Last week, we reported on new proposed regulations that the Department of Health and Human Services (HHS) released. These regulations go into greater detail concerning the anti-discrimination provisions found in §1557 of the Affordable Care Act (ACA). To read that news item which includes links to the press release and rules, click here. As we pointed out there, these provisions apply to a number of classes of individuals as the section prohibits discrimination based on race, color, national origin, disability, sex or age. In this post, we will look at what the proposed anti-discrimination regulations say regarding individuals with disabilities and how it affects their interaction with the enrollment process – specifically organizations acting as navigators.
Auxiliary Aids: Navigator organizations are required to have all their materials in alternative formats. This includes Braille materials, large print materials, qualified readers, taped texts and audio recordings. This provision also applies to an organization’s website and making sure that all websites are §508 compliant. If you want to learn more about §508 compliance, check out these websites:
Sign Language Interpreters: The proposed rules incorporate the current regulations under the Rehabilitation Act which make it clear that any organization receiving federal funds is obligated to make accommodations to the people they serve who have disabilities. This includes providing sign language interpreters to those who are deaf and use American Sign Language (ASL) as their primary means of communication. The interpreters must be provided to the consumer at no cost to them. The regulations also make it clear that navigators should not use another adult that accompanies the individual to provide sign language unless the consumer expressly requests this. Under no circumstances should a navigator utilize a child to provide sign language interpretation. Navigators should have reasonably quick access to ASL interpreters, so contacting an agency that provides these services ahead of open enrollment is critical. However, another suggestion for navigator organizations would be to give thought to recruiting and hiring individuals who are fluent in ASL so that they are on staff. Just as you may hire those who are fluent in other languages, ASL should be another language to consider when hiring your enrollment staff.
Building Accessibility: The proposed regulations require all organizations who receive federal funds, such as navigators, to be in compliance with the 2010 accessibility standards adopted by the Department of Justice. You can read more about these standards here. It should be noted that these only apply to buildings and permanent structures. Navigator organizations also need to make sure that temporary meeting spaces, such as those when you’re hosting an enrollment event in the community, need to also be accessible. Finally, while a building may be accessible in theory, consideration should be given to best practices and usability as well. A curb cut is only useful if it’s free of obstructions. Accessible offices/halls/waiting areas are only accessible if they remain free from clutter.
Miscellaneous: Organizations which have 15 or more employees will need to designate an employee to monitor compliance with all the anti-discrimination provisions in §1557. They also will be required to post in a public place, the protections available to individuals and what accommodations are available to consumers with special needs. HHS will prepare a sample notice that will be able to be used by all organizations, including navigators.
These are just a few of the provisions in the proposed rules. There are also provisions on the other classes of protected individuals, along with items on enforcement. Of course, these are just proposed rules and the final rules could be slightly different or have major alterations. Comments are due to HHS by November 6th.