Combating Discrimination Against Patients with HIV

In his State of the Union Address on February 5, 2019, President Trump announced the Administration’s goal to end the HIV epidemic in the United States within ten years. The President’s Initiative, Ending the HIV Epidemic: A Plan for America, is leveraging the data and tools now available to reduce new HIV infections in the United States by 75 percent in five years and by 90 percent in ten years.

The President’s Initiative identifies continuing challenges to good HIV policy, including discrimination that blocks the path to better health for individuals with HIV.

During my tenure as the Director of HHS OCR, we have investigated and resolved complaints of discrimination against individuals with HIV under multiple legal authorities. For example:

• Yesterday, we announced that HHS OCR has secured corrective action from the Florida Orthpaedic Institute (“Florida Orthopaedic”), a Tampa Bay comprehensive orthopedic practice employing 40 physicians working in 10 offices and 20 hospitals. The complaint alleged that Florida Orthopaedic cancelled a surgery because of a patient’s HIV positive status. After HHS OCR informed Florida Orthopaedic of the complaint and that it would be investigating the allegations, Florida Orthopaedic banned the patient from the practice and cited the patient’s complaint to HHS as a basis for doing so.

On the basis of HHS OCR’s investigation into the alleged retaliation, Florida Orthopaedic agreed to revise its nondiscrimination policies and procedures, its procedures for dismissing patients from the practice; train its staff on HIV and federal non-discrimination laws including prohibitions on retaliation; and refer the complainant to three orthopedic surgeons in the area to prevent further delays in the patient’s healthcare.

• In September 2017, HHS OCR entered into a resolution agreement with Heritage Hills Living & Rehabilitation Center, LLC (Heritage Hills). The agreement resolved a complaint alleging that Heritage Hills discharged a seriously ill patient from its facility upon learning of the patient’s HIV positive status, in violation of Section 504 of the Rehabilitation Act of 1973 and Section 1557 of the Affordable Care Act. The patient died in another facility not long after. Under the Agreement, Heritage Hills agreed to HHS OCR monitoring; appointed a Civil Rights Coordinator; published new non-discrimination policies and procedures; trained its staff on HIV and federal non-discrimination obligations; revised its admissions policy to ensure that individuals with disabilities are free from discrimination; and informed neighboring hospitals that it does not discriminate in admissions on the basis of disability.
  
• In May 2017, St. Luke’s-Roosevelt Hospital Center paid HHS $387,200 to settle potential violations, under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, and agreed to implement a comprehensive corrective action plan. The settlement resolved a complaint alleging that a staff member impermissibly faxed the complainant’s protected health information, (including HIV status) to the complainant’s employer contrary to explicit instructions.

We have also trained stakeholder groups and grant recipients about federal civil rights, conscience, and health information privacy protections for individuals, including people with HIV, and worked with HHS agencies and programs to inform providers and consumers of federal civil rights, conscience, and health information privacy laws.

In addition, we have implemented a new HIPAA Right of Access Initiative to assist individuals in exercising their right to obtain their medical records in a timely manner and at reasonable cost. Access to health information empowers patients to track their progress, monitor their lab results, communicate with their treatment teams, and adhere to their important treatment plans. Timely access to one’s health information is especially important for individuals with HIV.

As an HHS law enforcement agency, HHS OCR ensures compliance with our nation’s civil rights, conscience and religious freedom, and health information privacy and security laws by investigating complaints and conducting compliance reviews, requiring corrective and remedial action, promulgating policy and regulations, and providing technical assistance and public education for the American people. For additional information on HHS OCR’s work on HIV/AIDS issues, visit: www.hhs.gov/civil-rights/for-individuals/special-topics/hiv.

To learn more about non-discrimination and health information privacy laws, and to find information on filing a complaint, visit us at www.hhs.gov/ocr.

Follow HHS OCR on Twitter at twitter.com/HHSOCRExit Disclaimer.