Office for Civil Rights
Director's Corner
Since becoming the Director of the Office for Civil Rights (OCR), I have led OCR's efforts to carryout our mission of improving the health and well-being of all people affected by the Department's many programs through the prevention and elimination of unlawful discrimination, and by ensuring the privacy of individuals' personal health information. This mission is central to Secretary Mike Leavitt's 500 Day Plan to fulfill the President's vision of a healthier and more hopeful America.
OCR has engaged in a number of important compliance and outreach activities during my tenure to carry out our critical civil rights and health information privacy responsibilities. For your convenience, highlighted below are some recent and ongoing activities that support the Department's mission and Secretary Leavitt's priorities:
Emergency Preparedness and Response
Access to Health Care
Health Information Privacy and Confidentiality
Eliminating Racial and Ethnic Health Disparities
HIV/AIDS
Promoting the Economic Self-Sufficiency and Well-Being of Vulnerable Families
New Freedom Initiative to Break Down Barriers for Persons with Disabilities
Modernizing Medicare and Medicaid
Patient Safety and Quality Improvement
Miscellaneous
Emergency Preparedness and Response
OCR developed an Emergency Preparedness Planning and Response website containing information on OCR's role and in protecting civil rights and health information privacy in emergency situations. The site also contains valuable resources from other HHS agencies as well as information from other Federal departments. OCR developed a web-based tool to help emergency planners make decisions about when health information can be shared in compliance with the HIPAA Privacy Rule. Although initially targeted to emergency planning for persons with disabilities, it is applicable to most emergency planning efforts. Intended audiences include health care providers and health plans as well as emergency preparedness and recovery planners at the local, state, and federal levels. The HIPAA Privacy: Disclosures for Emergency Preparedness - A Decision Tool is on HHS' website. OCR staff unveiled the decision tool at the Working Conference on Emergency Management and Individuals with Disabilities and the Elderly in Washington, DC June 28 - 30, 2006. I was a keynote speaker on "Emergency Preparedness Planning: HIPAA Privacy and Special Needs Populations" at the New Orleans National Conference on Best Practices and Technologies for Success Emergency Preparedness, Response and Continuity in December 2006. I addressed the national audience of public and private sector providers and professionals involved in front line planning and provision of services in emergency situations. Keynote address OCR's regional offices are collaborating with public agencies and community organizations to ensure HIPAA Privacy Rule and civil rights protections, as well as the needs of vulnerable populations, such as persons with disabilities or who are limited English proficient, are addressed in emergency planning and response efforts.
Access to Health Care
Through our initiative on Effective Communication in Hospitals, OCR is helping to transform the healthcare system by assisting hospitals in meeting the communication needs of individuals who do not speak English as their primary language (i.e. are limited English proficient) or who are deaf or hard of hearing. OCR is collaborating with the American Hospital Association and its affiliates at the national, regional and state levels to develop and implement tailored technical assistance strategies, training programs, and other resources to ensure patients and their families are better informed and have more choices in hospital settings. Fourteen hospital associations in the following thirteen states have committed to working on this initiative: Arizona, Colorado, Hawaii, Illinois, Kentucky, Missouri, New Jersey, New York, Oklahoma, Pennsylvania, Rhode Island, Utah, and Washington. Additional state hospital associations may be added in the future. News Release - March 5, 2007, and OCR hospital association
Health Information Privacy and Confidentiality
OCR published the final Enforcement Rule of the Health Insurance Portability Accountability Act on February 16, 2006. I was a keynote speaker at the Twelfth National HIPAA Summit on April 10 in Washington, D.C., where I delivered an address on The Office for Civil Rights and Health Care Privacy (DOC), highlighting the Enforcement Rule, along with the full range of OCR's Privacy Rule activities. OCR has launched an enhanced Web site on privacy compliance and enforcement to coincide with the fourth anniversary of the HIPAA Privacy Rule. This site makes it easier for consumers, health care providers, health plans and others to get information about how the Department enforces the Privacy Rule. HHS has obtained significant change in the privacy practices of covered entities through its enforcement program. Corrective actions obtained by HHS from covered entities have resulted in change that is systemic and affects all the individuals they serve. OCR has worked vigorously to achieve the purposes of the Privacy Rule every day since April 14, 2003. These efforts significantly advance the Secretary's goal of increasing health care availability and accessibility. This anniversary is another milestone in our continuing efforts to protect the confidentiality and accessibility of the health information of all Americans.
