Federal Agencies Address Hepatitis B Discrimination

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The Department of Justice, the Department of Education, and the
Department of Health and Human Services have sent a joint letter to the
nation’s medical schools, dental schools, nursing schools, and other
health-related schools regarding hepatitis B discrimination.
In the letter, the departments express concern that some health-related
schools may be making enrollment decisions based on an incorrect
understanding of the hepatitis B virus, resulting in discrimination. The
letter updates schools on the latest recommendations from the Centers for
Disease Control and Prevention (CDC) regarding the participation of
students with hepatitis B in health-related schools. The letter also
emphasizes the importance of CDC’s recommendations, especially as they
relate to the schools’ obligation to comply with federal laws prohibiting
discrimination on the basis of disability, race, color, and national
origin. Approximately 800,000 to 1.4 million people in the United States
have hepatitis B.  Asians, Native Hawaiians, and Pacific Islanders make up
roughly 4.5 percent of the U.S. population, but represent 50 percent of the
persons with hepatitis B in the United States. The letter cites to a March
2013 settlement agreement that the Justice Department reached with a
medical school and a school of osteopathic medicine resolving allegations
that the schools violated the Americans with Disabilities Act by excluding
previously-accepted applicants with hepatitis B from their programs. The
updated CDC recommendations, based on the most current scientific
information, dispel many myths associated with hepatitis B and provide
guidance to health-related schools on managing students with the virus. The
CDC also notes that since the last update of the recommendations in 1991,
there have been no reports of hepatitis B transmission in the United States
or other developed countries from medical or dental students to patients.
Among other recommendations, the CDC recommends that chronic hepatitis B
virus infection, in itself, should not preclude the study or practice of
medicine, surgery, dentistry, or allied health professions. “The Justice
Department strongly urges health-related schools to review the CDC’s
recommendations and to ensure that their policies and practices comply with
federal nondiscrimination laws,” says Jocelyn Samuels, principal deputy
assistant attorney general for the Civil Rights Division of the Justice
Department.  “Applicants and students with hepatitis B should not have to
face exclusion on the basis of unfounded fears and stereotypes, and the
Justice Department will not tolerate it.” “Both public health and civil
rights will be promoted when medical schools rely on the most recent
scientific information, not overbroad generalizations, in dealing with
medical students with hepatitis B,” says Seth Galanter, acting assistant
secretary for civil rights in the Department of Education. Leon Rodriguez,
director of the Office for Civil Rights in the Department of Health and
Human Services, agrees that health-related schools must ensure that they do
not deny equal access to individuals based on discrimination, adding,
“The CDC recommendations promote public health and safety while also
offering guidance on the management of students with hepatitis B.  Our
agencies place considerable weight on this guidance in our enforcement of
Federal civil rights laws.” The Departments of Justice, Education, and
Health and Human Services share responsibility for protecting the rights of
students and applicants with disabilities, including those with hepatitis
B, in schools of higher education by enforcing titles II and III of the
Americans with Disabilities Act and Section 504 of the Rehabilitation Act.
These laws prohibit covered postsecondary institutions from discriminating
on the basis of disability and from refusing to make reasonable
modifications to their policies, practices, or procedures when necessary to
avoid discrimination on the basis of disability, unless such modifications
would fundamentally alter the nature of the program or the services
provided. The Departments of Justice, Education, and Health and Human
Services also enforce Title VI of the Civil Rights Act, which prohibits
discrimination on the basis of race, color, or national origin in programs
and activities receiving federal financial assistance, including those of
health-related schools.

The joint letter can be found on OCR’s website at:
http://www.hhs.gov/ocr/office/hep-b-letter.pdf