-  Civil Rights for Providers of Health Care and Human Services      -  Provider Obligations 
  -  Civil Rights Clearance for Medicare Provider Applicants 
  -  Compliance & Enforcement        -  Resolution Agreements 
    -  Enforcement Examples 
  -  Training 
  -  Civil Rights Laws, Regulations & Guidance        -  Regulatory Initiatives 
    -  Regulations Enforced by OCR 
  -  Civil Rights and COVID 

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# Voluntary Resolution Agreement Between the U.S. Department of Health and Human Services Office for Civil Rights (OCR) and the Pennsylvania Department of Human Services

**OCR Transaction Number: 20-359940**

**I.     Introduction**

The parties to this Voluntary Resolution Agreement (the “Agreement”) are the United States Department of Health and Human Services, Office for Civil Rights (“OCR”), and the Pennsylvania Department of Human Services (“DHS”).  DHS is comprised of seven program offices that administer services that provide care and support to Pennsylvania’s most vulnerable individuals and families.  DHS’s Office of Children, Youth and Families (OCYF) serves children and families by overseeing adoption and foster care services and works with counties on child abuse prevention and juvenile justice issues.  OCYF, through its Bureau of Children and Family Services BCFS, is responsible for licensing and oversight of county children and youth agencies (CYS agencies), including the Northumberland County Children and Youth Services (“Northumberland CYS”), which ensure the safety of vulnerable children in Pennsylvania and administer child protective services.  BCFS’s oversight is administered through its four regional offices responsible for licensing of the 67 county agencies that administer services in Pennsylvania.  BCFS’s mission is to provide an accessible, integrated, comprehensive, quality service system for Pennsylvania’s children and families, to help them achieve maximum potential and improve their quality of life.  This Agreement resolves a complaint filed by an individual with, opioid use disorder (OUD), who receives medication-assisted treatment (MAT).

The Complainant alleged that Northumberland CYS discouraged her from applying to be a foster parent because of Complainant’s use of medically prescribed methadone.  OCR investigated potential violations of Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, and its implementing regulation, 45 C.F.R. Part 84 (Section 504), and Title II of the Americans with Disabilities Act, 42 U.S.C. 12101 *et seq.*, and its implementing regulation, 28 C.F.R. Part 35 (Title II or ADA).  OCR’s investigation also identified systemic deficiencies in DHS ’s oversight of CYS agencies’ Section 504 and Title II policies, practices, and procedures to prevent discrimination against individuals with disabilities in Pennsylvania’s child welfare system.

Under Section 504 and Title II, child welfare agencies are required to ensure that individuals with disabilities are afforded an equal opportunity to participate in and benefit from all child welfare programs, activities, and services, including those services aimed at helping children achieve permanency with relatives.  **See** 29 U.S.C. § 794; 45 C.F.R. Part 84, and 42 U.S.C. §§ 12131-12134; 28 C.F.R. Part 35.  This may require, among other things, reasonable modifications to a CYS agency’s services and programs and the provision of auxiliary aids and services.  45 C.F.R. § 84.4(a), (b)(vii); 42 U.S.C. § 12132; 28 C.F.R. § 35.130(b)(3), (b)(7).  CYS agencies may not utilize criteria or methods of administration that have the effect of discriminating on the basis of disability.  45 C.F.R. § 84.4(b)(4); **see also** 42 U.S.C. § 12132; 28 C.F.R. § 35.130(b)(3); 28 C.F.R. pt. 35, App. B (discussing 28 C.F.R. § 35.130(b)(3)).
                          - Parties to the Agreement:                               - United States Department of Health and Human Services, Office for Civil Rights; and
                            - Pennsylvania Department of Human Services
                          - **Jurisdiction****:**DHS receives HHS funding including Foster Care Title IV-E, and Social Services Block Grant from the HHS Administration of Children and Families. As the recipient of Federal financial assistance, DHS and its program offices are obligated to comply with Federal civil rights laws and is subject to Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. § 794, and its implementing regulations, 45 C.F.R. Part 84.  Section 504 prohibits discrimination on the basis of disability in all operations of any program or activity receiving Federal financial assistance.	As a public entity providing state government services, DHS is obligated to comply with Title II of the Americans with Disabilities Act and its implementing regulation, 28 C.F.R. Part 35.  Title II prohibits discrimination on the basis of disability by state and local government agencies, including denying opportunities to benefit from services and failing to reasonably modify policies and procedures.
                          - **Purpose of the Agreement**: To resolve these matters without further burden or expense of investigation or litigation, DHS agrees to the terms stipulated in this Agreement and affirms that it will comply with all provisions of Section 504 and Title II of the ADA.  DHS’s willingness to enter into this Agreement with OCR in no way constitutes an admission of liability and demonstrates DHS’s ongoing efforts to accommodate individuals with disabilities.  The promises, obligations, or other terms and conditions set forth in this Agreement constitute the exchange of valuable consideration between DHS and OCR.  The actions described in this Agreement fully address the issues described in the complaint.  Nothing in this agreement shall be construed to require DHS to take actions that are not in the best interest of children.

