Missouri Department of Social Services (MDSS)

Division of Medical Services

Civil Rights Contract Compliance

General Information


In this section:

·       What is Civil Rights Contract Compliance?

·       Steps Providers Must Take to be in Compliance

·       Conducting a Civil Rights Contract Compliance Self Assessment Form

·       Desk Reviews and Site Visits for Civil Rights Compliance

·       Memorandums and Updates Related to Civil Rights Issues

·       Forms and Samples

·       Resources (under construction)

*    *    *    *    *

What is Civil Rights Contract Compliance?

The MDSS/Office for Civil Rights enforces several Federal civil rights laws that prohibit discrimination in programs or activities that receive federal financial assistance through the MDSS/Division of Medical Services. Discrimination on the basis of race, color, and national origin is prohibited by Title VI of the Civil Rights Act of 1964; sex discrimination is prohibited by Title IX of the Education Amendments of 1972; discrimination on the basis of disability is prohibited by Section 504 of the Rehabilitation Act of 1973; and age discrimination is prohibited by the Age Discrimination Act of 1975.

 

CIVIL RIGHTS LAWS PERTINENT TO VENDOR COMPLIANCE

¨       Civil Rights Act of 1964, as Amended

Title VI:

No person in the United States shall, on the grounds of race, color or national origin be excluded from participation in, be denied benefits of, or otherwise subjected to discrimination under any program or activity receiving federal assistance.  The Title VI regulation prohibits retaliation for filing an unlawful discrimination complaint or for advocacy for a right protected by Title VI.

Requirements –

1)       Designation of a ‘Civil Rights Coordinator’;

2)       Public notification of a non-discrimination policy;

3)       Civil Rights training for employees;

4)       Designating a particular complaint procedure for clients wanting to file a complaint of discrimination; and

5)       Collection of racial/ethnic data as required

 

Title VII:

Prohibits discrimination on the basis of race, color, national origin, sex, or religion in all employment activities (i.e., interviews, promotions, disciplinary actions, terminations, etc.).

 

Title IX

Prohibits discrimination against any person on the basis of sex, in any educational program or activity receiving federal financial assistance, in accordance with Title IX of the Education Amendments of 1973.  (P.L. 92-318)

 

¨       Age Discrimination in Employment Act of 1967

Prohibits discrimination on the basis of age (40 and above) in all employment activities.

 

¨       Rehabilitation Act of 1973

Section 503 – Relative to Employment

No otherwise qualified disabled individual in the United States, as defined (elsewhere in the Act), shall, solely by reason of disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination in employment, under any program or activity receiving federal financial assistance.  (P.L. 93-113)

Requirement:

Reasonable accommodation must be made to the known disabling condition of an employee or an applicant for employment unless it creates an undue hardship on the employer.

 

Section 504 – Relative to the Provision of Services

No qualified disabled person shall, on the basis of disability be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity which receives or benefits from federal financial assistance.  (45CFR part 84.4[a])

Requirements:

1)       Facility must be accessible to the disabled.

2)       Program, benefits or activity must be accessible to the disabled.

 

¨       Age Discrimination Act of 1975, as Amended

No person in the United States shall, on the basis of age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving financial assistance.  (45 CFR parts 91.4 and 91.11)

 

¨       Omnibus Budget Reconciliation Act of 1981

Title IX, Health Services and Facilities

Section 190B, (2)

No person shall, on the grounds of sex or religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded, in whole or in part, with funds made available under this part.

 

¨       The Americans with Disabilities Act of 1990

42 U.S.C. 12101 et seq (ADA)

The purpose of the Act is to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities and to bring persons with disabilities into the economic and social mainstream of American life; to provide enforceable standards addressing discrimination against individuals with disabilities and to ensure that the federal government plays a central role in enforcing these standards on behalf of individuals with disabilities.

 

¨       Civil Rights Act of 1991

This Act provides appropriate remedies for intentional discrimination and unlawful harassment in the workplace.  It also overturned recent decisions of the Supreme Court by expanding the scope of relevant Civil Rights Statutes in order to provide adequate protection to victims of discrimination.

 

 

DEFINITIONS

APPLICANT — One who submits an application or request to receive services, benefits or participates in any program or activity funded by or in part with federal monies; i.e., Medicaid.

 

CFR — Code of Federal Regulations

 

DISABLED VETERAN – A veteran who is entitled to compensation (or who but for the receipt of military or retirement would be entitled to compensation) for a service-connected disability under laws administered by the Veteran’s Administration.

 

INDIVIDUALS WITH DISABILITIES – Any person who has a physical or mental impairment that substantially limits one or more of the person’s major life activities, or who has a record of such impairment, or who is regarded as having such impairment.

 

MINORITY GROUP – Includes all defined, protected classes based on race and gender.  Specifically, African-American, Hispanic, Asian/Pacific Islander, Native American/Alaskan Native and female.

 

VENDOR – Any public or private agency, institution, organization, individual or other entity to whom federal financial assistance is extended for any program or delivery of services (i.e., nursing homes, child care providers, physicians, therapists, etc.).

 

VIETNAM ERA VETERAN – Any veteran who served on active duty for a period of more than 180 days, any part of which occurred during the Vietnam Era (August 5, 1964 through May 7, 1975) and who was discharged or released from service with other than a dishonorable discharge inclusive of those discharged or released from active duty for a service-connected disability.

