Reporting Violations

 
 

Your Rights: All birthing people have a right to receive healthcare without mistreatment and discrimination. Sometimes people don’t think of what they experienced as discrimination, but we have come to understand that much of the mistreatment that happens during the perinatal period has its roots in discrimination. Plus, discrimination is meaningful in U.S. law.

We, and many other advocates, are working to:

  • Help people understand how discrimination shows up in perinatal care and 

  • Help people file discrimination complaints to the Office for Civil Rights (OCR) when discrimination happens in the perinatal period. 

People often experience discrimination at the intersection of multiple identities which make it hard to fit neatly into the categories of current legal protections, which prohibit discrimination on the basis of race, sex, age, disability, color, or national origin. . This page is about helping you make a complaint to the Office for Civil Rights (OCR) that best articulates the way discrimination was a factor in the harm you experienced so that the OCR can hold people accountable for that harm.

A recent article in the LA Times describes a federal civil rights investigation in this context - we include a copy of the article and explain it in this blog post.

Learn more from Birth Rights: To learn more, beyond the discrimination and OCR complaints discussed here, check out this resource for everyday people to defend human rights during labor and birth in English and Spanish.

 

The Process:

Note: Each of the 5 steps in the process are explained deeper below. To learn more use the ╲╱ button to expand each step.

  • How do I know if what happened was discrimination?

    Sometimes, even if it feels super clear that something was discriminatory, it is hard to articulate how and why it was discriminatory. Click on any of the following links to learn more about how discrimination on the basis of race, color, national origin, sex, age, and disability often show up in the perinatal period. These explanations are not all-encompassing but are a starting point for connecting your story to broader trends of discrimination that we know exist throughout the perinatal period. Your story may include discrimination on the basis of several categories.

    For a deep dive on this, you can also read our memo on the subject here.

    What is OCR?

    The Department of Health and Human Services (HHS)’ Office for Civil Rights (OCR) is responsible for enforcing our nation’s civil rights laws. Section 42 USC 18116 (Section 1557) and its implementing regulation provide that an individual shall not be subjected to discrimination on the basis of race, color, national origin, sex, age, or disability while participating in any health program or activity that is receiving federal funds. OCR enforces these protections in the context of services and activities that receive HHS funding.

    Experiences of discrimination can be reported for free to OCR through the online complaint portal.

  • What is an OCR complaint?

    Experiences of discrimination can be reported for free to OCR through the online complaint portal. This is not the same as a legal complaint, but rather a short written account that explains both what happened, and why you believe the treatment was discriminatory on the basis of a/several protected characteristic(s). These include race, color and national origin; sex; disability; and age.

    Who can file an OCR complaint?

    The person who was directly impacted, or someone who has gotten their consent to file on their behalf. You do not need to be, or have, a lawyer to file an OCR complaint.

    Any acts of discrimination that are prohibited under Section 1557 may be investigated and addressed by OCR so long as they occur in a health program or activity that receives federal funding from the Department of Health and Human Services (HHS), or that is administered by HHS, or any entity established under Title I of the Affordable Care Act. This includes the Maternal Child Health Block Grant, which helps provide care for 92% of all pregnant people and 98% percent of infants. Find out if your health facility gets federal funding here.

    When can I file an OCR complaint?

    Although OCR does ask that complaints be filed within 180 days of the events that you are reporting, there are exceptions for people who have “good cause” for needing more time than that. We believe that being postpartum is a valid reason why someone might need more time to file a complaint.

    What happens after I file?

    At a minimum, your complaint will be read by an OCR official and you will get a response. OCR also has the power to investigate what happened, issue recommendations to the healthcare provider or facility for how to address the situation and/or prevent it from happening again, and they can follow up to make sure that their recommendations are being followed. If the facility or institution does not comply, OCR has the ultimate authority to take away their federal funding.

    What are some next steps?

    Elephant Circle is happy to help you think about your options after you experience discrimination during the perinatal period. If you would like to speak with someone from our legal team, please feel free to contact us at (720) 335-5033 or email our Director of Legal Services, Anna Reed, at anna@elephantcircle.org.

  • You can file a complaint through OCR’s online portal or by mail, fax, or e-mail. OCR provides free language assistance services and services are accessible to persons with disabilities.

    You will need to:

    • Name the health care or social service provider that discriminated against you,

    • Describe what happened,

    • Explain why you believe what happened was discrimination (were you treated differently than other people on the basis of race, color, national origin, sex, age and/or disability ? Does the facility or institution have a practice or policy that applies to everyone, but that has a discriminatory impact on a protected group?).

    • File the complaint through the portal within 180 days of when the act or omission complained of occurred, or if that time has already passed, explain why you had “good cause” to need more time.

    Here are a few tips for writing a complaint.

    • State what happened: Keep it simple, but do give context: Facility name, provider name, and if you have data about outcomes, do include it.

    • Be as specific as possible: It is helpful to state which Section 1557 non-discrimination protection your complaint falls under: Title VI, Title IX, the Americans with Disabilities Act, or The Age Discrimination Act.

    • Use buzzwords: “discriminatory treatment” or “disparate impact”!) whether this is a case of discriminatory treatment (individual was treated differently on the basis of a protected characteristic) or disparate impact (the institution or facility has a facially neutral policy or practice that has an impermissible, discriminatory effect on an individual or group).

    We are also happy to help you write your complaint and we can file it for you. Just fill out the form below.

  • You can submit your complaint here.

    Let us know if you would like us to submit your complaint on your behalf, or contact us below for help in submitting your complaint

  • Filing a complaint might be part of your healing journey, but it may also bring up hard feelings.

    Make a plan to take care of yourself throughout the process. Consider reading the section on mental health support after experiencing violence or mistreatment in the Birth Rights resource, available in English and Spanish

 

Filing a report to OCR is just one way you can address a violation experienced during the perinatal period.

For other ideas, check out this graphic from the Birth Rights resources and read that section in the guide, in English or Spanish.

 

How Elephant Circle can support:

Elephant Circle can assist you with filing an OCR complaint. Please fill out this form to set up a meeting if you would like to speak with a member of our team about navigating the OCR Process and identifying next steps.