**II.     Definitions**

For purposes of this Agreement, the terms listed below shall have the following meaning:
                          - “Child Protective Services” means the services provided by the program offices of DHS responsible for adoption, foster care, and child protective services, including the services as provided under Title 23 of the Pennsylvania Child Protective Services Law.
                          -  “Participant” means any individual who meets the qualification requirements to be eligible for Child Protective Services’ services, programs, or activities, including legal guardianship, foster care, and adoption programs.
                          - “Contractor” means any entity through which CYS agencies provide direct services to Participants of Child Protective Services programs, and adoption and foster care under a contractual agreement with the CYS agency or reimbursement, which includes monies that DHS has allocated to BCFS as Federal financial assistance from HHS. 
                          - “Disability” is synonymous with the definition of “disability” contained in Section 504 and Title II of the ADA.
                          - “Medication Assisted Treatment” or “MAT,” refers to the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to treatment to treat an opioid use disorder or other substance use disorders.
                          - “Medications for Opioid Use Disorder” or “MOUD” involves a combination of a medications that targets the brain, and psychosocial interventions (e.g., counseling, skills development) aimed at improving treatment outcomes. 
                          - “Reasonable Modification” and “Reasonable Accommodation” means changes or adjustments to DHS programs or contracted child welfare service providers’ policies, practices, or procedures to avoid discrimination on the basis of disability and to afford individuals with disabilities an equal opportunity to participate in, and benefit from, services provided under a covered program or activity.
                          - “Section 504/ADA Coordinator” means the individual or individuals designated to be responsible for coordination of DHS’s efforts to comply with and carry out its Section 504 and ADA responsibilities in its child welfare programs.
                          - “Section 504/ADA Grievance Procedure” means DHS’s process for addressing complaints of disability discrimination from Participants, advocates, attorneys, and other interested parties that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints.
                          - “DHS” and/or “DHS staff” means BCFS employees under DHS’s supervision or control, including but not limited to social workers, child protective workers, foster care and adoption workers, supervisors, volunteers, and administrative staff members.

