Original Broadcast: April 22, 2020
Recording and Transcripts Episode 80: Rationing of Medical Care and Protecting the Rights of People with Disabilities
Contents
- Center for Public Representation (CPR)Resources
- Federal Policy and Actions Enforcing Disability Rights
- State Actions and Policies Affecting Disability Rights
- Disability Rights Advocacy and Medical Care Rationing
- ADA National Network Webinars
- News Articles about Medical Care Rationing.80
- Medical Policy and Analysis
Center for Public Representation (CPR) Resources
- Center for Public Representation (CPR)
This organization uses legal strategies, advocacy, and policy to promote the integration and full community participation of people with disabilities and all others who are devalued in today’s society.
Link: centerforpublicrep.org - COVID-19 Information and Resources from Center for Public Representation
Coronavirus (COVID-19) pandemic information for people with disabilities about useful resources, current and possible legislation, disability rights advocacy, and medical rationing.
Link: centerforpublicrep.org/covid-19/
Federal Policy and Actions Enforcing Disability Rights
- COVID-19 Medical Rationing information from Center for Public Representation
A complete list of federal OCR Complaints and Letters of Complaint sent to state agencies
Link: centerforpublicrep.org/covid-19-medical-rationing/ - Crisis Standards of Care and Civil Rights Laws [PDF file]
Released on April 14, 2020 by the Health Care Resilience Taskforce (composed of HHS, FEMA, and the Army Corps of Engineers)
Source: Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS)
Link: files.asprtracie.hhs.gov/documents/crisis-standards-of-care-and-civil-rights-laws-covid-19.pdf - Bulletin: Civil Rights, HIPAA, and the Coronavirus Disease 2019 (COVID-19) [PDF file]
Released on March 28, 2020
Source: Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS)
Link: hhs.gov/sites/default/files/ocr-bulletin-3-28-20.pdf - Office for Civil Rights (OCR) Announcements Related to COVID-19
Link: hhs.gov/hipaa/for-professionals/special-topics/hipaa-covid19/index.html - Resources on Civil Rights and Emergency Preparedness during COVID-19
Link: hhs.gov/civil-rights/for-individuals/special-topics/emergency-preparedness/index.html - Information on Civil Rights, HIPAA and COVID-19
Web:.hhs.gov/hipaa/for-professionals/special-topics/hipaa-covid19/index.html - OCR Reaches Early Case Resolution with Alabama after It Removes Discriminatory Ventilator Triaging Guidelines
April 8, 2020
Source: Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS)
Link: hhs.gov/about/news/2020/04/08/ocr-reaches-early-case-resolution-alabama-after-it-removes-discriminatory-ventilator-triaging.html - OCR Resolves Civil Rights Complaint Against Pennsylvania After it Revises its Pandemic Health Care Triaging Policies to Protect Against Disability Discrimination
April 16, 2020
Source: Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS)
Link: hhs.gov/about/news/2020/04/16/ocr-resolves-civil-rights-complaint-against-pennsylvania-after-it-revises-its-pandemic-health-care.html - White Paper: Fair Resource Allocation During the COVID-19 Pandemic
Source: Ruderman Family Foundation
Link: rudermanfoundation.org/white_papers/fair-resource-allocation-during-the-covid-19-pandemic/
State Actions and Policies Affecting Disability Rights
- COVID-19 Medical Rationing information from Center for Public Representation
A complete list of federal OCR Complaints and Letters of Complaint sent to state agencies
Link: centerforpublicrep.org/covid-19-medical-rationing/
Kentucky
- Ensuring Ethical and Equitable Care Decisions for Patients with Disabilities with COVID-19 [PDF file]
Source: Kentucky Protection and Advocacy
Link: nebula.wsimg.com/ff062f97228f480d979b03249d8e94f6?AccessKeyId=65CDDAA309ED09126F01&disposition=0&alloworigin=1
Pennsylvania
- Civil Rights Complaint Filed by Disability Rights PA Resulted in Progress on Medical Rationing Guidelines
April 16
Source: Rehabilitation & Community Providers Association (RCPA)
