Civil Rights Enforcement Success Stories Involving HIV/AIDS
Summary of Selected OCR Compliance Reviews and Complaint Investigations
The U.S. Department of Health and Human Services announced the termination of Medicaid funding to a California surgeon who intentionally discriminated against an HIV-positive patient by refusing to perform much needed back surgery. An order, issued by the HHS Departmental Appeals Board, concluded that the surgeon violated Section 504 of the Rehabilitation Act of 1973, which prohibits disability discrimination by health care providers who receive federal funds. Read the HHS Press Release | Read the HHS Departmental Appeals Board Decision (PDF - 67 KB) | Read the OCR Violation Letter of Findings
Kaiser Permanente Los Angeles Medical Center (LAMC) (CA) - OCR Region IX secured corrective action to prohibit discriminatory treatment against HIV+ patients at LAMC. The complainant alleged that LAMC transferred a patient who objected to having an HIV+ roommate to another patient’s room in violation of Section 504 of the Rehabilitation Act of 1973. During the investigation, LAMC voluntarily agreed to: (1) assign HIV+ patients to rooms on the same basis as other patients; (2) assign patients to rooms without regard to whether the roommate is HIV+; (3) refuse to accommodate patient requests for room transfers based on prohibited discriminatory reasons; (4) amend its staff training manual to reflect the above; (5) provide staff training; and (6) issue a letter of apology to the complainant.
Kaiser Permanente South Sacramento Medical Center (SSMC) (CA) - OCR Region IX secured corrective action from SSMC to resolve a complaint that SSMC discriminated against a patient on the basis of disability (HIV disease), in violation of Section 504 of the Rehabilitation Act of 1973. The complaint arose because a SSMC physician declined to insert tubes in a patient’s ear to treat an ear infection, allegedly because the physician believed that leaks from the tubes could place the patient’s caregiver at risk for HIV. During the course of the investigation, SSMC voluntarily agreed to have the physician receive additional training on HIV transmission and issue a letter of apology to the complainant. OCR provided additional technical assistance, including advising SSMC to provide the patient’s caregiver and other affected caregivers with resources and guidelines for caring for individuals living with HIV, such as the CDC brochure, "Caring for Someone with HIV/AIDS at Home."
Minnesota Department of Health (MDH) - OCR Region V resolved a complaint alleging that MDH discriminated against seven predominately African-American community-based organizations (CBOs) based on race during the request for proposal (RFP) process for Community HIV Health Education and Risk Reduction Projects. During the course of OCR’s investigation, MDH voluntarily took corrective actions to ensure compliance with Title VI of the Civil Rights Act of 1964, including: (1) establishing a non-discriminatory selection process for members of its Community Review Committee charged with evaluating RFP submissions; (2) adopting new scoring sheets and evaluation procedures for RFP submissions; (3) interviewing CBO applicants to determine their capacity to serve African-American high-risk populations; (4) adopting and publishing an extensive anti-discrimination policy; and (5) informing consumers of their right to file grievances with MDH and OCR.
New Hampshire Department of Health and Human Services (NH DHHS) - OCR Region I secured corrective action with NH DHHS to ensure individuals with HIV have equal access to personal care services as required by Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act of 1990. The complainant, who is HIV+ and had received personal care services in his home for four years, stopped his personal care services and then attempted to have his services reinstated. The complaint alleged that the individual’s personal care services could not be reinstated because New Hampshire’s Administrative Rule 601 prohibited social services agencies from accepting clients with HIV disease. On March 29, 2011, the NH DHHS amended Administrative Rule 601 and deleted that portion of the Rule prohibiting social services agencies from providing personal care services to individuals with HIV. NH DHHS also assured OCR that its programs and activities do not discriminate on the basis of disability. As part of the settlement, the complainant is again receiving personal care services in his home.
Pennsylvania Dentist (PA) - OCR Region III investigated a complaint that a dentist in State College, Pennsylvania refused to accept a new patient after the individual disclosed his HIV status in violation of Section 504 of the Rehabilitation Act of 1973. The complaint also alleged that staff disclosed the individual’s HIV status to a third party in violation of the HIPAA Privacy Rule. During OCR’s investigation, the dentist agreed to: (1) adopt a nondiscrimination policy and incorporate it in his employee handbook; (2) post the nondiscrimination policy and distribute it to his employees; and (3) ensure that his employees receive training on universal precautions and the HIPAA Privacy Rule.