**III.     General Provisions**
                          - **Programs Covered by the Agreement**:  This Agreement covers all Child Protective Services programs, services and activities that DHS administers, oversees, or provides directly or through the CYS agencies or through sub-recipients or contractors, throughout the Term of this Agreement.
                          - **Suspension of Administrative Actions**:  Subject to DHS’s continued performance of the stated obligations and required actions contained in this Agreement and in conformity with Section III-D, Failure to Comply with the Agreement, OCR shall suspend administrative action on OCR Transaction Number:  20-359940.
                          - **Effective Date and Term of the Agreement:**This Agreement shall become effective on the date it is signed by all parties (the “Effective Date”) and will remain in effect for two (2) years after the Effective Date, at which point if OCR determines that DHS has substantially complied with this Agreement, then OCR’s review and monitoring of this Agreement shall terminate.  Notwithstanding the Term of this Agreement, DHS acknowledges that it will comply with Section 504, Title II of the ADA, and other applicable Federal nondiscrimination statutes and their implementing regulations, for so long as it continues to receive Federal financial assistance and continues to operate as a public entity providing state government services.
                          - **Failure to Comply with the Agreement:**If OCR determines that DHS has failed to substantially comply with any provision of this Agreement, the parties will confer and attempt to reach agreement as to what steps may be necessary to resolve the compliance issues to both parties’ satisfaction.  If an agreement is not reached, OCR may terminate this Agreement with thirty (30) calendar days’ notice and take appropriate measures to effectuate DHS’s compliance with Section 504 and Title II of the ADA.  Such measures may include OCR reopening its investigation of DHS’s compliance with Section 504 and Title II of the ADA.  OCR may incorporate into its reopened investigation any relevant evidence of noncompliance with the Agreement and any relevant evidence obtained by OCR prior to signing of the Agreement.  OCR may also exercise all rights available under Section 504 and Title II of the ADA, including, but not limited to issuing noncompliance findings and the initiation of enforcement proceedings to terminate Federal financial assistance to DHS.
                          - **Effect on Other Compliance Matters**:  The terms of this Agreement do not apply to any other issues, reviews, investigations, or complaints of discrimination that are unrelated to the subject matter of this Agreement and that may be pending before OCR or any other Federal agency.  Any unrelated compliance matter arising from subsequent reviews or investigations shall be addressed and resolved separately.  Nothing in this Agreement shall be construed to limit or restrict OCR’s statutory and regulatory authority to conduct future complaint investigations and compliance reviews related to DHS and the subject matter of this Agreement.  This Agreement does not address or resolve issues involved in any other complaint investigation, compliance review, or administrative action under Federal laws by other Federal Agencies or with any issues or complaints that relate to any other division of DHS, including any action or investigation under Section 504 and/or Title II of the ADA.
                          - **Prohibition Against Retaliation and Intimidation****:**DHS, whether directly or through its program offices, shall not retaliate, intimidate, threaten, coerce or discriminate against any person who has filed a complaint or who has assisted or participated in the investigation of any matter addressed in this Agreement.
                          - **OCR’s Review of DHS’s Compliance with the Agreement:**OCR may review DHS’s compliance with this Agreement at any time while the Agreement is in effect.  As part of such review, OCR may require written reports, access to witnesses, copies of documents, and/or inspection of DHS’s offices.  Throughout the duration of this Agreement, DHS agrees to retain the records required by OCR to assess its compliance.  OCR will maintain the confidentiality of all information, including documents, files and records received from DHS and the CYS agencies; and will not disclose their contents except where necessary in formal enforcement proceedings or where otherwise required by law.
                          - **Non-Waiver Provision:**OCR’s failure to enforce this entire Agreement or any provision thereof with respect to any deadline or any other provision shall not be construed as a waiver of OCR’s right to enforce other deadlines or any provisions of this Agreement.
                          - **Entire Agreement****:**This Agreement constitutes the entire understanding between DHS and OCR in resolution of OCR Transaction Number: 20-359940.  Any statement, promise, or agreement not contained herein shall not be enforceable through this Agreement.
                          - **Modification of Agreement:**This Agreement may be modified by mutual agreement of the parties in writing.
                          - **Publication or Release of Agreement**:  OCR places no restrictions on the publication of this Agreement or its terms.  In addition, OCR may be required to release this Agreement and all related materials to any person upon request, consistent with the requirements of the Freedom of Information Act, 5 U.S.C. § 522, and its implementing regulation, 45 C.F.R. Part 5.
                          - **Third Party Rights****:**This Agreement can be enforced only by the parties specified in this Agreement, their legal representatives and assigns.  This Agreement shall be unenforceable by third parties and shall not be construed to create third party beneficiary rights.
                          - **Technical Assistance:**OCR will provide appropriate technical assistance to DHS regarding compliance with this Agreement, as requested and as reasonably necessary.
                          - **Miscellaneous:**When OCR verifies that DHS has completed all actions contained in this Agreement, OCR shall consider all matters related to this investigation resolved and so notify DHS in writing.
                          - **Authority of Signer**:  The individual who signs this Agreement on behalf of DHS represents that he or she is authorized to bind DHS to the Agreement.
                          - **Severability:**In the event that a court of competent jurisdiction determines that any provision of this Agreement is unenforceable, such provision shall be severed from the Agreement and all other provisions shall remain valid and enforceable; provided, however, that if the severance of any such provision materially alters the rights or obligation of the Parties, they shall, through reasonable, good faith negotiations, agree upon such other amendments hereto as may be necessary to restore the Parties as closely as possible to the relative rights and obligation initially intended to them hereunder.
                          - **Successor in Interest:**This Agreement is binding on the Parties, and their successors in interest, and DHS shall have a duty to so notify all such successors in interest of the existence and terms of this Agreement.

