Spotlight: Puerto Rico - Prioritizing Building Coalitions and Safeguarding Civil Rights and Privacy Protections for the 3.2M Residents in Puerto Rico

Advancing equity and removing barriers in access to health care for every community across the nation is a key priority of the Biden-Harris Administration. As Hispanic Heritage Month comes to an end, I am proud of the work that we have done to advance equity and address disparities in health care to help ensure that all people can access health care, free from discrimination. That’s why I am proud that this past June, the Office for Civil Rights (OCR) traveled to Puerto Rico to meet with the public and engage with our government partners.

As a result of an investigation by OCR, during our visit in June we announced numerous corrective actions that the Puerto Rico Department of the Family committed to take to ensure that parents who are deaf or hard of hearing receive appropriate auxiliary aids and services, including sign language interpreters. My team and I met with the Department of the Family Secretary, Cieni Rodriguez Troche, in San Juan and discussed actions taken by the Department of the Family to ensure their compliance with federal civil rights laws. We also discussed the measures the Department of the Family has taken to strengthen existing communication policies and procedures and areas for future work and collaboration. Puerto Rico news media reported that OCR required the Family Department to improve services for deaf people.

Photo Caption: OCR Director Melanie Fontes Rainer, Chief of Staff Dennis Gonzalez, Deputy Director of Enforcement Luis Perez, Regional Manager Linda Colon, Supervisor Tony Zayas, and Puerto Rico Family Secretary Cieni Rodriguez Troche in Puerto Rico.

I also met with Puerto Rico’s Patient Advocate, the Disability Ombudsman, the Governor’s Liaison for the Deaf Community, and the Director of the Puerto Rico Commission on Civil Rights. The discussion focused on opportunities to ensure that deaf and hard of hearing people in Puerto Rico can access health and human services free from discrimination, by addressing disability-based disparities and maintaining an ongoing commitment to compliance with federal civil rights laws.

During our trip, I met with advocates to discuss reproductive health issues and challenges in Puerto Rico, as well as advancements in our new HIPAA Privacy Rule to Support Reproductive Privacy. My team and I also explored outreach and training opportunities on civil rights with the Chancellor and Deans of the University of Puerto Rico, Rio Piedras campus to ensure students can access health care.

Our team joined LGBTQI+ advocates at a community roundtable, coinciding with Pride Month, to learn about the systemic discrimination and health disparities the community faces. We discussed OCR’s work to advance nondiscrimination and help advance equity for the LGBTQI+ community in Puerto Rico.

Photo Caption: OCR Director Melanie Fontes Rainer and Deputy Director of Enforcement Luis Perez with WAVES Ahead, an organization that provides advocacy and services for the LGBTQI+ older adults in Puerto Rico.

Photo Caption: OCR Director Melanie Fontes Rainer and Deputy Director of Enforcement Luis Perez joined LGBTQI+ advocates in San Juan, Puerto Rico, at a roundtable discussion alongside Puerto Rico Senators Ana Irma Rivera Lassén and Héctor Santiago.

OCR’s commitment to Puerto Rico did not end with our June visit. In September 2024, OCR issued a Letter of Findings against San Juan Capestrano Hospital, a psychiatric hospital in Puerto Rico that offers treatment for mental health and substance use disorders. OCR concluded that the hospital’s failure to provide a sign language interpreter requested by a deaf patient during a mental health evaluation violated Section 504 of the Rehabilitation Act and Section 1557 of the Affordable Care Act. Effective communication during mental health evaluations is critical to ensure appropriate care and treatment for every patient. Patients who are deaf or hard-of-hearing must receive communication that is as effective as communication received by patients without auditory disabilities. The news media in Puerto Rico reported on OCR’s determination that San Juan Capestrano Hospital violated a deaf patient's rights.

OCR will continue to rigorously enforce the laws and regulations in strengthening access to health services for individuals with disabilities to ensure equity and nondiscrimination in health care and human services for every person in Puerto Rico – and across every corner of our nation.

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.