Eliminating Racial and Ethnic Health Disparities
On February 29, 2008, I delivered a keynote address, entitled �The Provision of Services in 2008 and Beyond: A Civil Rights Perspective,� at the first annual cultural competency conference hosted by the St. Louis Maternal, Child, and Family Health Coalition in St. Louis, Missouri. More than 150 individual and organizations representing a diverse array of disciplines and institutions, including state and local agencies, universities, hospital associations, and public health schools attended the conference. On November 8, 2007, OCR hosted a panel discussion at the U.S. Conference on AIDS in Palm Springs, CA entitled "Know Your Rights – HHS in Action." Our interactive panel provided an overview of federal laws that prohibit discrimination and protect health information privacy rights. The attendees learned: 1) how to spot a violation of federal civil rights or health information privacy rights; 2) what to do about a possible violation; and 3) some proactive steps their organization could take to ensure effective communication with patients or clients with HIV-AIDS who are deaf or have limited English proficiency. On October 25, 2007, I delivered opening remarks at the "2nd Annual Taking the Road to Eliminate Health Disparities: A Holistic Approach" conference in Long Island, NY. I emphasized the importance of eliminating disparities in mental health, and the array of significant efforts by the Department to address them. The annual event was sponsored by the Suffolk County Department of Health Services Office of Minority Health and the Multicultural Advisory Committee of Suffolk County. On October 22, 2007, I delivered remarks at the National Conference on African Americans and Cancer in Wilmington, DE, which was hosted by Minority Healthcare Communications, Inc. I used the platform to emphasize the Department's commitment to eliminate disparities in cancer, and highlight some of the important initiatives currently underway. OCR collaborated with the Department of Justice and other Federal agencies to sponsor the 2007 Federal Interagency Conference on Limited English Proficiency (LEP) held on March 15 & 16, 2007, at the National Institutes of Health. This conference brought together experts in the field of language access including federal, state, and local officials, non-governmental entities, funding organizations, and language access advocates. Participants shared ideas, tools and cross-cutting strategies for ensuring high quality, cost-effective, language access services are provided to LEP customers. I delivered a keynote address at the conference and OCR partnered with the Office of Minority Health to co-sponsor a panel entitled "LEP Strategies at the Local, State, and Federal Levels," which focused on best practices for providing language access at all levels of government. Through its position on the Federal Interagency Working Group on LEP, OCR will continue working with HHS agencies, DOJ and non-governmental entities to identify innovative ways to increase access to quality health services for LEP communities. OCR LEP website I delivered the keynote luncheon address, along with Dr. Garth Graham, the Director of HHS' Office of Minority Health, at the New England Regional Minority Health Conference held at Foxwoods Conference Center on April 2 - 4, 2007. My address focused on Secretary Leavitt's priority of eliminating inequalities in health care, and how OCR accomplishes its mission of improving the health and well-being of all people affected by HHS-funded programs through prevention and elimination of unlawful discrimination. Keynote luncheon address I delivered a keynote address on "Stopping the Spread; Working Together to Ensure Access to Treatment and Care for Persons with HIV/AIDS," at a World AIDS Day outreach event in the Harlem communities of New York City on December 1, 2006. The event was attended by local health educators, city health officials, social workers, and leaders of community and faith-based organizations. OCR's Region II Office collaborated with the Central Harlem HIV Care Network and the East Harlem HIV Care Network on this event. Additional HHS supporters included the Office of the Regional Health Administrator, Office of Minority Health, Office of Women's Health, Office of Family Planning, and the Regional Resource Network Project. OCR co-sponsored the National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health in Washington, D.C. on January 9 - 11, 2006. This Summit attracted more than 1,000 local and state policy makers, health care professionals, and community organizations. OCR staff led panels on key priority areas for OCR, including Title VI of the Civil Rights Act of 1964, our guidance on services for persons with limited English proficiency, and HIV/AIDS issues under the Americans with Disabilities Act and the HIPAA Privacy Rule.
HIV/AIDS
On April 30, 2008, I participated in the Conversations on AIDS.gov. Each month on the http://www.aids.gov site a conversation with a government official about HIV/AIDS is conducted. Below are the links to the podcast or to the transcription of my conversation.
