Ensuring accessibility under the Affordable Care Act

October 16, 2017  //  FOUND IN: Updates & Resources

Michigan Medicine prides itself as being an open and welcoming environment — placing an emphasis on diversity, equity and inclusion across the academic medical center.

As part of those efforts, the organization must adhere to the Affordable Care Act’s (ACA) provision called Section 1557 — the non-discrimination portion of the law.

Under Section 1557, a covered entity may not discriminate on the basis of race, color, national origin, sex, age or disability in certain health programs or activities. The rule defines sex broadly, which includes: pregnancy, gender identity, gender expression and sex stereotypes. 

For example, the ACA makes it illegal to charge women more for health insurance than men — previously a common practice. Additionally, it is required that covered entities treat all patients consistent with their current gender identity. This includes patients having access to rooms or restrooms corresponding to their current gender identity.

In the continuing effort to meet the requirements, changes with the planned Oct. 21 MiChart upgrade will be implemented that will serve as a cue to providers and staff that a patient has specific preferences around how they wish to be treated with respect to their gender identity.

A tip sheet can be found by clicking here

Education regarding these changes and additional resources will be provided as the upgrade is rolled out. 

The MiChart changes are only a small component of the civil rights work underway to meet the requirements. 

Section 1557 also requires ensuring access to those with limited proficiency in English. To ensure access, the organization provides patients with free and timely language services, including both oral interpretation and written translations.

There are also notices that contain short statements in 18 languages posted around clinical areas to provide individuals information on who to contact regarding a concern and their ability to request free language services. Furthermore, certain critical documents — such as consent forms — are required to be translated while non-critical documents require the non-discrimination notice and language services statements be added. 

Section 1557 also incorporates protections for patients with disabilities. When a patient asks for an accommodation, the patient and providers must have a conversation in order to determine what is required and how to achieve that accommodation. Some auxiliary aids might include an American Sign Language interpreter, accessible exam tables or accessible scales. 

A non-discrimination policy at Michigan Medicine is nearing completion and will set the standard for ensuring that the organization provides the most accessible care possible to all patients.

Trainings will also be provided for staff to help identify situations and provide best practices. 

Michigan Medicine will also conduct an investigation when any concern is reported. If there is a concern that Section 1557 was violated or if you have any questions on how to follow the rules, contact the Patient Civil Rights Coordinator at 734-936-6439 or by emailing MichMed_patients_rights@med.umich.edu.

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