DOJ & HHS Telehealth Guidance Issued for Complying with Nondiscrimination Laws

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The US. Department of Health and Human Services (HHS) and the US Department of Justice (DOJ) have issued new telehealth guidance to reduce discrimination in telehealth. These telehealth social justice changes are related to federal nondiscrimination laws, including the American Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, Section 1557 of the Patient Protection and Affordable Care Act, and Title VI of the Civil Rights Act of 1964.

These changes require telehealth to be accessible to everyone, including people with poor English skills and disabilities. These laws aim to reduce discrimination and ensure everyone has access to health care. Acting Director, Melanie Fontes Rainer of HHS’s Office for Civil Rights, referenced these new telehealth social justice guidelines in her address.

We have seen important expansions in health care technologies, such as telehealth, that provide great convenience and help for people seeking care. This guidance makes clear that there is a legal obligation to ensure that all people receive full access to needed health care and can connect to telehealth services, free of discriminatory barriers. 

Discrimination and Telehealth Social Justice

Being mindful of telehealth social justice is increasing as organizations diligently work to address telehealth disparities. Here’s how some individuals or groups face barriers or discrimination when accessing health care through telehealth:

• Individuals with poor English have difficulty understanding the language, which makes it harder to set up appointments or follow instructions. This is why it is important to give the option to access telehealth portals in multiple languages or translate existing content.
• Differently abled individuals, including people with limited vision, often have difficulty using a web-based portal due to the absence of screen reader tools. These tools allow blind and visually impaired users to read their computer or digital device screens using text-to-speech output or a refreshable Braille display.
• Video conferencing tools may not be suitable for individuals with hearing difficulties if a transcript is not visible simultaneously. They may require an interpreter who can use sign language to translate the session for them.

The nondiscrimination law document issued by the HHS and DOJ states, 

A health care provider’s failure to take appropriate action to ensure that care provided through telehealth is accessible can result in unlawful discrimination.

For example, a practice that usually limits appointments to 30 minutes may need to schedule more time for a patient or client who requires an accommodation for  their disability.

Nondiscrimination Laws 

The document suggests that telehealth care providers avoid discriminating based on disability by reviewing their policies, practices, or procedures and consider providing additional support to patients when needed before, during, and after a virtual visit. The DOJ and HHS telehealth guidance document adds:

This guidance builds on work that HHS and DOJ have previously done to promote nondiscrimination and access in health care. For example, HHS has developed a website for consumers and providers of telehealth that promotes access to patients, including those who face barriers accessing technology. The website has a health equity section that includes practical tips about how to improve access to telehealth, including making materials accessible in different formats and multiple languages and using assistive devices. 

Following these guidelines will ensure that organizations follow all nondiscrimination laws and provide telehealth social justice.

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