On July 26, 1990, the Americans with Disabilities Act (ADA) was signed into law, affirming the inherent dignity of every person, regardless of disability. The ADA works in tandem with our other federal civil rights laws, including Section 504 of the Rehabilitation Act of 1973 (Section 504) and Section 1557 of the Affordable Care Act (ACA) (Section 1557), enforced by the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS), that protect people from discrimination on the basis on disability.

Today, as we commemorate the 32nd anniversary of the ADA, OCR is proud to continue its work of standing up against discrimination on the basis of disability and enforcing the ADA and other federal civil rights laws that guarantee equity, opportunity, inclusion, and independent living for people with disabilities, free of discrimination.  Below are some key examples of this important work at HHS.

Achieving the Promise of the ADA through Enforcement

Over the past year, OCR has produced the following results through enforcement of the ADA, sending a strong message to the health care industry about the importance of ensuring nondiscrimination for people with disabilities:

• Resolving Allegations of Discriminatory Practices Regarding Patients Needing Opioid Use Disorder Treatment

  OCR and the United States (U.S.) Attorney’s Offices for the District of Rhode Island and Massachusetts reached an agreement with twelve skilled nursing facilities in Rhode Island and Massachusetts operated by Genesis HealthCare, Inc., to resolve allegations that the facilities denied admission to prospective residents because they were taking an FDA-approved medical treatment to treat Opioid Use Disorder, in violation of the ADA, the Section 1557, and Section 504.

• Working to Ensure Communication with Individuals Who are Deaf or Hard of Hearing

  OCR, in partnership with the U.S. Attorney’s Office for the District of Connecticut, entered into a Voluntary Resolution Agreement with Backus Hospital, to ensure effective communication with individuals who are deaf or hard of hearing.  The Agreement resolves a complaint filed with the U.S. Department of Justice (DOJ) on behalf of an individual who is deaf, alleging that Backus Hospital failed to provide timely auxiliary aids and services to effectively communicate with the patient during an inpatient stay in violation of the ADA, ACA, and Section 504. According to the complaint, despite requesting services upon arrival and receiving them during his emergency room stay, the complainant was not provided an interpreter or video remote interpreting services at critical points of care during his inpatient stay and relied on hand-written notes to communicate with doctors and staff during the hospital visit.

• Working to Help Those Who are Deaf or Hard of Hearing with Appropriate Services and Equipment

  OCR, in partnership with the U.S. Attorney’s Office for the District of Massachusetts, entered into a Voluntary Resolution Agreement with Baystate Medical Center (Baystate), to ensure effective communication with individuals who are deaf or hard of hearing under Section 504 and Section 1557 of the ACA. The Agreement resolves a complaint filed with DOJ on behalf of an individual who is deaf and utilizes American Sign Language (ASL), alleging that Baystate failed to furnish appropriate auxiliary aids and services necessary to effectively communicate with the patient. According to the complaint, despite requesting a qualified ASL interpreter prior to her scheduled arrival to induce labor, Baystate failed to take appropriate steps to ensure that its communications with her during labor and childbirth were effective.

• Resolving Allegations of Discriminatory Practices Regarding Patients Needing Medication Assisted Treatment (MAT)

  OCR and U.S. Attorney’s Office for the District of Massachusetts reached agreement with The Oaks, a skilled nursing facility in Massachusetts operated by Life Care Centers of America, Inc., to resolve allegations that the facility denied admission to a prospective resident because he was taking an FDA-approved medication to treat Opioid Use Disorder (OUD), in violation of Section 1557, Section 504, and the ADA. The investigation was opened after the U.S. Attorney’s Office received information alleging that The Oaks had a practice of denying admission to individuals solely because the individuals were being treated with buprenorphine or methadone, medications used to treat OUD. The complainant was seeking admission to The Oaks for conditions other than OUD, but also needed the facility to administer medication for OUD, as they would administer medication for any other chronic illness. Under the terms of the agreement, The Oaks will, among other things, revise its admissions policy, and provide training to admissions personnel on Federal civil rights laws and OUD, to ensure that it will not deny admission to individuals with disabilities because they are taking a medication to treat OUD and will determine whether an individual with OUD is qualified for admission with or without reasonable accommodations. The Oaks will also pay the DOJ a civil penalty of $5,000.    