**IV.     Obligations**
                          - **Recognition:**DHS recognizes that Participants with disabilities, including individuals with drug addiction and substance use disorders that substantially limit one or more major life activities, those with a record of a drug addiction that substantially limits a major life activity, and those regarded as having an impairment, including drug addiction or Substance Use Disorder must be provided opportunities to benefit from or participate in DHS programs, services, and activities that are equal to those extended to Participants without disabilities.1  Therefore, pursuant to DHS policy, and in compliance with Section 504 and Title II, DHS agrees that it will not unlawfully discriminate on the basis of disability in the provision of programs, services, and activities to Participants with disabilities in the child welfare programs, including but not limited to child protective services, adoption, traditional and kinship foster care services, and safe haven programs.  Participants who are currently engaging in the illegal use of drugs are not individuals with a disability under the ADA and Section 504, and an entity covered by the ADA and/or Section 504, like DHS, may generally act on the basis of such use without violating the ADA2 and Section 504.3*See* 29 U.S.C. § 705(20)(C)(i-iii); 42 U.S.C. § 12210. 
                          - **General Nondiscrimination Requirements**:  DHS, directly and through contractual, licensing, or other arrangements, with respect to any Participant with a disability, agrees to comply with Section 504, Title II, and their implementing regulations, by implementing the provisions of this Agreement.                               - DHS, whether directly or through its program offices, will not exclude from or otherwise deny the benefits of its services, programs, or activities to any Participant with a disability on the basis of disability.  DHS will also not exclude or otherwise deny equal services, programs, or activities to a Participant or other individual because of their relationship or association with a Participant with a disability. **See** 42 U.S.C. § 12132; 29 U.S.C. § 794(a); 28 C.F.R. § 35.130(a), (g); 45 C.F.R. §§ 84.4(a), 84.52(a).
                            - DHS will ensure that Participants with disabilities (or individuals who associate with or have a relationship with a person with a disability) are afforded an opportunity to preserve and reunify their families that is equal to the opportunity offered to Participants without disabilities.  Similarly, DHS will ensure that Participants with disabilities are afforded opportunities to serve as legal guardians, foster parents, and adoptive parents that are equal to the opportunities offered to Participants without disabilities.  28 C.F.R. § 35.130(b), (g); 45 C.F.R. §§ 84.4(b)(1)(ii), 84.52(a)(2).
                            - DHS will ensure that the CYS agencies’ safety requirements are based on actual risks that pertain to the Participant with a disability and not on mere speculation, generalizations, or stereotypes about individuals with disabilities. **See** 28 C.F.R. § 35.130(h); 45 C.F.R. §§ 84.4(b), 84.52(a)(2)-(5).
                            - DHS will ensure that it and the CYS agencies make reasonable modifications in policies, practices, and procedures when the modifications are necessary to avoid discrimination on the basis of disability, unless DHS and/or the CYS agencies can demonstrate that making a modification would fundamentally alter the nature of the service, program, or activity.  Reasonable modifications should be appropriately tailored to the needs of the Participant with a disability.  **See** 28 C.F.R. § 35.130(b)(7); 45 C.F.R. § 84.4(a), (b)(vii).
                            - DHS will ensure that it and the CYS agencies furnish appropriate auxiliary aids and services when necessary to afford qualified Participants with disabilities and their companions an equal opportunity to participate in and enjoy the benefits of DHS’s child welfare services, programs, and activities.  28 C.F.R. § 35.160(b)(1); 45 C.F.R. § 84.52(d).
                            - DHS will ensure it, and each CYS agency, have grievance procedures providing for prompt and equitable resolution of complaints alleging disability discrimination, and DHS will designate at least one employee to coordinate its efforts to comply with and carry out its responsibilities under the ADA and Section 504, including any investigation of any complaint communicated to it alleging noncompliance or otherwise alleging disability discrimination.  28 C.F.R. § 35.107; 45 C.F.R. § 84.7.
                            - DHS and the CYS agencies will ensure that no surcharge will be placed on a particular Participant with a disability or any group of individuals with disabilities to cover the costs of measures, such as the provision of auxiliary aids or program accessibility, that are required for DHS to provide such Participant(s) with nondiscriminatory treatment. 28 C.F.R. § 35.130(f); 45 C.F.R. §§ 84.4(a), 84.52(d).
                            - DHS, whether on its own behalf or through the CYS agencies, will not coerce, intimidate, threaten, interfere, or engage in other discriminatory or retaliatory conduct against anyone because he or she has either taken action or participated in an action to secure rights protected by Title II and Section 504, including making a request for reasonable modifications or auxiliary aids and services and filing a disability discrimination complaint with DHS or OCR.  See 45 C.F.R. § 84.61, incorporating 45 C.F.R. § 80.7(e).    
