U.S. Department of Health and Human Services
Office for Civil Rights
Washington, D.C. 20201
COMMUNITY SERVICE ASSURANCE
Under the Hill-Burton Act
THE OFFICE FOR CIVIL RIGHTS
The Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (DHHS) enforces Federal laws that prohibit discrimination by health care and human service providers that receive funds from DHHS. This Fact Sheet addresses your rights and recipients' responsibilities under the Community Service Assurance provisions of the Hill-Burton Act, which are formally known as Titles VI and XVI of the Public Health Service (PHS) Act.
WHAT IS HILL-BURTON?
The Hill-Burton Act authorizes assistance to public and other non-profit medical facilities such as acute care general hospitals, special hospitals, nursing homes, public health centers, and rehabilitation facilities.
The Community Service Assurance under Title VI of the PHS Act requires recipients (entities that received Hill-Burton funds) to make services provided by the facility available to persons residing in the facility's service area without discrimination on the basis of race, color, national origin, creed, or any other ground unrelated to the individual's need for the service or the availability of the needed service in the facility. In the case of facilities funded under Title XVI of the PHS Act, the requirements apply also to persons employed in the facility's service area.
Except for emergency services, a facility may deny services to persons unable to pay for them unless those persons are required to be provided free care under the uncompensated services provisions of the Hill-Burton Act. There are several basic requirements that every Hill-Burton hospital or other Hill-Burton facility must comply with to fulfill the community service obligation:
A person residing in the Hill-Burton facility's service area has the right to medical treat- ment at the facility without regard to race, color, national origin or creed.
A Hill-Burton facility may not deny emergency services to any person residing in the facility's service area on the qrounds that the person is unable to pay for those services.
Hill-Burton facilities must participate in the Medicare and Medicaid programs unless the facilities are ineliqible to participate in these Federal reimbursement programs.
Hill-Burton facilities must also make arrangements for reimbursement for services with principal State and local third-party payors that provide reimbursement that is not less than the actual cost of the services.
A Hill-Burton facility may not adopt patient admissions policies that have the effect of excluding persons on grounds of race, color, national origin, creed or any other ground unrelated to the patient's need for the service or the availability of the needed service.
A Hill-Burton facility must post notices informing the public of its community service obligations in English and Spanish. If 10% or more of the households in the service area usually speak a language other than English or Spanish, the facility must translate the notice into that language and post it.
HOW TO FILE A COMPLAINT WITH OCR
Aug. 1990