Under federal law, a bleeding disorder is considered a disability. This means people with bleeding disorders are protected from discrimination in many healthcare settings.

Behavioral health facilities are not required to accept every patient, including patients with disabilities. However, facilities that receive federal financial assistance (which includes most inpatient and residential mental health and substance use treatment programs) must follow specific nondiscrimination rules.

In May 2024, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), finalized a new rule under Section 504 of the Rehabilitation Act of 1973 called (Section 504):

“Discrimination on the Basis of Disability in Health and Human Service Programs or Activities.”

This rule makes something very clear:

Medical providers — including mental health and substance use treatment facilities — that receive federal funding must conduct an individualized assessment when considering a person with a disability for admission.

That means:

• A facility cannot deny you access solely because you have a bleeding disorder
  
  

• A facility cannot rely on blanket policies, assumptions, or fear
  
  

• A facility must look at you as an individual, not just your diagnosis
  
  

If a behavioral health facility is concerned about your bleeding disorder, they should, at a minimum, speak with your provider team (such as your hematologist or HTC) as part of that individualized assessment.

Behavioral health facilities are regulated at the state level so states may have different requirements, however, federal non-discrimination laws still apply. This means, generally speaking, 

Facilities CAN:

• Decide not to admit someone if they genuinely cannot safely meet that person’s medical needs
  
  

• Make decisions based on staffing, training, or available medical support
  
  

• Deny admission if, after an individualized assessment, they determine a person is too medically complex for that specific facility
  
  

Facilities CANNOT:

• Deny admission simply because you have a bleeding disorder
  
  

• Refuse care based on assumptions, fear, or lack of understanding
  
  

• Skip an individualized assessment
  
  

• Decline to consult with your medical team when medical questions are the reason for denial
  
  

A denial based on fear, rather than actual inability to provide safe care, is not appropriate and may raise legal concerns.

It is important to reach out to your bleeding disorders treatment team to share your denial experience. You can read more about asking your bleeding disorder treatment team for help advocating for access to care here: https://www.bdsumhac.org/contact-treatment-team