HHS Office for Civil Rights Settles with Delaware to Enforce Federal Disability Rights Laws

This action marks OCR’s second Olmstead agreement in 2024 resolving a complaint involving an individual’s unnecessary institutional confinement

Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced a resolution agreement with the State of Delaware Department of Health and Social Services to enforce Federal disability rights laws. The agreement resolves a complaint alleging that an individual with a disability had been confined in a nursing home for four years following an acute hospitalization, because Delaware did not provide the individual with necessary medical equipment, home modifications, and support services to allow the individual to live at home. OCR’s action was based on Federal civil rights laws that prohibit discrimination on the basis of a person’s disability: Section 504 of the Rehabilitation Act of 1973 (Section 504), Section 1557 of the Affordable Care Act (Section 1557), and Title II of the Americans with Disabilities Act, and require that services are provided in the most integrated setting appropriate to the needs of a person with a disability — including within their own home and community.

“Nursing home placement should never be the automatic option after a person with disabilities is discharged from a hospital. Alternatives, including returning the individual to their home, must first be considered. States must ensure they support community-based placement and independent living to the fullest extent of the law, so people with disabilities are not denied the right to live in their homes and communities,” said OCR Director Melanie Fontes Rainer. “Twenty-five years after the Supreme Court made these legal protections clear in Olmstead, OCR’s unwavering commitment to enforce these legal protections for individuals with disabilities is equally clear.”

OCR initiated the Expedited Complaint Resolution process to resolve this matter in its investigation. Delaware agreed to participate in the process to work with OCR and the individual to take the needed steps to support their move home. Specific corrective actions taken by Delaware include:

• Ensuring appropriate assessments to identify the individual’s needs.
• Providing the specialty equipment, home modifications, and personal supports needed to return to her home.
• Facilitating the individual’s discharge from the nursing home and transferring her to her modified family home on October 15, 2024.

Delaware also agreed to continue to provide needed support to the individual in their home, including:

• Ensuring that a person-centered plan addresses the individual’s personal care and support needs.
• Regularly reviewing the individual’s services to ensure they are adequate for the individual to continue to live at home.
• Designating officials in Delaware to resolve any potential issues involving the individual’s support services.
• Reporting to OCR on a monthly basis, during a nine-month monitoring period.

A copy of the Memorialization of Corrective Actions may be found here: https://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/agreements/mca-dmma/index.html

This action is just the latest in a series of efforts OCR has made to advance and protect the civil rights of people with disabilities. This includes the announcement of the Section 504 of the Rehabilitation Act of 1973 final rule and the Section 1557 of the Affordable Care Act final rule.

OCR is committed to enforcing the rights of individuals with disabilities and their right to live in the most integrated setting.

If you believe that you or someone else has been discriminated against because of your race, color, national origin, disability, age, sex, or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with the HHS Office for Civil Rights at: https://www.hhs.gov/ocr/complaints/index.html.

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