Link: paproviders.org/civil-rights-complaint-filed-by-disability-rights-pa-resulted-in-progress-on-medical-rationing-guidelines/ - Health Care Rationing: What Patients with Disabilities Need to Know During the COVID-19 Pandemic [PDF file]
Source: Disability Rights Pennsylvania
Link: disabilityrightspa.org/wp-content/uploads/2020/04/2-MEDICAL-RATIONING-.pdf
Tennessee
- Tennessee COVID Treatment Rationing Plan Triggers Disability Discrimination Complaint
March 27, 2020
Source: Disability Rights Tennessee
Link: disabilityrightstn.org/resources/news/march-2020/tn-covid-treatment-rationing-triggers-disability-d - Tennessee Complaint on Healthcare Rationing Plan [PDF file]
Source: Disability Rights Tennessee
Link: thearc.org/wp-content/uploads/2020/03/2020-03-27-TN-OCR-Complaint-re-Healthcare-Rationing-Guidelines.pdf
Washington
- Disability Discrimination Complaint Filed over COVID-19 Treatment Rationing Plan in Washington State
March 23, 2020
Source: Disability Rights Washington
Link: disabilityrightswa.org/2020/03/23/disability-discrimination-complaint-filed-over-covid-19-treatment-rationing-plan-in-washington-state/
Wisconsin
- COVID-19 Ventilator Triage, Nursing Home Transfers Taken Up by State Committee
April 10, 2020
Source: Wisconsin State Journal
Link: madison.com/wsj/news/local/health-med-fit/covid-19-ventilator-triage-nursing-home-transfers-taken-up-by-state-committee/article_b86292f8-22c1-50e3-be7a-89ae2127a999.html - Letter on Wisconsin state guidelines for allocation of ventilators during COVID-19 [PDF file]
Link: bloximages.chicago2.vip.townnews.com/madison.com/content/tncms/assets/v3/editorial/f/87/f8740832-d045-5056-8bb0-3722278ac46f/5e8f806acc898.pdf
Disability Rights Advocacy and Medical Care Rationing
- Bazelon Center and Partners Release New Rationing Evaluation Tool
Together with other partners, the Bazelon Center on April 9 released a tool or framework for evaluating Crisis Standard of Care plans that ration scarce medical resources, in order to determine whether they comply with federal laws prohibiting disability discrimination. The tool contains six questions that are useful for scrutinizing these rationing plans. It is a companion to the guidance that Bazelon and its partners released on April 3, 2020 applying HHS Office of Civil Rights’ bulletin concerning disability discrimination in medical rationing schemes. Also check their website for other resources and information on disability rights during the COVID-19 pandemic.
Bazelon Center for Mental Health Law
Link: bazelon.org
Evaluation Framework for Crisis Standard of Care Plans [PDF file]
Link: bazelon.org/wp-content/uploads/2020/04/4-9-20-Evaluation-framework-for-crisis-standards-of-care-plans_final.pdf
Applying HHS’s Guidance for States and Health Care Providers on Avoiding Disability-Based Discrimination In Treatment Rationing [PDF file]
Link: bazelon.org/wp-content/uploads/2020/04/4-3-20-Guidance-to-States-Hospitals_FINAL.pdf - Preventing Discrimination in the Treatment of COVID-19 Patients: The Illegality of Medical Rationing on the Basis of Disability
March 25, 2020
Source: Disability Rights Education and Defense Fund (DREDF)
Link: dredf.org/the-illegality-of-medical-rationing-on-the-basis-of-disability/ - Over 400 Organizations Urge Department of Health and Human Services to Issue Guidance to Prohibit Discrimination during Medical Rationing
Source: American Association of People with Disabilities (AAPD)- Link: aapd.com/advocate-letter-supporting-nondiscrimination-final/
- Letter 3/20/2020 from the Consortium for Citizens with Disabilities to the Office for Civil Rights at the U.S. Department of Health and Human Services [PDF file]
Source: Consortium for Citizens with Disabilities
Link: c-c-d.org/fichiers/Letter-re-COVID-19-and-Disability-Discrimination-final.pdf - Partnership for Inclusive Disaster Strategies COVID-19 Information
Link: disasterstrategies.org/index.php/news - COVID-19 Disability Community-Wide Resource List [Google Document]
Link: docs.google.com/document/d/1-53u6OnvUCB0OaWs8ys8RRDbfQLN-9zmZzzYPHF7bHU/edit
ADA National Network Webinars
- ADA National Network Learning Session: COVID19, Health Care, and the ADA
Date: April 23, 2020
Sponsored by: Pacific ADA Center and the ADA National Network.