On December 7, 2007, I commemorated World AIDS Day in New York by participating in the Bronx AIDS Services' (BAS) week of educational events. I met with BAS staff to talk about the civil rights and health information privacy rights of their clients with HIV/AIDS. I spent the afternoon at the Bronx Lab School, where I participated in a discussion with a large audience of high school students about the issues they face and the legal rights they have. I take advantage of opportunities to meet with youth whenever I can because they are very much at risk; and my hope is that my message resonates, and that they share it with their peers, parents, and neighbors.
Promoting the Economic Self-Sufficiency and Well-Being of Vulnerable Families
OCR entered into a comprehensive resolution agreement with the Massachusetts Department of Transitional Assistance (DTA) on December 28, 2006. DTA is the agency that administers Massachusetts' Temporary Assistance for Needy Families (TANF) program. The OCR - DTA agreement ensures that people with learning disabilities have equal access to participate in and benefit from DTA's Employment Services Program. The Employment Services Program provides basic skills, education, and support services needed to acquire and retain jobs. Summary of Selected OCR Compliance Reviews and Complaint Investigations
New Freedom Initiative to Break Down Barriers for Persons with Disabilities
On July 1, 2008, HHS OCR entered into a statewide Olmstead settlement agreement with Georgia to expand community alternatives to institutionalization for individuals with disabilities. The settlement agreement ensures that more than 2,500 persons in Georgia with intellectual and developmental disabilities (DD) and mental illness (MI) institutionalized in Georgia's eight public psychiatric hospitals and mental retardation facilities will have the opportunity to live in their communities with appropriate supports tailored to meet their individualized needs. This is the first statewide Olmstead Settlement Agreement covering all public psychiatric hospitals and mental retardation facilities in a state, and effectuates the U.S. Supreme Court decision in Olmstead v. L.C., 527 U.S. 597 (1999), which requires states to provide services in the most integrating setting, i.e. the setting that enables people with disabilities to interact with people without disabilities to the fullest extent possible. Please click here for more information. OCR participated in the National Behavioral Health Conference on Returning Veterans and their Families in Washington, D.C. on March 16 - 18, 2006. OCR staff led a panel on "Help for Veterans and their Families through Civil Rights Laws, the Privacy Rule, and Disability-Related Federal Supports."
Modernizing Medicare and Medicaid
OCR published guidance on March 14, 2006, that clarifies how Medicare Part D and other health plans may disclose beneficiary information to persons, such as staff from the Centers for Medicare and Medicaid Services (CMS), who call the plans on behalf of beneficiaries. In addition, OCR guidance about dually eligible enrollees in the drug prescription benefit was sent on March 10, 2006, to each State Medicaid Director.
Patient Safety and Quality Improvement
OCR will be taking a lead role in fulfilling the Department's mandate to improve patient safety through its enforcement of the privilege and confidentiality protections of the Patient Safety and Quality Improvement Act of 2005 (P.L. 109-41), as delegated to OCR by Secretary Leavitt on April 3, 2006. As part of its responsibility, OCR will develop regulations regarding enforcement and administer the enforcement program through conducting investigations and making determinations of compliance, imposing civil monetary penalties when appropriate, interpreting standards for enforcement, and providing technical assistance and public information regarding the enforcement program. OCR will be working closely with the Agency for Healthcare Research and Quality (AHRQ) who will certify organizations seeking designation as Patient Safety Organizations. For more information, see OCR's new Patient Safety page.
Miscellaneous
On January 15, 2008, I delivered a keynote address for HHS' MLK Day Celebration. My speech, entitled "Live the Dream," addressed Dr. Martin Luther King Jr.'s vision and dream for America. It also emphasized the importance of community service, and the need to approach Monday, January 21, 2008, (National MLK Day) as "A Day On, Not a Day Off" to achieve this purpose. The annual event was hosted by HHS' Office of Diversity Management and Equal Employment Opportunity. Keynote Address
These are but a few examples of the many ways in which OCR plays an integral role in implementing the Department's and the Administration's priorities. I look forward to highlighting our continuing efforts in these areas over the coming months.
Winston Wilkinson
Director, Office for Civil Rights
Last revised: July 3, 2008
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