Health Care, Human Services, and Title VI of the Civil Rights Act of 1964

Title VI of the Civil Rights Act of 1964 is a federal law prohibiting discrimination in programs and activities receiving federal financial assistance. It offers protection based on:

• Race
• Color
• National origin

That means if you're eligible for Medicaid or certain other health or human services, those services can't deny you help because of your race, color, or national origin.

The Office of Civil Rights (OCR) in the U. S. Department of Health and Human Services (HHS) is the federal agency that enforces Title VI. It also enforces other civil rights laws, including the Americans with Disabilities Act (ADA), the Hill-Burton Act, and the Health Insurance Portability and Accountability Act (HIPAA).

This article addresses what entities must follow Title VI. It also discusses what discriminatory acts are prohibited and the nondiscrimination obligations of health care entities under Title VI. Finally, the article addresses what happens if a covered agency or entity fails to follow Title VI.

What Entities Must Follow Title VI?

As mentioned above, Title VI applies to any program or activity receiving federal financial help. Some of the institutions or programs Title VI covers are:

• Extended care facilities
• Public assistance or social services programs
• Nursing homes
• Adoption agencies
• Hospitals and other health care providers
• Daycare centers
• Mental health centers
• Senior citizen centers
• Medicaid and Medicare
• Public health centers and clinics
• Alcohol and drug treatment centers

Prohibited Discriminatory Acts

There are many forms of illegal discrimination based on race, color, or national origin. Title VI of the Civil Rights Act of 1964 prevents a recipient of federal financial aid, on the basis of race, color, or national origin, from:

• Denying services, financial aid, or other benefits as a part of health or human service programs
• Providing a different service, financial aid, or other benefit, or providing these things differently from those provided to others under the program
• Segregating or separately treating people in any matter related to the receipt of any service, financial aid, or other benefit

Title VI Obligations of Health Care Entities

Health care entities getting federal funds must perform specific actions to follow Title VI. These directives include:

• Providing free oral and written language help to patients with limited English proficiency (LEP). The U.S. Supreme Court has said that discrimination against people with LEP is national origin discrimination. The law entitles LEP patients to equal access as if they were English speakers. This includes giving patients notice that they have a right to these services.
• Providing free written and oral help to patients with other special communication needs. This includes those patients who need audio help, large print, an interpreter, or Braille.
• Posting signs and materials in the languages of the service area's predominant cultural and ethnic groups. This includes making consent forms and other essential documents available in these languages.

Noncompliance Outcomes

Failing to follow Title VI can result in losing federal or state funding for the health care entity. For example, a nursing home can lose its funding and have to close. Health care entities can also face medical malpractice charges.

Suppose the Office for Civil Rights (OCR) conducts an investigation and determines there's been a violation of Title VI. In that case, the OCR will seek voluntary compliance from the offending organization. If the organization can't comply, termination of federal funding may begin. The matter may also get referred to the Department of Justice (DOJ) for legal action.

Title VI requires government enforcement. It also provides a private right of action in federal court, ensuring a right to sue federally assisted programs and institutions engaging in intentional discrimination. Patients have the right to sue regardless of the findings of an OCR investigation.

Learn about Your Rights from a Civil Rights Attorney

Do you believe there's been a Title VI violation? Perhaps a nursing home mistreated you because of your race. Recipients of federal financial funding can't discriminate against you based on race or other protected factors. Learn more about your rights under Title VI by talking to a civil rights attorney. They can give technical assistance and determine your eligibility to bring a private lawsuit. Discrimination in health care and human services is illegal, just like employment discrimination. Whether you live in Washington, D.C., or elsewhere, knowing your rights is important.