• Addressing Discrimination Against Parents with Disabilities

  OCR and U.S. Attorney’s Office for the District of Rhode Island reached an agreement with the Rhode Island Department of Children, Youth and Families (DCYF) to resolve alleged violations of the ADA and Section 504. The investigation was opened after OCR and the U.S. Attorney’s Office received multiple complaints from parents with disabilities. Three complaints alleged that DCYF failed to provide sign language interpreter services to parents who are deaf during child protection investigations, including when DCYF removed their children from their homes. A fourth complaint alleged that DCYF based conclusions about the parental capacity on a parent’s disabilities (epilepsy and intellectual disabilities) and failed to provide reasonable modifications to the parent’s plan. Under the terms of the agreement, DCYF will, among other things, create and implement a policy on how it will communicate effectively with individuals who have communication disabilities including individuals who are deaf and hard of hearing. In addition, it will ensure sufficient contracts with qualified interpreting services, provide training to all personnel on federal civil rights laws and accommodations for individuals with disabilities, designate an ADA coordinator, and report quarterly for three years.

Making Clear that the ADA Guarantees the Rights of People with Disabilities to Nondiscrimination

• Proposed Rule to Strengthen Nondiscrimination in Health Care

  OCR issued a proposed rule revising Section 1557 of the Affordable Care Act that includes robust provisions to protect people from discrimination and supports the Biden-Harris Administration’s priority of advancing 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 to ensure nondiscriminatory access to health care.

• Guidance to the Nation’s Retail Pharmacies Clarifying Their Obligations to Ensure Access to Comprehensive Reproductive Health Care Services

  OCR issued guidance to remind the roughly 60,000 pharmacies in the United States of the unique role pharmacies play in ensuring access to comprehensive reproductive health care services and the nondiscrimination obligations of pharmacies under federal civil rights laws. Under Section 1557 and Section 504, recipients of federal financial assistance are prohibited from excluding an individual from participation in, denying them the benefits of, or otherwise subjecting them to discrimination on the basis of sex and disability, among other bases, in their health programs and activities.

• Reaffirming Support and Protection for LGBTQI+ Children and Youth

  OCR issued guidance clearly stating that attempts to block access to gender affirming care may run afoul of federal civil rights laws that prohibit discrimination on the basis of sex (Section 1557) and disability (ADA, Section 504, and Section 1557). The guidance clarifies that gender dysphoria, in some cases, may qualify as a disability under the laws. Therefore, restrictions that prevent otherwise qualified individuals from receiving medically necessary care on the basis of their gender dysphoria, gender dysphoria diagnosis, or perception of gender dysphoria may violate the ADA, Section 504, and Section 1557. This guidance is one of many steps HHS has taken to stand with transgender and gender nonconforming youth and their families—and the significant majority of expert medical associations—in unequivocally stating that gender affirming care for minors, when medically appropriate and necessary, improves their physical and mental health.

• Guidance for Health Care Providers on Civil Rights Protections for People with Disabilities

  OCR issued guidance making clear that in light of the continuing COVID-19 public health emergency, when resources can be scarce, it is vital that individuals with disabilities are not prevented from receiving needed health care benefits and services because of discrimination. The guidance clarifies that federal civil rights laws continue to apply to health care providers during a public health emergency, including to administering COVID-19 testing, medical supplies, and medication.  These requirements also continue to apply to covered entities providing hospitalization, long-term care, intensive treatments, and critical care, such as oxygen therapy and mechanical ventilators.  Additionally, federal civil rights laws apply to state Crisis Standard of Care plans, procedures, and related standards for triaging scarce resources that hospitals are required to follow.  The FAQs remind health care providers of their obligations under law and provide examples of applicability. This guidance is one of many comprehensive action steps taken by HHS to support President Biden’s National Strategy for the COVID-19 Response and Pandemic Preparedness to protect those most at risk, advance equity, and address disparities in rates of infection, illness, and death.

• Joint Guidance on “Long COVID” and Disability Rights Under the ADA, Section 504, and Section 1557

  With the rise of long COVID as a persistent and significant health issue, the HHS Office for Civil Rights (OCR) and the DOJ Civil Rights Division have joined together to provide this guidance.  The guidance explains that long COVID can be a disability under the ADA, Section 504, and Section 1557, and explains how these laws may apply.  Each of these federal laws protects people with disabilities from discrimination.  The guidance also provides resources for additional information and best practices.

Learn More about the ADA
Together with our partners at the HHS Administration on Community Living (ACL), OCR created a website to celebrate the ADA by telling the story of how the ADA came to be, showcase some of the progress we have made as a country toward achieving its promise, and illustrate some of the work being done by OCR and ACL, as well as other partners within HHS and across government. The site also shines a spotlight on the impact of the ADA by letting people with disabilities share stories about their lives.

File a Complaint
If you believe that you or someone else has been discriminated against because of disability by an entity receiving financial assistance from HHS, you or your legal representative may file a complaint with OCR.

As we celebrate the 32nd anniversary of the signing of the ADA into law, it is a time to reflect on our history and accomplishments and look onward to our future.  I am honored to join OCR as Acting Director, to continue advancing the work of our agency and our commitment to robust enforcement of the ADA. I look forward to working with our communities and partners as we advance this critical work.