                            - DHS will obligate the CYS agencies, subrecipients, and Contractors to comply with Section 504 and Title II in all DHS’s sub-recipient and Contractor agreements.
                            - Nothing in this agreement prohibits DHS or the CYS agencies from removing a child from a Participant with a disability or denying the placement of a child with a Participant with a disability if DHS through the CYS agency determines the Participant represents a direct threat to the safety of the child. However, DHS will ensure that the CYS agency will not base decisions about whether the Participant with a disability represents a direct threat to the safety of a child on stereotypes or generalizations about persons with disabilities, or a Participant’s diagnosis or intelligence measures (e.g., IQ scores) or a Participant’s history of an opioid use disorder or participation in MAT or MOUD alone. Rather, DHS will ensure that the CYS agency will base such decisions on an individualized assessment of the Participant with a disability, based on reasonable judgment that relies on current medical knowledge or on the best available objective evidence, to ascertain the nature, duration, and severity of the risk to the child; the probability that the potential injury to the child will actually occur; and whether reasonable modifications of policies, practices, or procedures or the provision of auxiliary aids or services will mitigate the risk. 28 C.F.R. § 35.139; 45 C.F.R. § 84.4(a), (b)(1), (b)(4).     
                          - **Designation of Responsible Employee:**Within thirty (30) calendar days of the Effective Date of this Agreement, DHS shall appoint or otherwise designate a staff member to coordinate its efforts to comply with Section 504 and Title II of the ADA, their implementing regulations, and the provisions of this Agreement.  The Section 504/ADA Coordinator shall be responsible for:                              - Providing oversight to the CYS agencies to ensure compliance with Section 504 and Title II.
                            - Reviewing and amending as necessary all DHS policies, procedures, safety assessment tools, protocols, training materials, and regulations that cite drug addiction, opioid use disorder, substance use disorder, or any similar phrases to emphasize that individuals with a drug addiction or substance use disorder, including persons receiving MAT or MOUD, are entitled to the protections of Section 504 and Title II in specific circumstances.  The amended materials and regulations should also reflect the requirement under Section 504 and Title II that individuals with disabilities must be treated on a case-by-case basis consistent with facts and objective evidence and may not be treated on the basis of generalizations or stereotypes.
                            - Developing training and professional development opportunities for DHS staff and CYS agencies, including child protective services workers, foster care and adoption workers, supervisors, and other volunteers and employees on its nondiscrimination policies and procedures, including increasing knowledge of resources and methodologies available to assist Participants with disabilities to achieve appropriate goals.
                          - **Notice of Nondiscrimination:**Within ninety (90) calendar days of the Effective Date of this Agreement, DHS and the CYS agencies shall adopt the Notice of Nondiscrimination Policy set forth in **Appendix A**. The policy will be submitted to OCR for review and approval.  Once OCR approves, DHS and the CYS agencies shall also prominently display the Notice of Nondiscrimination Policy, attached as **Appendix A**, in its waiting areas or lobbies and shall publish the Nondiscrimination Policy in DHS and CYS agency’s brochures, websites, and/or other existing promotional materials. 
                          - **Nondiscrimination Policies and Procedures:**Within one hundred eighty (180) calendar days of the appointment of the Section 504/ADA coordinator of this Agreement, and in collaboration with the 504/ADA Coordinator, DHS shall revise and or develop disability nondiscrimination policies and procedures regarding Section 504 and the ADA that are applicable to the CYS agencies.  DHS will submit the new or revised nondiscrimination policies to OCR for approval.  The nondiscrimination policies and procedures should, at a minimum, include:                              - An explanation that drug addiction and substance use disorders, including opioid use disorder, are disabilities under Section 504 and Title II when they substantially limit a major life activity. These laws protect qualified individuals with drug addiction or substance use disorder that substantially limits a major life activity when: 1) individuals have successfully completed a supervised drug rehabilitation program or have otherwise been successfully rehabilitated and are not currently engaged in the illegal use of drugs; 2) individuals  are participating in a supervised drug rehabilitation program and are currently not engaged in the illegal use of drugs; or 3) individuals are erroneously regarded as engaging in such use, but are not engaging in such use.
                            - An explanation that MAT and MOUD are not the illegal use of drugs and that an individual’s receipt of MAT or MOUD is not the illegal use of drugs.
