Fiscal Year 2010 Budget in Brief

Office of the Secretary
Office for Civil Rights

(dollars in millions)

The Office for Civil Rights promotes and ensures that people have equal access to and opportunity to participate in and receive services in all HHS programs without facing unlawful discrimination and that the privacy of their health information is protected while ensuring access to care. Through prevention and elimination of unlawful discrimination and by protecting the privacy of individually identifiable health information, OCR helps HHS carry out its overall mission of improving the health and well-being of all people affected by its many programs.

The FY 2010 Budget request is $41 million for the Office for Civil Rights (OCR), an increase of $1 million over FY 2009. The budget supports OCR’s activities as the primary defender of the public's right to nondiscriminatory access to and receipt of Federally funded health and human services – from hospitals and nursing homes to Head Start and senior centers. In addition, the budget supports OCR’s significantly expanded compliance responsibilities that protect the rights of individuals’ personal health information under the Privacy Rule issued pursuant to the Health Insurance Portability and Accountability Act (HIPAA).

OCR assesses compliance with nondiscrimination and Privacy Rule requirements through:

• complaint investigation, resolution, and monitoring;
• public education;
• technical assistance; and
• compliance reviews, including civil rights reviews of new Medicare provider applicants.

OCR’s work protects individual rights while supporting HHS goals for strengthening the health and well being of individuals, families, and communities by improving access to HHS programs.

Key priorities for OCR in FY 2009 and FY 2010 include: ensuring understanding of and compliance with the HIPAA Privacy Rule; implementing additional privacy protections for genetic information; promoting adequate privacy protections in health information technology; enforcing the confidentiality protections afforded to patient safety information; increasing non-discriminatory access to quality health care and human services, including adoption, foster care, and TANF; promoting best practices for effective communication in hospital settings with persons who are deaf or hard of hearing and persons of limited English proficiency; strategically disseminating an OCR- developed Federal civil rights curriculum for medical schools to help narrow disparities in health care quality, access and patient safety; supporting appropriate services in the most integrated setting for persons with disabilities; and promoting non-discrimination and privacy protections in emergency preparedness and response activities.

Through these varied efforts, OCR promotes integrity in the expenditure of Federal funds by ensuring that these funds support programs which provide access to services free from discrimination on the basis of race, color, national origin, disability, age, religion and sex. OCR’s efforts also promote public trust and confidence that the health care system will maintain the privacy of protected health information while ensuring access to care.

ENSURING PRIVACY AND CONFIDENTIALITY IN HEALTH CARE

HIPAA – Health Information Privacy: OCR is responsible for administering and enforcing the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information maintained or transmitted by health plans, health providers, and clearinghouses. Since the compliance date of April 14, 2003, OCR has responded to more than 33,000 complaints. Of the approximately 11,000 complaints where OCR has had the authority to investigate, OCR found no violation in about 3,600 and has obtained corrective action from the investigated entities in over 7,200 cases.

Privacy Provisions of the Genetic Information Non-discrimination Act of 2008 (GINA): GINA protects individuals against discrimination by employers and health plans based on an individual’s genetic information. To help implement these important new Federal protections, OCR will amend the HIPAA Privacy Rule, as required by GINA, to prohibit health plans from using or disclosing an individual’s genetic information for underwriting purposes.

Privacy and Security Provisions of the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009: In FY 2009 and FY 2010 OCR will develop the regulations and guidance required under Subtitle D of the HITECH Act for the purpose of strengthening and enhancing privacy protections of the HIPAA Privacy Rule. Additionally in accordance with the Act, OCR will expand its significant outreach efforts by implementing a comprehensive national education initiative, to be conducted in a variety of languages, which will enhance public transparency regarding the uses of protected health information and the rights of individuals with respect to those uses.

OCR will continue to provide policy support to HHS leadership to ensure consideration of privacy and civil rights issues in the development of standards for a national health information infrastructure.

Patient Safety: OCR is taking a lead role in fulfilling the Department’s mandate to improve patient safety and reduce the incidence of events that adversely affect patient safety by establishing and enforcing the confidentiality protections afforded by the Patient Safety and Quality Improvement Act of 2005.

ENSURING NON DISCRIMINATORY ACCESS TO HEALTH CARE AND HUMAN SERVICES

OCR works to ensure non-discriminatory access to HHS-funded health and human services regardless of race, color, national origin, disability, age, religion or sex, and to reduce health disparities.

OCR investigates and resolves complaints, initiates compliance reviews, and provides technical assistance to programs receiving Federal financial assistance. OCR works with Federal and State partners, providers and community- and faith-based organizations to ensure non discriminatory access to health and human services. For example, OCR is partnering with the American Hospital Association and 17 state and regional hospital associations to facilitate effective communication in hospitals with persons who are deaf or hard of hearing and persons with limited English proficiency.

In FY 2010, OCR will continue to focus on equal access to quality health services to eliminate health disparities and a broad range of non-discrimination issues in human services, including adoption, foster care, emergency preparedness activities, and TANF. Also, as part of its effort to ensure that all recipients of Federal financial assistance are aware of their obligations under Federal civil rights laws, OCR will promote accessibility of health information technology for underserved populations, including people with limited English proficiency and those with disabilities.

Olmstead: OCR is the HHS agency with authority and responsibility to protect the rights of persons with disabilities under the Americans with Disabilities Act. It plays a leading role in working with the States to achieve community integration for individuals with disabilities in accordance with the Supreme Court’s Olmstead v. L.C. decision. For example, in FY 2008 OCR entered into a statewide Olmstead settlement agreement in which the State of Georgia has committed to developing adequate community services for all persons with disabilities in public and private institutions and at risk of institutionalization, with an individual focus the more than 2,500 individuals currently institutionalized in eight Georgia psychiatric and developmental disabilities facilities.

FY 2010 Budget in Brief Home