Link: adapresentations.org/healthcare/schedule.php
News Articles about Medical Care Rationing
- Who Gets the Ventilator? Disability Discrimination in COVID-19 Medical-Rationing Protocols
The coronavirus pandemic has forced us to reckon with the possibility of having to ration life-saving medical treatments. In response, many health systems have employed protocols that explicitly de-prioritize people for these treatments based on pre-existing disabilities. This Essay argues that such protocols violate the Americans with Disabilities Act, the Rehabilitation Act, and the Affordable Care Act. Such explicit discrimination on its face violates these statutes. Nor can medical providers simply define disabled patients as being “unqualified” because of disabilities that do not affect the ability to ameliorate the condition for which treatment is sought. A proper interpretation of the law may permit medical providers to use disability as a basis for a rationing decision where an individual’s underlying disability will kill the individual in the immediate term regardless of the treatment. However, as this Essay demonstrates, those circumstances will be narrow. Further, the law requires that such imminent-death determinations will be made based on the best available objective evidence, free from both bias against people with disabilities and devaluation of their lives.
Source: Yale Law Journal
Link: www.yalelawjournal.org/forum/who-gets-the-ventilator - People with Disabilities Fear Pandemic Will Worsen Medical Biases
April 15, 2020
Also available as an audio file/podcast
Source: National Public Radio (NPR)
Link: npr.org/2020/04/15/828906002/people-with-disabilities-fear-pandemic-will-worsen-medical-biases?fbclid=IwAR2At53EzeQK01iZPWlouZjKYXFtuLprPceXwzr4mD4GTf3h3klmfeGyF-M - For People with Disabilities, COVID-19 Puts Question of Who Lives or Dies in Stark Relief
April 14, 2020
Source: Arizona Republic
Link: azcentral.com/story/news/2020/04/14/coronavirus-pandemic-people-disabilities-worry-covid-19-care/5108774002/ - The Disability Community Fights Deadly Discrimination Amid the COVID-19 Pandemic
April 14, 2020
Source: Forbes
Link: forbes.com/sites/andrewpulrang/2020/04/14/the-disability-community-fights-deadly-discrimination-amid-the-covid-19-pandemic/#6df416ba309c - HHS Warns States Not to Put People with Disabilities at the Back of the Line for Care
March 28, 2020
Source: National Public Radio (NPR)
Link: npr.org/2020/03/28/823254597/hhs-warns-states-not-to-put-people-with-disabilities-at-the-back-of-the-line-for
Medical Policy and Analysis
- Stemming the Risk of Disability Bias During the COVID-19 Pandemic
April 8, 2020
Source: Center for Health Care Strategies (CHCS)
Link: chcs.org/stemming-the-risk-of-disability-bias-during-the-covid-19-pandemic/ - Confronting Disability Discrimination During the Pandemic
April 2, 2020
Source: The Hastings Center
Link: thehastingscenter.org/confronting-disability-discrimination-during-the-pandemic/ - COVID-19 Triage and Disability: What NOT To Do
March 30, 2020
Source: Bioethics.net
Link: bioethics.net/2020/03/covid-19-triage-and-disability-what-not-to-do/ - Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (COVID-19) Guidelines for Institutional Ethics Services Responding to COVID-19 Managing Uncertainty, Safeguarding Communities, Guiding Practice [PDF file]
March 16, 2020
Source: The Hastings Center
Link: thehastingscenter.org/wp-content/uploads/HastingsCenterCovidFramework2020.pdf