                            - Individuals should not be discouraged from applying or denied participation in a DHS CYS agency program based on unfounded discriminatory assumptions that MAT or MOUD limits their ability to participate and enjoy the benefits of the program. DHS will ensure that the CYS agencies are not imposing eligibility requirements that screen out individuals with disabilities on the basis of substance use disorder, including on the basis of receiving medication to treat substance use disorder.
                            - A process for requesting reasonable modifications and auxiliary aids and services within each DHS and CYS agency office.  The policy must make clear that an individual does not need to reference Title II, Section 504, their implementing regulations, or any provisions therein, or use any terms of art, such as “reasonable modification,” to make such a request.  Such policy must require that such requests be addressed and reasonable modifications provided to a Participant with disabilities, or the request be otherwise resolved, in a timely manner to ensure the individual has an equal opportunity to participate in DHS and CYS agency programs.
                            - A statement informing Participants with disabilities that DHS and the CYS agencies will not impose a surcharge on a particular Participant with a disability or any group of Participants with disabilities to cover the costs of measures, such as the provision of auxiliary aids and services, reasonable modifications, or program accessibility, that are required for DHS and the CYS agencies to provide such Participant(s) with nondiscriminatory treatment.
                            - A statement informing Participants with disabilities of the right under Section 504 and Title II to file a complaint and/or a grievance alleging discrimination on the basis of disability to DHS and/or the CYS agency, and to OCR.
                            - A statement informing Participants that DHS and the CYS agencies will not coerce, intimidate, threaten, interfere, or engage in other discriminatory or retaliatory conduct against anyone because he or she has either taken action or participated in an action to secure rights protected by Section 504 and the ADA, including making a request for reasonable modifications or auxiliary aids and services or filing a disability discrimination complaint with DHS or OCR.
                          - **Grievance Procedure:**Within one hundred twenty (120) calendar days of the appointment of the Section 504/ADA coordinator, DHS shall revise its Grievance Procedure, to make clear that it provides for the prompt and equitable resolution of complaints alleging discrimination on the protected bases covered by Section 504 and Title II of the ADA, as set forth in **Appendix C**.  In addition, within one hundred twenty (120) calendar days of the appointment of a Section 504/ADA coordinator, DHS shall ensure that each CYS agency has a Section 504/ADA grievance procedure that provides for the prompt and equitable resolution of complaints alleging discrimination on the protected bases covered by Section 504 and Title II of the ADA, as set forth in Appendix C.  DHS will submit the revised Grievance Procedures to OCR for review and approval.
                          - **Monitoring of Accommodations Requests in CYS Programs:**Within one hundred eighty (180) calendar days of the Effective Date of this Agreement, DHS shall develop a tracking system to collect and analyze data annually from local CYS agencies on:                              - The number and type of requests for accommodations or modifications received from individuals with disabilities, and
                            - The status and/or outcome of each such request for accommodation or modification.
                          - **Staff Training:**Within one hundred eighty (180) calendar days of the appointment of the Section 504/ADA coordinator, DHS, with input from the Section 504/ADA Coordinator, shall develop and provide mandatory annual training to all Contractors and DHS staff who serve Participants in DHS Programs as defined in Section III.A. of this Agreement.  This training shall cover compliance with Federal civil rights laws, including Section 504 and Title II of the ADA and working with Participants with disabilities, including individuals in recovery from a substance use disorder.  All new Contractors and DHS staff must also complete this training within sixty (60) calendar days of the employment start date.  On an annual basis after the first training, DHS will provide a mandatory refresher training to all Contractors and DHS staff.  The training materials, agenda, and resume(s) of the person(s) administering the training shall be submitted to OCR for review and approval.  All trainings conducted pursuant to this provision will be conducted in an interactive format so as to ensure staff’s engagement with the materials and their ability to ask and receive answers to follow-up questions.
                          - **Documentation:**DHS will maintain documentation of its training materials under this Section and documentation that each DHS and/or CYS agency staff member has received the training required by this Section.
                          - **Other Action:**Within fifteen (15) calendar days of the Effective Date of this Agreement, DHS shall ensure that the appropriate CYS agency personnel contacts Complainant to determine whether she is still interested in applying to be a foster parent.  If Complainant is interested and submits an updated application, DHS through the CYS agency should consider the application consistent with the requirements of this Agreement.

