Data collected from the Centers for Disease Control and Prevention (CDC) shows a trend of discrimination in testing and treatment for COVID-19 among racial and ethnic minority groups. Since the U.S. Department of Health and Human Services (HHS) provides significant federal financial assistance to healthcare providers as part of the national response to the coronavirus pandemic, steps were taken to ensure healthcare anti-discrimination during COVID-19. As a result, the HHS Office for Civil Rights (OCR) recently issued a Bulletin for healthcare providers, hospitals, and state and local agencies that receive federal financial assistance.
This guidance document titled Civil Rights Protections Prohibiting Race, Color, and National Origin Discrimination during COVID-19, 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.
Anti-Discrimination Obligations for Healthcare Providers
Based on current data, CDC points out a disproportionate burden of illness and death among racial and ethnic minority groups, including African American, Hispanic, and Native American populations. Given that these racial and ethnic minority groups are already at an increased risk of contracting COVID-19, additional health and social inequalities put them at an even bigger risk.
In the effort to find a solution for this problem, the OCR’s Bulletin aims to enforce Title VI, and prompt healthcare providers to eliminate healthcare disparities since they are legally obliged to prohibit any discrimination associated with race, color, and national origin in HHS-funded programs. This includes intentional discrimination and methods of administration that have a disproportionate and adverse impact based on race, color, or national origin. At the same time, to prevent anti-discrimination during COVID- 19, HHS has been working on creating a strategy for state and local agencies, hospitals, and other healthcare providers to implement.
Healthcare Anti-Discrimination during COVID-19 Strategies
The OCR’s Bulletin provides specific guidance to help ensure Title VI compliance and healthcare anti-discrimination during COVID-19, 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 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.
Apart from providing guidance on how to comply with Title VI, the bulletin highlights different OCR and HHS measures taken 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 Initiative,
- Establishment of the National Infrastructure for Mitigating the Impact of COVID-19 within Racial and Ethnic Minority Communities Initiative,
- 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.
Taking Timely Measures to Comply with OCR Guidance
OCR and HHS continue working on removing barriers and giving equal access to quality healthcare during this critical time, thus ensuring healthcare anti-discrimination during COVID-19. Minorities have long experienced disparities when it comes to quality healthcare access, but this is especially magnified in light of the novel coronavirus pandemic. However, the existing situation gives an opportunity to state and local agencies, hospitals, and other healthcare providers to acknowledge disparities and properly address them.
The OCR Bulletin, created in response to a current rise in discrimination complaints, serves as a reminder to healthcare providers to prevent healthcare anti-discrimination during COVID-19 and take active steps to address healthcare inequities affecting minority communities. However, making additional compliance efforts in a time of limited resources and amid the global pandemic may be challenging for providers. Still, removing discriminatory barriers that impede equal access to quality healthcare and following other regulations can be significantly simplified with an automated exclusion screening solution. This allows healthcare providers to effectively handle data, reduce potential risks, and set higher standards when it comes to adhering to the HHS proposed rules and standards. Thus, they can easily track changing regulations, prevent costly mistakes, and save resources while maintaining effective healthcare compliance.