NHC Section 504 Nondiscrimination Proposed Rule Comments

By: Allen Pinn, Policy Coordinator 

On November 13, the National Health Council (NHC) submitted comments to the Office of Civil Rights at the Department of Health and Human Services (HHS) regarding a proposed rule on Discrimination on the Basis of Disability in Health and Human Service Programs or Activities. The comments submitted by the NHC supported increased efforts to eliminate discrimination against people with disabilities and kept patients’ experiences and access to health care at the forefront. Below is a summary of the comments. 

Accessibility and anti-discrimination  
The NHC is committed to supporting individuals with disabilities when seeking care. The proposed rule emphasizes the prohibition of discriminatory methods in the allocation of scarce medical resources. As seen during the COVID-19 pandemic, standard resource allocation can disproportionately discriminate against individuals with disabilities. The NHC commended HHS for seeking to remedy this ongoing issue. 

Regarding equitable access to web/mobile/kiosk services and medical equipment, the NHC commended HHS for recognizing the importance of accessibility. Regardless of an individual’s ability, all individuals should have access to in-person and digital health care services. In addition to accessible services, the NHC is also strongly advocates for more inclusive communication. Plain language for patients with cognitive, developmental, intellectual, or neurological disabilities should not only be an optional modification, but a mandatory standard across all communications. A mandatory plain language standard will increase inclusivity and widen patient engagement.  

Health care services and support  
The NHC is in full support of the proposed rule’s intent to eliminate discriminatory practices in medical treatment. For instance, studies have shown that physicians’ biases can impact their clinical decisions, which can lead to inequalities in medical treatment.1 No discrimination, whether based on medical expertise or not, should ever be allowed under Section 504 of the Rehabilitation Act. Additionally, the NHC urged HHS to maintain and strengthen protections and guidelines regarding the provision of emergency treatment for hard of hearing and/or deaf individuals. The NHC insisted that new guidance, designed to streamline communication requirements, be made clear and actionable for health care providers.  

Value assessment methods  
As the cost of health care has risen, the NHC has centered its advocacy on proposals that promote value as determined by patients. The NHC applauded HHS efforts to remedy discriminatory value assessment methods. As HHS attempts to address longstanding discriminatory practices in value assessment models, the NHC urged the Department to consider a patient-defined definition of value. The NHC believes in an approach that values rigorous research standards, and the patient voice can make significant progress in eliminating discriminatory practices within value assessment models. 

General Requirements and Procedures 
A significant concept that must be met for individuals living with a disability to fully participate in all aspects of life is moving towards more full integration. HHS’ commitment to uphold the integration mandate outlined in Section 504 and the ADA showcases the Department’s intention that all individuals living with a disability can enjoy full and holistic participation in society. To strengthen the Department’s mandate, the NHC recommended the following: application of the integration mandate, prohibition of discriminatory actions, and clarifies the definition of segregated settings. 

To read the NHC’s full comments, click here. If you have any questions about the NHC’s comments on the proposed rule, please contact Shion Chang, the NHC’s Director of Policy, at schang@nhcouncil.org 

Click here for NHC Comments on Notice of Proposed Rulemaking on Discrimination on the Basis of Disability in Health and Human Service Programs or Activities .