On July 29, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the Department of Justice’s (DOJ) Civil Rights Division released Guidance on Nondiscrimination in Telehealth: Federal Protections to Ensure Accessibility to People with Disabilities and Limited English Proficient Persons. The guidance acknowledges that there are many benefits to telehealth and notes that those with disabilities or with limited language proficiencies often find it difficult to access these services and the associated benefits.
According to this guidance, there are several federal laws including Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, Title VI of the Civil Rights Act of 1964, and Section 1557 of the Patient Protection and Affordable Care Act that require telehealth to be made accessible for those with disabilities and those with limited language proficiency.
These laws require reasonable modifications and effective communication for people with disabilities. The guidance provides examples that can help providers remain compliant, such as offering additional time in advance of an appointment, scheduling a longer appointment, and providing a qualified sign language interpreter and real-time captioning. Notably, the guidance recommends phone consultations for those patients with visual disabilities. Recipients of federal financial assistance must take reasonable steps to ensure meaningful access and language assistance for those with limited English proficiency. For meaningful access the guidance provides additional examples such as providing information about the availability of telehealth services, the process for scheduling telehealth appointments, and the appointment itself. For language assistance the guidance provides examples such as oral language assistance, performed by a qualified interpreter or bilingual employee, and written translation of documents performed by a qualified translator.
This guidance continues to build on work that the HHS and the DOJ have previously done to promote nondiscrimination and access in health care. For example, the HHS provides grants to promote the equitable use of telehealth and has also developed a website for patients and providers to promote access. The OCR has issued guidance on non-discriminatory access to health care based on disability, race, color, national origin, sex, and age [refer to Washington Highlights, July 29].