil rights laws to ensure nondiscrimination based on race, color, and national origin.  This month and throughout the year, our office recognizes the countless contributions of Black Americans, the historic fight for equality, and the work ahead to address health inequities for Black Americans.

President Biden reflected on his commitment to equity and diversity in a Proclamation on National Black History Month, 2024. The President recognized the vast contributions and advancements made by Black Americans and that “Black history is American history.”

At HHS, OCR contributes to this mission by leading the Department’s work on nondiscrimination and by working to promote better health access and outcomes for people of color and other underserved communities.  This is reflected in our persistent enforcement of federal civil rights and privacy laws to safeguard our services from discrimination, bias, and barriers.

Some of OCR’s recent efforts include:

Strengthening Nondiscrimination in Health Care

OCR issued a proposed rule revising Section 1557 of the Affordable Care Act (Section 1557) that includes robust provisions to protect people from discrimination and supports the Biden-Harris Administration’s priority of advancing health equity and civil rights. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, or disability in certain health programs or activities and is one of the government’s most powerful tools for ensuring nondiscriminatory access to health care. OCR is working to finalize the Rule.

Enforcement

Black Maternal Health: OCR is investigating allegations of racism and discrimination in hospitals across the country, including in one of Los Angeles’ wealthiest facilities, where a local woman died from the pregnancy care she had received.

Environmental Justice

Lowndes County, Alabama: On May 4, 2023, OCR and the Department of Justice announced an interim resolution agreement in their environmental justice investigation into the Alabama Department of Public Health (ADPH) regarding the discriminatory administration of a wastewater disposal system program.  The investigation in Lowndes County, Alabama, a predominately Black county with a high poverty rate, revealed that ADPH had failed to take meaningful actions to remedy sanitation conditions. This was despite awareness of resident’s exposure to raw sewage, a burden that placed disproportionate health and financial impacts on the County’s Black residents, who could face potential property loss or even criminal penalties if they were not able to remediate.

The Agreement was reached after an 18-month investigation. Under the resolution agreement, ADPH will be required to develop equitable and safe wastewater disposal and management services, as well as raise awareness of the health impacts of exposure to wastewater.  

The Agreement requires ADPH to address health disparities and improve health outcomes by ensuring compliance with federal civil rights laws and the fulfilment of agreement terms.

“Environmental justice is a public health issue, and where you live should not determine whether you get sick from basic environmental hazards not faced in other affluent and white communities,” said Department of Health and Human Services Office for Civil Rights Director Melanie Fontes Rainer. “We are pleased that Alabama’s Public Health Department has committed to take immediate and long-term steps to protect the health of Lowndes County residents. This community has long been at the heart of the civil rights struggle, and today’s resolution is yet another testament to the ongoing work that is the pursuit of racial justice.” 

Removing Language Barriers

As a part of this Administration’s accessibility and inclusion efforts, including through responsibilities outlined in President Biden’s Executive Orders and the HHS Equity Action Plan, OCR is working to ensure that all people have meaningful access to health and human services programs and activities regardless of race, ethnicity or linguistic ability.  This issue is of significant importance to OCR, as racial minorities are more likely to speak a language other than English at home, and communication barriers often result in negative health outcomes including increased morbidity and mortality. OCR is leading HHS on Language Access by launching and organizing the Department-wide Language Access Steering Committee, which is currently overseeing the implementation of Language Access Plan updates for HHS Staff Divisions and Operating Divisions.

• As part of this effort, the Language Access Steering Committee is overseeing the implementation of updated Language Access Plans for all of HHS’ component Staff Divisions and Operating Divisions.  The updates made to component Language Access Plans will improve and ensure the quality and accuracy of language access services in HHS-funded health and human services programs and activities for people with limited English proficiency and people with disabilities.
• OCR also releases an annual progress report based on language access work being done across HHS. The annual report tracks enforcement activity and the progress of the Language Access Steering Committee.

Ensuring Equal Access to Telehealth

OCR and the Department of Justice Civil Rights Division issued guidance on nondiscrimination on the basis of race, color, national origin, and disability in accessing telehealth.

• The guidance explains legal obligations under Title VI, Section 1557 of the Affordable Care Act, Section 504 of the Rehabilitation Act, and the Americans with Disabilities Act.
• It provides information to health care providers about their nondiscrimination obligations and practical tips about how to provide accessible telehealth.

Strengthening the Health Care Workforce to Meet America’s Diverse Needs

Each summer, OCR continues a long-standing collaboration with the Association of American Medical Colleges to deliver civil rights compliance training to pre-medical and pre-dental college students.

• From June to August, OCR staff members deliver training to approximately 1,000 students at colleges and universities across the country, including historically Black institutions, Howard University, and Charles R. Drew University of Medicine and Science.

If you or someone you know has experienced discrimination, you can file a complaint with HHS at: https://www.hhs.gov/ocr/complaints/index.html.