Civil Rights FAQs

Civil rights are personal rights guaranteed and protected by the U.S. Constitution and federal laws enacted by Congress, such as the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990. Civil rights include protection from unlawful discrimination.

"Vital documents" are generally documents that affect access to, retention in, or termination or exclusion from a recipient’s program services or benefits.

If you feel a health care provider, human services agency, or program or activity conducted by HHS has discriminated against you (or someone else) unlawfully, you may file a civil rights compliant with OCR.

If you believe you have been discriminated against because of race, color, national origin, age, disability, religion, or sex (including pregnancy, sexual orientation, and gender identity) by a state and local social and health services agency, hospital, clinic, nursing home, or other HHS entity, you may file a complaint with OCR. Disability discrimination complaints may also be filed with OCR.

You may file electronically via the OCR Complaint Portal or use the Civil Rights Discrimination Complaint Form Package from OCR. You will need to save the PDF forms to your computer or other storage device. See full answer for instructions on filing a written complaint.

Complaints must be filed within 180 days from the date of the alleged discrimination. (The Office for Civil Rights may extend this period if there is good cause.)

You can file your complaint against an HHS entity via the OCR Complaint Portal, at OCRComplaint@hhs.gov, or you can mail or fax your complaint. See Filing a Complaint for more information.

Any individual or organization can file a civil rights complaint; you do not need to be the victim of discrimination in order to file a complaint, so long as the complaint is against an entity that is covered by one of the civil rights laws that OCR enforces and the complaint is on a basis covered by those laws, e.g., race, color, national origin, sex (including pregnancy, sexual orientation, and gender identity), age, or disability.

The following are recipients of federal financial assistance from HHS:

  • Health care providers participating in CHIP and Medicaid programs
  • Hospitals and nursing homes (recipients under Medicare Part A)
  • Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C)
  • Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D)
  • Human or social service agencies
  • Insurers who are participating in the Marketplaces and receiving premium tax credits.

Yes, the HHS Office for Civil Rights can investigate such complaints if certain conditions are met.

No. The HHS Office for Civil Rights (OCR) is a neutral fact-finding agency. You should consult an attorney as soon as possible about your right to file a private lawsuit in court if you wish to protect fully your individual rights and remedies.

In most cases, yes. Under most of the statutes enforced by the HHS Office for Civil Rights (OCR), a complainant who has been discriminated against may initiate private court action instead of, or in addition to, filing a complaint with OCR. To do so, you should consult an attorney as soon as possible.

The HHS Office for Civil Rights will try to identify the appropriate federal agency and refer your case unless you advise us not to.

Once a complaint is received, OCR must determine if it has the legal authority to review and investigate the complaint. OCR’s primary authority is over certain health and human services entities only. Information is then gather in an investigation, and we will issue a closure letter, which presents OCR's decision on whether there has been a violation of a federal statute or regulation. If there is a violation finding, the recipient must take corrective action.

View the list of offices that address alleged discrimination by an HHS-funded health or human services entity.

Title VI of the Civil Rights Act of 1964 is a federal law that protects persons from unlawful discrimination based on race, color, or national origin in programs and activities that receive federal financial assistance. Recipients of federal financial assistance are covered by Title VI and its implementing regulations. This means that such recipients may not treat people differently on the basis of race, color, or national origin or use criteria or methods of administration that have the effect of discriminating against persons on the basis of their race, color, or national origin.

"Federal financial assistance” is assistance in the form of any grant, loan, or contract (other than a contract of insurance or guaranty). See the full answer for details.

Medicaid and CHIP are considered federal financial assistance. Medicare Part A is also considered federal financial assistance.  However, the receipt of Medicare Part B is not considered federal financial assistance. Medicare Part C and Part D are considered federal financial assistance.

Recipients of federal financial assistance include:

  • Health care providers participating in CHIP and Medicaid
  • Hospitals and nursing homes (recipients under Medicare Part A)
  • Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C)
  • Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D)

HHS’s LEP policy guidance implements a provision of Executive Order 13166, Improving Access to Services for Persons With Limited English Proficiency, that directs Federal agencies to work to ensure that recipients of their funds provide meaningful access to LEP customers.

Under Title VI and its implementing regulations, recipients of federal financial assistance must take reasonable steps to ensure meaningful access to their programs, services, and activities by eligible limited English proficient (LEP) persons. See the full answer for details.

Federal funding to help states and health providers pay for language services is primarily available through Medicaid and the Children’s Health Insurance Program (CHIP).

Please see Civil Rights Enforcement through Other Agencies.
 

The American Civil Liberties Union (ACLU) is not a government agency, and it decides what issues to become involved in on a case-by-case basis. “Civil liberties” encompasses many more rights than those enforced by the HHS Office for Civil Rights. It also concerns freedom of speech, association, and religion. For further information, call the local ACLU office in your area.

OCR enforces laws prohibiting discrimination on the basis of disability, age, race, color, national origin, religion, and sex (including pregnancy, sexual orientation, and gender identity) in the provision of health and social services only. OCR can investigate only matters that are covered by the laws it enforces.

Most employment discrimination complaints, especially those against private employers, should be addressed to the local Equal Employment Opportunity Commission (EEOC) that services your state.

HHS’s LEP guidance identifies criteria that its recipients can use to assess whether they are operating their programs in compliance with Title VI of the Civil Rights Act of 1964. The LEP guidance also identifies specific actions recipients can take to improve access by persons with LEP to their programs and activities, such as providing interpreters and translating important documents. The guidance is also a resource to members of the public who want to learn more about steps that health and human providers can take to make their programs accessible to persons with LEP.

