Sec. 903. Accountability and transparency within the Department of Health and Human Services
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Title XXXIV of the Public Health Service Act , as amended by titles I, II, and III of this Act, is further amended by inserting after subtitle C the following: The Secretary shall establish within the Office for Civil Rights an Office of Health Disparities, which shall be headed by a director to be appointed by the Secretary. The Office of Health Disparities shall ensure that the health programs, activities, and operations of health entities that receive Federal financial assistance are in compliance with title VI of the Civil Rights Act, including through the following activities:
The development and implementation of an action plan to address racial and ethnic health care disparities, which shall address concerns relating to the Office for Civil Rights as released by the United States Commission on Civil Rights in the report entitled Health Care Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equity (September 1999) in conjunction with the reports by the National Academy of Sciences (formerly known as the Institute of Medicine) entitled Unequal Treatment:
Confronting Racial and Ethnic Disparities in Health Care , Crossing the Quality Chasm: A New Health System for the 21st Century , In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce , The National Partnership for Action to End Health Disparities , and The Health of Lesbian, Gay, Bisexual, and Transgender People , and other related reports by the National Academy of Sciences. This plan shall be publicly disclosed for review and comment and the final plan shall address any comments or concerns that are received by the Office.
Investigative and enforcement actions against intentional discrimination and policies and practices that have a disparate impact on minorities. The review of racial, ethnic, gender identity, sexual orientation, sex, disability status, socioeconomic status, and primary language health data collected by Federal health agencies to assess health care disparities related to intentional discrimination and policies and practices that have a disparate impact on minorities. Such review shall include an assessment of health disparities in communities with a combination of these classes.
Outreach and education activities relating to compliance with title VI of the Civil Rights Act. The provision of technical assistance for health entities to facilitate compliance with title VI of the Civil Rights Act. Coordination and oversight of activities of the civil rights compliance offices established under section 3442. Ensuring— at a minimum, compliance with the most recent version of the Office of Management and Budget statistical policy directive entitled Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity ; and consideration of available data and language standards such as— the standards for collecting and reporting data under section 3101; and the National Standards on Culturally and Linguistically Appropriate Services of the Office of Minority Health.
The Secretary shall ensure the effectiveness of the Office of Health Disparities by ensuring that the Office is provided with— adequate funding to enable the Office to carry out its duties under this section; and staff with expertise in— epidemiology; statistics; health quality assurance; minority health and health disparities; cultural and linguistic competency; civil rights; and social, behavioral, and economic determinants of health. Not later than December 31, 2021, and annually thereafter, the Secretary, in collaboration with the Director of the Office for Civil Rights and the Deputy Assistant Secretary for Minority Health, shall submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives that includes— the number of cases filed, broken down by category; the number of cases investigated and closed by the office; the outcomes of cases investigated; the staffing levels of the office including staff credentials; the number of other lingering and emerging cases in which civil rights inequities can be demonstrated; and the number of cases remaining open and an explanation for their open status.
There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2021 through 2026. The Secretary shall establish civil rights compliance offices in each agency within the Department of Health and Human Services that administers health programs. Each office established under subsection
(a)shall ensure that recipients of Federal financial assistance under Federal health programs administer programs, services, and activities in a manner that— does not discriminate, either intentionally or in effect, on the basis of race, national origin, language, ethnicity, sex, age, disability, sexual orientation, and gender identity; and promotes the reduction and elimination of disparities in health and health care based on race, national origin, language, ethnicity, sex, age, disability, sexual orientation, and gender identity. The offices established in subsection
(a)shall have the following powers and duties: The establishment of compliance and program participation standards for recipients of Federal financial assistance under each program administered by the applicable agency, including the establishment of disparity reduction standards to encompass disparities in health and health care related to race, national origin, language, ethnicity, sex, age, disability, sexual orientation, and gender identity. The development and implementation of program-specific guidelines that interpret and apply Department of Health and Human Services guidance under title VI of the Civil Rights Act of 1964 and section 1557 of the Patient Protection and Affordable Care Act to each Federal health program administered by the agency. The development of a disparity-reduction impact analysis methodology that shall be applied to every rule issued by the agency and published as part of the formal rulemaking process under sections 555, 556, and 557 of title 5, United States Code. Oversight of data collection, analysis, and publication requirements for all recipients of Federal financial assistance under each Federal health program administered by the agency; compliance with, at a minimum, the most recent version of the Office of Management and Budget statistical policy directive entitled Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity ; and consideration of available data and language standards such as— the standards for collecting and reporting data under section 3101; and the National Standards on Culturally and Linguistically Appropriate Services of the Office of Minority Health. The conduct of publicly available studies regarding discrimination within Federal health programs administered by the agency as well as disparity reduction initiatives by recipients of Federal financial assistance under Federal health programs. Annual reports to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives on the progress in reducing disparities in health and health care through the Federal programs administered by the agency. The Office for Civil Rights of the Department of Health and Human Services shall provide standard-setting and compliance review investigation support services to the Civil Rights Compliance Office for each agency described in subsection (a), subject to paragraph (2). The Office for Civil Rights of the Department of Justice may, as appropriate, institute formal proceedings when a civil rights compliance office established under subsection
(a)determines that a recipient of Federal financial assistance is not in compliance with the disparity reduction standards of the applicable agency. In this section, the term Federal health programs mean programs— under the Social Security Act ( 42 U.S.C. 301 et seq.) that pay for health care and services; and under this Act that provide Federal financial assistance for health care, biomedical research, health services research, and programs designed to improve the public’s health, including health service programs. .
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Sec. 903
Accountability and transparency within the Department of Health and Human Services
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