 

Steps Providers Must Take to be in Compliance

Requirements –

  1. Designate a ‘Civil Rights Coordinator’ or contact person for your facility.
  2. Public notification of a non-discrimination policy.  (Click here for a sample policy.)
  3. Display a “Non-Discrimination in the provision of services” poster in a location easily accessible and visible to clients.  (Click here for a sample poster).
  4. Conduct civil rights training for employees.
  5. Develop a particular complaint procedure for clients wanting to file a complaint of discrimination (Click here for a sample complaint/grievance procedure).
  6. Collect and maintain information regarding racial/ethnic makeup of workforce (if over 50 employees) and information on client or service complaints.

 

Conducting a Civil Rights Contract Compliance Self Assessment Form

It is recommended that each provider complete a Civil Rights Contract Compliance Self Assessment Form annually.  (Instructions for completing the Self Assessment Form are available on this website.)  The Civil Rights Contract Compliance Self Assessment Form is designed to assist providers in identifying those areas which the provider facility must improve in order to be found in compliance.  The form identifies several key areas that would be part of any facility desk review or site visit conducted by the MDSS Office for Civil Rights.  Completing this form will help providers understand civil rights compliance requirements.  Providers should maintain a copy of the completed form in their records.

 

Desk Reviews and Site Visits for Civil Rights Compliance

Purpose of Desk Reviews

Provider desk reviews offer both educational and technical assistance to the provider and office staff. Desk reviews provide the opportunity to conduct a preliminary review of the provider’s facility, policies, and procedures and ensure the provider understands the applicable civil rights laws and MDSS standards, policies and procedures.  A desk review generally consists of a request for information which can be submitted by the provider by mail or facsimile.

 

Purpose of Site Visits

Provider site visits offer both educational and technical assistance to the provider and office staff.  In addition, site visits provide MDSS with the opportunity to evaluate the practices, procedures, and level of service offered by our contract providers.  Site visits provide the opportunity to:

  • Ensure there is effective interaction between the contractor and the provider;
  • Increase provider communication;
  • Ensure compliance by the provider with the contractors and MDSS standards, policies and procedures;
  • Evaluate the need for accommodations; and
  • Review unlawful discrimination complaints and resolutions to ensure compliance with applicable civil rights laws.

 

Who Conducts Desk Reviews and Site Visits

Desk reviews and site visits may be conducted by the Department of Health and Human Services and/or the Department of Social Services’ Office for Civil Rights staff, and as required, staff from other units within the Department.  Prior to a desk review or site visit by the MDSS, Office for Civil Rights, the Office for Civil Rights will generally contact the provider to arrange the date and scope of the review or site visit.  The MDSS, Office for Civil Rights review or site visit may include a review of:

  • A provider's performance in the area of civil rights;
  • Medicaid recipient concerns or complaints based on unlawful discrimination about the provider; 
  • Information from other staff related to a provider's operations and performance as relevant to civil rights issues; and
  • Record keeping related to unlawful discrimination complaint.

Notifying a Provider About a Site Visit

Except in cases where advance notice is not possible or advance notice may render the visit less useful, site visits are scheduled with the provider prior to the visit. A letter may be sent to the provider prior to the site visit, listing the areas that will be evaluated and discussed. The frequency of a site visit will depend upon:

  • The provider type;
  • Recepient concerns or complaints about the provider;
  • The provider's performance; and
  • The provider's compliance with the MDSS standards, policies and procedures related to civil rights.

 

Results of a Desk Review or Site Visit

Issues and concerns related to civil rights matters that are brought up during the desk review or site visit are followed up promptly either verbally or in writing. A follow-up letter may be sent to the provider after the review or visit that will address outstanding issues, clarify any discussion items and notify the provider of any changes that must be made for the provider to be found in compliance. Results from the MDSS, Office for Civil rights site visit and related correspondence may be placed in the provider file.  Providers that are repeatedly found to be non-compliant may be exited from the Missouri Medicaid Program.

 

Memorandums and Updates Related to Civil Rights Issues

Compliance with Civil Rights Laws and Regulations (dated March 15, 2004 ).

 

Forms and Samples

Non-Discrimination Policy Statement

Sample Complaint/Grievance Procedure

Non-Discrimination in the Provision of Services Poster

Self Assessment Form

Instructions for Completing a Self Assessment Form

 

Links to MCHR Posters and Information

Links to HHS Posters and Information

 

Resources

 

ü       Assistance with language barriers can usually be found through your nearest high school, college or university. 

 

ü       Governor’s Committee on Employment of People with Disabilities

(573) 751-2600 or (800) 877-8249 

 

ü       Missouri School for the Deaf

(573) 592-4000

 

ü       Wolfner Library for the Blind and Physically Handicapped

(800) 392-2614

 

ü       Relay Missouri (enables telephone communication between the hearing and those who are hearing impaired or deaf)

Voice:                     (800) 735-8466

Teletype:               (800) 735-2966

 

ü       JAN (Free consulting service designed to increase the employability of people with disabilities.)

 

ü       ADA/IT(Resource for information on the Americans with Disabilities Act and Accessible Information Technology)

 

ü       Language Line {Click here for link to languageline.com}

 

ü       University Outreach and Extension {Click here for link to http://www.communityconnection.org/ccver2/index.jsp}