TANF agencies must comply with:

  • Title VI of the Civil Rights Act of 1964
  • Section 504 of the Rehabilitation Act of 1973
  • The Age Discrimination Act of 1975
  • Title IX of the Education Amendments of 1972

Additionally, TANF agencies are typically part of state or local governments and must comply with Title II of the Americans with Disabilities Act of 1990.

TANF agencies are required to ensure that their programs do not discriminate against people on the basis of their race, color, or national origin.

No. TANF agencies have the same legal obligations to comply with Title VI, Section 504, the ADA, the Age Discrimination Act, and Title IX that they had prior to the DRA and its changes to TANF.

Under Section 504 and the ADA, TANF agencies must: (1) ensure equal access to people with disabilities; (2) reasonably modify policies, practices, and procedures for people with disabilities where necessary; and (3) ensure that methods of administration do not discriminate on the basis of disability.

Under Title VI regulations, to avoid discrimination on the basis of national origin, TANF agencies must take reasonable steps to provide meaningful access for people with limited English proficiency (LEP). Since every TANF agency serves a different population, TANF agency obligations to people with LEP may vary.

Sometimes people with disabilities are unable to participate in or benefit from a TANF program without modifications to policies, practices, and procedures. Under Section 504 and the ADA, TANF agencies must reasonably modify policies, practices, and procedures to avoid discrimination on the basis of disability, unless the modification would fundamentally alter the nature of the service, program or activity.

Yes. Section 504 and the ADA require nondiscriminatory treatment of people with disabilities by TANF agencies. By focusing on what applicants and beneficiaries with disabilities need in order to move from government dependency to self-sufficiency, TANF agencies can ensure compliance with civil rights laws. If a TANF client with a disability needs a program modification or accommodation and providing the modification means that the State will not be able to count the person in its Federal work participation rate, the State is still obligated to provide the program modification.

To ensure that its methods of administration are not discriminatory, a TANF agency may develop and implement official written policies related to meeting the needs of people with disabilities, as well as actual practices (i.e., ways of ensuring that TANF agency staff are knowledgeable about policies) to meet the needs of people with disabilities.

Section 504 and the ADA define the terms "handicap" or "disability" with respect to an individual to mean a physical or mental impairment that substantially limits one or more of the major life activities of such an individual. Included in the definition are people who have a record of such an impairment, or are regarded as having such an impairment.

For further information on TANF agency civil rights compliance and meeting the needs of TANF applicants and beneficiaries with disabilities or limited English proficiency, please contact the Office for Civil Rights or your regional TANF program manager in the HHS Administration for Children and Families, Office of Family Assistance.

Generally, HHS does not investigate educational institutions unless the complaint is against a health-related portion of the university (e.g., the university's school of medicine). Several departments could have provided federal financial assistance to that university. We coordinate with other agencies to determine the most appropriate agency to handle your complaint.

No. Since its enactment, Title VI of the Civil Rights Act of 1964 has prohibited discrimination on the basis of race, color or national origin in any program or activity that receives Federal financial assistance.

Covered entities include any state or local agency, private institution or organization, or any public or private individual that (1) operates, provides or engages in health, or social service programs and activities, and (2) receives Federal financial assistance from HHS directly or through another recipient/covered entity.

Small practitioners and providers will have considerable flexibility in determining precisely how to fulfill their obligations to take reasonable steps to provide meaningful access for persons with limited English proficiency. OCR will assess compliance on a case by case basis.

No. The circumstances outlined in the guidance are intended to identify circumstances which amount to a "safe harbor" for recipients who desire greater certainty of Title VI compliance by translating their written documents, including written information posted to their websites.

Depending on the circumstances, it is often not in the best interest of the person being served to use a family member or friend to interpret important and possibly confidential information. When interpreter services are necessary in order for a recipient to comply with Title VI, the interpreter must be competent and provided at no cost to the person being served.

No.

Privacy Act notice and confidentiality rules are in place. In Office for Civil Rights (OCR) investigations, the name of the complainant usually is kept confidential unless its disclosure is necessary to the case. If OCR determines that release of your identity is required for the processing of the case, you will be asked to sign a release. If you choose not to provide a release, the investigation may be impeded or stopped.

In the case of LEP persons, a recipient is required to take reasonable steps to provide meaningful access to its programs and activities. In the case of LEP persons that are blind or deaf, under Section 504 of the Rehabilitation Act of 1973, recipients must provide equal access through auxiliary aids and services.

OCR provides substantial technical assistance to recipient/covered entities seeking to ensure that LEP persons can meaningfully access their programs or services.

The requirement to take reasonable steps to provide meaningful access to LEP persons is enforced by OCR through the procedures identified in the Title VI implementing regulations. These procedures include complaint investigations, compliance reviews, efforts to secure voluntary compliance, and technical assistance.

A TANF agency ensures equal access to TANF applicants and beneficiaries with disabilities by delivering services that: (a) are appropriate in view of their particular physical or mental impairment; and (b) provide an equal opportunity to benefit from the agency's job placement, education, skills training, employment, and other TANF activities.

HHS agencies provide a variety of services for LEP persons. These services include oral language assistance services such as language lines and interpreters; translation of written materials; and foreign language web sites. HHS continues to explore how it can share language assistance measures, resources, cost-containment approaches, and other information and knowledge, developed with respect to its own federally conducted programs and activities, and welcomes any suggestions.

No. OCR enforces Title VI in accordance with the Title VI implementing regulations. The methods and procedures used to investigate and resolve complaints, and conduct compliance reviews, have not changed.