**V.     Reporting Requirements**

DHS agrees to provide OCR with the following:
                          - No later than ninety (90) calendar days after the Effective Date of this Agreement, DHS’s Notice of Non-Discrimination.
                          - No later than one hundred twenty (120) calendar days after the appointment of a Section 504/ADA coordinator, DHS’s and CYS agencies’ Draft Grievance Procedures.
                          - No later than one hundred eighty (180) calendar days of the appointment of the Section 504/ADA coordinator, copies of new or revised nondiscrimination policies and procedures regarding Section 504 and the ADA.
                          - No later than one hundred eighty (180) calendar days of the appointment of the Section 504/ADA coordinator, a copy of training materials that DHS proposes to use to train DHS and CYS agency staff members regarding compliance with Section 504 and Title II of the ADA and working with Participants with disabilities.
                          - No later than one hundred eighty (180) calendar days of the appointment of the Section 504/ADA coordinator, copies of DHS and CYS agency pamphlets, brochures, website and/or other existing promotional material in which the Notice of Nondiscrimination Policy was published pursuant to this Agreement, Section IV.D, Notice of Nondiscrimination.
                          - No later than twelve (12) months and twenty-four (24) months after the Effective Date of this Agreement, a list of DHS and CYS agency staff members who attended the training required by this agreement.
                          - At twelve (12) months and twenty-four (24) months after the Effective Date of this Agreement, letters describing:                               - the number and type of grievances and complaints filed by or on behalf of Participants (pursuant to this Agreement, Section II, Definitions) alleging discrimination on any protected basis under Section 504 or Title II of the ADA, with DHS, CYS agencies,  and/or a member of their staff and/or with any Federal, state, or local agency, provided DHS or the CYS agency is given notification;
                            - the number and type of requests for accommodations or modifications received from individuals with disabilities; and
                            - the status and/or outcome of each such grievance/complaint and request for accommodation or modification.

**VI.     Signatures**

The individuals signing represent that they are authorized to execute this Agreement and legally bind the parties to this Agreement.

**For the Pennsylvania Department of Human Services**

_______________________________________                 Date: April 6, 2023Laval Miller-Wilson, Deputy Secretary                                            Office of Children, Youth, and Families                                                                                           Pennsylvania Department of Human Services625 Forster StreetHarrisburg, PA 17120

**For the U.S. Department of Health and Human Services**

_______________________________________                             Date: July 5, 2023Melanie Fontes Rainer, Director                                           Office for Civil RightsLuis Perez, Deputy DirectorEnforcement Division

U.S. Department of Health and Human Services200 Independence Avenue, SWRoom 509F, HHH BuildingWashington, DC 20201

Jamie Rahn Ballay, Regional ManagerRegion III (Mid-Atlantic), Office for Civil RightsU.S. Department of Health and Human Services801 Market Street, Suite 9300Philadelphia, PA 19107

**Appendix A**

**Notice of Nondiscrimination Policy**

The Pennsylvania Department of Human Services (“DHS”) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.  DHS does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

If you have questions or need assistance, contact the [Section 504/ADA Coordinator Title].

If you believe that DHS has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the:

[Section 504/ADA Coordinator Title]Pennsylvania Department of Human Services

You can file a grievance in person or by mail, email, or in person. If you need help filing a grievance, the [title] is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services200 Independence Avenue, SWRoom 509F, HHH BuildingWashington, D.C. 202011-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at https://www.hhs.gov/ocr/complaints/index.html.

