Under the HHS Section 504 web rule, a conforming alternate version is a separate version of web content that meets WCAG 2.1 AA when the primary version does not. It can be used in limited cases where making the original accessible is not technically possible. The alternate must have the same information, the same functionality, be up to date, and be reachable from the non-conforming page through an accessible mechanism. It is not a shortcut. It is a narrow allowance with strict criteria.
| Element | What It Means |
|---|---|
| Standard referenced | WCAG 2.1 Level AA, per the HHS Section 504 rule |
| When allowed | Only when full conformance of the primary version is not technically possible |
| Same information | Content and data must match the original version |
| Same functionality | All interactive features must work the same way |
| Up to date | The alternate must update at the same time as the primary version |
| Reachable | Linked from the non-conforming page through an accessible mechanism |
| Not a substitute | Cannot replace accessibility work on the primary site |
What the HHS Rule Actually Says
The HHS Section 504 final rule, published in May 2024, requires covered entities to make their web content and mobile apps conform to WCAG 2.1 Level AA. The rule applies to recipients of federal financial assistance from the Department of Health and Human Services, including hospitals, state health agencies, and many healthcare programs.
The rule borrows the conforming alternate version concept directly from WCAG itself. WCAG allows a separate accessible version to count toward conformance when the original page does not meet the criteria, but only under tight conditions.
When Can a Conforming Alternate Version Be Used?
A conforming alternate version is appropriate only when the original page cannot be made accessible due to technical reasons. This is a high bar. Aesthetic preference, development time, or cost considerations do not qualify.
If a chart, interactive map, or legacy widget cannot be made to meet WCAG 2.1 AA after a good faith effort, an alternate version that conveys the same information accessibly can serve as the conforming path. The non-conforming original still has to link to the alternate.
What Makes an Alternate Version Conforming?
Four requirements must be met for the alternate version to count.
First, it must fully conform to WCAG 2.1 AA on its own. A partially accessible alternate does not satisfy the rule.
Second, it must contain the same information and serve the same functionality. A stripped-down or summarized version is not equivalent.
Third, it must be as up to date as the non-conforming version. If the primary page changes, the alternate has to change at the same time.
Fourth, the user must be able to reach the alternate from the non-conforming page through an accessible mechanism, such as a clearly labeled link near the top of the page.
Why Conforming Alternate Versions Are Rarely the Right Path
In practice, maintaining two synchronized versions of a page is harder than fixing the original. Every content update doubles. Every feature change has to be mirrored. Over time, the alternate falls behind, and the non-conforming version becomes the only working page.
For most healthcare entities working through HHS Section 504 web requirements, remediating the primary page is the more sustainable path. Conforming alternate versions should be reserved for narrow technical edge cases, not used as a general approach to accessibility.
How Auditors Treat Conforming Alternate Versions
An accessibility audit will evaluate the alternate version against the same WCAG 2.1 AA criteria as any other page. The auditor also verifies that the alternate carries the same information, matches the functionality of the original, is current, and is reachable through an accessible link.
If any of those conditions are not met, the alternate does not count, and the original page is recorded as non-conforming. The audit report identifies which pages depend on alternates and whether those alternates hold up.
FAQ
Does a conforming alternate version reduce my legal risk under Section 504?
Only if it meets every criterion in the rule. A poorly maintained or partially accessible alternate provides no protection and may increase risk by signaling that the entity knew about the issue and did not address it properly.
Can I use a PDF as a conforming alternate version of a web page?
A PDF can serve as a conforming alternate version only if the PDF itself meets WCAG 2.1 AA, contains the same information and functionality, stays up to date with the web page, and is reachable from the non-conforming page through an accessible link. Most PDFs do not meet these requirements without dedicated remediation work.
What is the compliance deadline for the HHS Section 504 web rule?
Compliance dates vary by entity size. Larger recipients had earlier deadlines, with smaller recipients following on a later schedule. Healthcare organizations should confirm their specific deadline based on their classification under the rule.
How do I know if my organization needs to comply?
If your organization receives federal financial assistance from HHS, the rule likely applies. This covers hospitals, health departments, federally qualified health centers, and many programs that receive HHS funding either directly or through state agencies.
For an expert evaluation of your web content against WCAG 2.1 AA and the HHS rule, Contact Kris Rivenburgh.