On Nov. 13, 2023, ADvancing States submitted comments to the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) on the Discrimination on the Basis of Disability in Health and Human Service Programs or Activities (Section 504) NPRM. The Section 504 NPRM strengthens protections for all people with disabilities, including older adults who may not think of themselves as people with disabilities. The proposed rule also clarifies obligations in areas not explicitly addressed in the current rule, including the obligation to provide services in the most integrated setting appropriate.
ADvancing States strongly supports the HHS Office of Civil Rights in issuing this Notice of Proposed Rulemaking (NPRM). As the first substantive update to Section 504 of the Rehabilitation Act, the NPRM strengthens the law with necessary updates and underscores the critical importance of non-discrimination in the administration of the many programs and activities within the purview of HHS – including state and territory Medicaid, Disability, and Aging programs that receive federal funding through the Administration for Community Living (ACL) and the Centers for Medicare & Medicaid Services (CMS). In the comments we note that this broad-sweeping regulation could result in unintended impacts, particularly when applied to the complex array of OAA funded service delivery systems. Further guidance is needed where there are conflicts of laws or regulation, such as an entity being in compliance with CMS regulations while out of compliance with 504 non-discrimination requirements. To realize the intent of non-discrimination, we strongly support more coordination between HHS, and CMS and ACL in the implementation of the final rule.