Section 504 of the Rehabilitation Act of 1973 Part 84 Final Rule: Fact Sheet
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has issued a final rule to advance equity and bolster protections for people with disabilities. The final rule, Discrimination on the Basis of Disability in Health and Human Service Programs or Activities, updates, modernizes, clarifies, and strengthens the implementing regulation for Section 504 of the Rehabilitation Act of 1973. Section 504 prohibits discrimination on the basis of disability in programs and activities that receive Federal financial assistance.
The historic rule provides robust civil rights protections for people with disabilities in federally funded health and human services programs, such as hospitals, health care providers participating in CHIP and Medicaid programs, state and local human or social service agencies, and nursing homes. Reflecting over 50 years of advocacy by the disability community, it advances the promise of the Rehabilitation Act and helps to ensure that people with disabilities are not subjected to discrimination in any program or activity receiving funding from HHS. This final rule is consistent with Section 504 statutory text, congressional intent, legal precedent, and the Biden-Harris Administration’s commitment to advancing equity and civil rights.
Summary of the Final Rule
Clarifies the application of Section 504 to several critical areas.
The current Section 504 regulation for Part 84 sets forth a number of prohibitions against discrimination on the basis of disability. Those include ensuring people with disabilities have an equal opportunity to participate in a program or activity funded by HHS. The final rule updates the current Section 504 regulations to clarify several crucial areas not explicitly addressed in the current rule. Specifically, the rule addresses:
- Medical treatment. Pervasive discrimination on the basis of disability in accessing medical care leads to significant health disparities and poorer health outcomes for individuals with disabilities. This pattern of discrimination appears in a variety of contexts including organ transplantation, life-sustaining treatment, participation in clinical research, and in crisis standards of care that may go into effect when health care resources are limited. The rule ensures that medical treatment decisions by those that receive Federal financial assistance from the Department (“recipients”) are not based on biases or stereotypes about individuals with disabilities, judgments that an individual with a disability will be a burden on others, or beliefs that the life of an individual with a disability has less value than the life of a person without a disability.
- Value assessment methods. Value assessment methods can play an important role in determining whether a particular intervention, such as a medicine or treatment, will be provided and under what circumstances. They are an increasingly significant tool for cost containment and quality improvement efforts. However, value assessment methods may lead to discrimination against individuals with disabilities when they place a lower value on life-extension for individuals with disabilities or when that method is used to limit access or deny aids, benefits, or services. The final rule prohibits the discriminatory use of such methods.
- Child welfare programs and activities. Children, parents, caregivers, foster parents, and prospective parents with disabilities may encounter many types of discrimination in the child welfare systems designed to protect children and strengthen families. This section sets forth detailed requirements to ensure nondiscrimination in the services provided by child welfare agencies, including, but not limited to, parent-child visitation, reunification services, child placement, parenting skills programs, and in- and out-of-home services.
- Web and mobile accessibility. As technology continues to provide new ways to deliver health and human services programs and activities, it is vital to ensure that those methods are readily accessible to and usable by individuals with disabilities. The final rule defines what accessibility means for websites and mobile applications and requires compliance with specific technical standards, the Web Content Accessibility Guidelines (WCAG) 2.1 AA. This approach aligns the with the standards recently published by the Department of Justice under Title II of the Americans with Disabilities Act.
- Accessible medical equipment. People with disabilities experience barriers to medical care because of inaccessible medical equipment. Exam tables that are not height adjustable, mammography machines that require a person to stand, and weight scales that do not accommodate wheelchairs all result in inequities and exclusion from basic health services for individuals with disabilities, contributing to poor health outcomes. The final rule adopts the U.S. Access Board’s standards for accessible medical diagnostic equipment. The final rule also requires that, within two years of the effective date, recipients using examination tables and/or weight scales have at least one accessible version of the equipment.
- Integration. The existing Section 504 regulation requires programs and activities to be administered in the most integrated setting appropriate to the needs of a person with a disability. The final rule incorporates language reflecting principles established through Supreme Court and other significant court decisions that require the provision of community-based services to people with disabilities The final rule will help recipients better understand and comply with their obligations under Section 504 and provide more detail about the right to be served in the most integrated setting appropriate for individuals with disabilities.
The final rule incorporates changes needed to reflect amendments to Section 504, enactment of the Americans with Disabilities Act (ADA), and significant case law. Most HHS recipients have been covered by the ADA since 1991. New sections added to ensure consistency are:
- Service animals. Recipients must permit the use of trained service animals except under certain circumstances.
- Maintenance of accessible features. Facilities and equipment required to be accessible to individuals with disabilities must be maintained in operable working order.
- Personal services and devices. Personal services and devices are not required unless they are customarily provided to individuals without disabilities.
- Mobility devices. Recipients must permit individuals to use manually powered mobility devices such as wheelchairs in areas open to pedestrian use and power-driven mobility devices, such as Segways® and golf carts, under certain circumstances.
- Communications. Recipients must ensure effective communications with individuals with hearing, vision, and speech disabilities through the provision of auxiliary aids and services. Such aids and services may include qualified interpreters or readers, assistive listening devices or systems, text telephones, captioning, and information in Braille, large print, or electronically for use with a computer screen-reading program.
- Direct threat. Recipients are not required to permit individuals in programs or activities when they pose a direct threat to the health or safety of others as described in the final rule.
- Retaliation and coercion. Recipients may not retaliate against an individual for making a complaint or objecting to any act or practice made unlawful by Section 504.
- Limitations. Recipients need not take actions if those actions would result in a fundamental alteration in the nature of their program or in undue financial and administrative burdens. A recipient must still take other action that would not result in such alteration or burdens but would nevertheless ensure that people with disabilities receive benefits or services to the maximum extent possible.
