Sec. 9003. 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, III, and IV of this Act, is further amended by inserting after subtitle D the following: Beginning on the date of enactment of this subtitle, the Office for Civil Rights of the Department of Health and Human Services shall be known as the Office for Civil Rights and Health Equity of the Department of Health and Human Services. Any reference to the Office for Civil Rights of the Department of Health and Human Services in any law, regulation, map, document, record, or other paper of the United States shall be deemed to be a reference to the Office for Civil Rights and Health Equity.
The head of the Office for Civil Rights and Health Equity shall be the Director for Civil Rights and Health Equity, to be appointed by the President. Any reference to the Director of the Office for Civil Rights of the Department of Health and Human Services in any law, regulation, map, document, record, or other paper of the United States shall be deemed to be a reference to the Director for Civil Rights and Health Equity. The Director for Civil Rights and Health Equity shall ensure that the health programs, activities, policies, projects, procedures, and operations of health entities that receive Federal financial assistance are in compliance with title VI of the Civil Rights Act of 1964 ( 42 U.S.C. 2000d et seq. ), including through the following activities:
The development and implementation of an action plan to address racial and ethnic health care disparities. Such plan shall— address concerns relating to the Office for Civil Rights and Health Equity 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 existing and future reports of the National Academy of Medicine (formerly known as the Institute of Medicine) including the reports titled 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 of the National Academies of Sciences, Engineering, and Medicine; be issued in proposed form for public review and comment; and be finalized taking into consideration any comments or concerns that are received by the Office.
Investigative and enforcement actions against intentional or in effect discrimination and policies and practices that have a disparate impact on racial or ethnic minorities and communities of color pursuant to section 9007 of the Health Equity and Accountability Act of 2022. 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 of 1964, including the process of filing a complaint in accordance with section 9007 of the Health Equity and Accountability Act of 2022 . The provision of technical assistance for health entities to facilitate compliance with title VI of the Civil Rights Act of 1964. Coordination and oversight of activities of the civil rights compliance offices established under section 3452.
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, monitoring, 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 for Civil Rights and Health Equity 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; health equity; cultural and linguistic competency; civil rights; and social, political, mental, behavioral, economic, and related determinants of health, including education access and quality, health care access and quality, neighborhood and built environment, and social and community context.
The Secretary, in collaboration with the Director Civil Rights and Health Equity and the Deputy Assistant Secretary for Minority Health, shall establish an advisory board (in this subsection referred to as the advisory board ) to report in accordance with paragraph (2). Not later than December 31, 2023, and annually thereafter, the advisory board shall publish and submit to the Office, other Federal agencies, and the Congress a report that includes— the number of complaints filed in accordance with section 9007 of the Health Equity and Accountability Act of 2022 during the reporting period under title VI of the Civil Rights Act of 1964, broken down by category; the number of such complaints investigated and closed by the Office; the outcomes of such complaints investigated; the staffing levels of the Office, including staff credentials; the number of such complaints that are pending (including backlogged complaints) in which civil rights inequities can be demonstrated and an explanation of why such complaints remain pending; and trends among filed complaints and other systemic patterns or themes, including an analysis from the Department of Justice about litigation concerning such complaints.
The members of the advisory board shall include— representatives of stakeholders; and subject matter- and disciplinary-appropriate experts. There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2023 through 2027. 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, and determine and implement policies, services, and activities, in a manner that— does not discriminate, either intentionally or in effect, on the basis of race, color, national origin, language, ethnicity, sex, age, disability status, sexual orientation, or gender identity; and promotes the reduction and elimination of disparities in health and health care based on race, color, national origin, language, ethnicity, sex, age, disability status, sexual orientation, or gender identity. The offices established in subsection
(a)shall, with respect to the applicable agency, 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 agency, including the establishment of disparity reduction standards to encompass disparities in health and health care related to race, color, national origin, language, ethnicity, sex, age, disability, sexual orientation, or gender identity. The development and implementation of policies, procedures, and 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; and include an analysis of the intersecting forms of discrimination. Oversight of data collection, reporting, 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; the National Standards on Culturally and Linguistically Appropriate Services of the Office of Minority Health; and the disaggregation of all health and health care data by racial and ethnic minority population group. 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 each civil rights compliance office established under 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, or health services research; or are designed to improve the public’s health, including health service programs. .
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Sec. 9003
Accountability and transparency within the Department of Health and Human Services
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