Windsor Rosewood Care Center, LLC (WRCC) (CA) - OCR Region IX entered into a Settlement Agreement with WRCC to ensure that individuals with HIV/AIDS have equal access to its skilled nursing facility, as required by Section 504 of the Rehabilitation Act of 1973. After receiving an administrative complaint from the Contra Costa HIV Legal Service Project and conducting a comprehensive investigation, OCR issued a Violation Letter of Finding to WRCC, concluding that when it was owned and operated by Helios Healthcare, LLC, the skilled nursing facility violated Section 504 by denying admission to a Medicaid beneficiary because he was HIV-positive. Under the Settlement Agreement, WRCC will establish non-discrimination, reasonable accommodation, and universal precautions policies; report to OCR for an eighteen month period; implement patient grievance procedures; and inform patients of their right to file with OCR and have their discrimination complaints investigated. In addition, WRCC supervisory staff will receive comprehensive training from the Pacific AIDS Education and Training Center, which is funded by the HHS Health Resources and Services Administration, through the Ryan White HIV/AIDS Treatment Extension Act of 2009. Read the HHS Press Release (Spanish) Read the Letter of Finding Read the Settlement Agreement Read OCR Director's "Guest Blog" on AIDS.gov
Austin Orthopaedic Surgeon (TX) - OCR Region VI secured a Settlement Agreement with an orthopaedic surgeon in Austin, Texas, to ensure that individuals living with HIV/AIDS have equal access to medially appropriate treatment. After receiving an administrative complaint against the orthopaedic surgeon and conducting a thorough investigation, OCR issued a Letter of Finding, concluding that the surgeon violated Section 504 of the Rehabilitation Act of 1973, when he declined to perform knee surgery on an HIV-positive Latino male patient and instead referred the patient to another surgeon 200 miles away. Under the settlement agreement, the orthopaedic surgeon, whose practice group sees an average of 200 patients per week, agreed that he and his staff will not deny or withhold medically appropriate treatment from patients solely because they are HIV-positive. In addition, the surgeon will establish a non-discrimination policy, make reasonable modifications to his procedures to avoid discrimination against individuals living with HIV/AIDS, receive comprehensive training, implement patient grievance procedures, and inform patients of their right to file a complaint with OCR. Read the Letter of Finding Read the Settlement Agreement Read the HHS Press Release
HospitalBuen Samaritano (P.R.) – OCR Region II secured Voluntary Corrective Action to substantially improve access to care for persons with HIV/AIDS at Hospital Buen Samaritano in Puerto Rico. After OCR’s site visit, the Hospital, which serves seven Puerto Rico Municipalities with a total population of 300,000, hired a full-time Infectious Disease Specialist to care for persons with HIV disease; employed an Emergency Room Facilitator to address long wait times; revised its Emergency Room triage policy; reinstituted community outreach initiatives; and developed and implemented a grievance procedure to achieve compliance with Section 504 of the Rehabilitation Act of 1973.
A.T. Associates, Inc. (CA) - OCR Region IX secured Corrective Action at A.T. Associates’ nursing home chain to make approximately 200 additional nursing home beds available to persons with HIV/AIDS in Northern California. OCR investigated the complaint, which was filed by an African-American veteran who attempted to get admitted to an A. T. Associates nursing home after hip-replacement surgery. However, because of the complainant’s HIV status and young age, the nursing home refused to admit him. After completing the investigation, OCR intervened and required the nursing home chain (which consists of three Northern California skilled nursing facilities) to: (1) issue to all staff a new nondiscrimination policy expressly prohibiting HIV/AIDS discrimination and place the new policy in patient brochures; (2) provide annual mandatory staff training on the new nondiscrimination policy, procedures for admitting persons with HIV/AIDS, universal precautions, and the protection of patients’ health information privacy; (3) notify hospital discharge planners that its facilities now admit otherwise qualified persons with HIV/AIDS; and (4) affirm its compliance with Section 504 of the Rehabilitation Act of 1973; and the Age Discrimination Act of 1975. Read the A.T. Associates Closure Letter
Milwaukee Orthopedic Surgeon (MI) - OCR Region V secured Voluntary Corrective Action to ensure equal access for individuals with HIV/AIDS. The AIDS Resource Center of Wisconsin filed an administrative complaint with OCR alleging that in violation of Section 504 of the Rehabilitation Act of 1973, a Milwaukee orthopedic surgeon declined to perform surgery on the Affected Party after he tested positive for HIV. During the OCR investigation, the surgeon chose to resolve the complaint voluntarily and agreed to: (1) seek the opinion of an infectious diseased specialist before ruling out a course of treatment for a patient with HIV/AIDS; (2) implement a non-discrimination policy; (3) notify patients of the non-discrimination policy; (4) establish an HIV testing and counseling policy, consistent with the recommendations of the CDC; and (5) receive comprehensive HIV training from the American Academy of Orthopaedic Surgeons.
Lexington Health Care Center of Chicago Ridge (MI) - OCR Region V achieved Corrective Action to ensure equal access to a skilled nursing facility for individuals with HIV/AIDS. The AIDS Legal Council of Chicago filed an administrative complaint with OCR alleging that in violation of Section 504 of the Rehabilitation Act of 1973, Lexington Chicago Ridge, a 224 bed skilled nursing facility, discriminated against the Affected Party by denying him admission to the facility because he is HIV-positive. After OCR investigated the complaint, Lexington Chicago Ridge agreed to: (1) develop a non-discriminatory, open admissions policy; (2) disseminate its open admissions policy to twenty-three of its referral sources; (3) provide its infection control procedures to OCR for approval; and (4) train its staff in the OCR-approved infection control procedures.