**Appendix B**

**Notice of Nondiscrimination Policy (short-form for 1 page documents)**

*[For pamphlets, brochures and purchased advertising where space is limited, DHS may use the following short-form Nondiscrimination Policy:]*

The Pennsylvania Department of Human Services complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

**Appendix C**

**Grievance Procedure**

It is the policy of the Pennsylvania Department of Human Services (DHS) not to discriminate on the basis of race, color, national origin, sex, age, or disability.  DHS has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging discrimination.

Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age, or disability may file a grievance under this procedure.  It is against the law for DHS to retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance.

**Procedure:**
                          - Grievances must be submitted to [Section 504/ADA Coordinator Title], within sixty (60) calendar days of the date the person filing the grievance becomes aware of the alleged discriminatory action.
                          - A complaint must be in writing, containing the name and address of the person filing it.  The complaint must state the problem or action alleged to be discriminatory and the remedy or relief sought.
                          - The [Section 504/ADA Coordinator Title] (or his/her designee) shall conduct an investigation of the complaint.  This investigation may be informal, but it will be thorough, affording all interested persons an opportunity to submit evidence relevant to the complaint.  The [Section 504/ADA Coordinator Title] will maintain the files and records of DHS relating to such grievances.  To the extent possible, and in accordance with applicable law, the [Section 504/ADA Coordinator Title] will take appropriate steps to preserve the confidentiality of files and records relating to grievances and will share them only with those who have a need to know.
                          - The [Section 504/ADA Coordinator Title] will issue a written decision on the grievance, based on a preponderance of the evidence, no later than thirty (30) calendar days after its filing, including a notice to the complainant of his or her right to pursue further administrative or legal remedies.  The person filing the grievance may appeal the decision of the [Section 504/ADA Coordinator Title] by writing to the Director of DHS within fifteen (15) calendar days of receiving the [Section 504/ADA Coordinator Title]’s decision.  The Director of DHS shall issue a written decision in response to the appeal no later than thirty (30) calendar days after its filing.

The availability and use of this grievance procedure does not prevent a person from pursuing other legal or administrative remedies, including filing a complaint of discrimination on the basis of race, color, national origin, sex, age, or disability in court or with the U.S. Department of Health and Human Services, Office for Civil Rights.  A person can file a complaint of discrimination electronically through the Office for Civil Rights Complaint Portal, which is available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services200 Independence Avenue, SWRoom 509F, HHH BuildingWashington, D.C. 202011-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at: https://www.hhs.gov/ocr/complaints/index.html.  Such complaints must be filed within one hundred eighty (180) calendar days of the date of the alleged discrimination.

DHS will make appropriate arrangements to ensure that individuals with disabilities and individuals with limited English proficiency are provided auxiliary aids and services or language assistance services, respectively, if needed to participate in this grievance process.  Such arrangements may include, but are not limited to, providing qualified interpreters, providing recorded material for individuals with low vision, or assuring a barrier-free location for the proceedings.  The [Section 504/ADA Coordinator Title] will be responsible for such arrangements.

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### Endnotes:

1  Federal disability rights laws also protect individuals if they: (1) have successfully completed a supervised drug rehabilitation program or have otherwise been successfully rehabilitated and are not currently engaged in the illegal use of drugs; (2) are participating in a supervised drug rehabilitation program and are currently not engaged in the illegal use of drugs; or (3) are erroneously regarded as engaging in such use but are not engaging in such use. 29 U.S.C. § 705(20)(C)(ii); 42 U.S.C. § 12210(b).

2  Covered entities cannot deny health services, services provided in connection with drug rehabilitation, or vocational rehabilitation services, on the basis of the current illegal use of drugs if the individual is otherwise entitled to such services.  *See* 29 U.S.C. § 705(20)(C)(iii); 42 U.S.C. § 12210(c).

3  Section 504 provides that for purposes of programs and activities providing health services and services provided under subchapters I, II, and III, [of the Rehabilitation Act] an individual shall not be excluded from the benefits of such programs or activities on the basis of his or her current illegal use of drugs if he or she is otherwise entitled to such services.  29 U.S.C. § 794(a); 29 U.S.C. § 705(20)(C)(iii).

Content last reviewed April 16, 2024