COVID crisis – Healthcare Rationing on Basis of Disability is Illegal

In the current COVID-19 health crisis, people with disabilities are at double risk. The virus itself hits people with underlying conditions harder, and long-standing discrimination in our healthcare system means that people with disabilities are most likely to bear the burden of “rationing” measures that hospitals and providers will put into place as patient needs strain the resources of the U.S. healthcare system.

Let’s not forget that people with disabilities have historically experienced discrimination in the provision of medical treatment. Long-standing triage protocols in other states such as Alabama and Colorado already exclude many people with developmental disabilities or neuromuscular disease. Studies collected by the National Council on Disability document that a large segment of the medical community refuses even to treat patients with disabilities; a quarter of doctors in one study refused to schedule an appointment with potential patients who used wheelchairs. Disabled patients “experience health care disparities, such as lower rates of screening and more difficulty accessing services, compared to people without disabilities.”

Disability Rights California

  • Do not deny or limit care to people with disabilities based on existing disabilities. The lives of people with disabilities are equally valuable to the lives of people without disabilities.
  • Do not deny or limit care to people with disabilities because a disabled person has a lower likelihood of survival or may require more intensive care.
  • Do not impose quality of life judgements when deciding to deny or limit COVID-19 treatment.
  • Do not deny or limit treatment to people with disabilities who may require reasonable accommodation during or after treatment

Successes

Complaints Filed with HHS Office of Civil Rights

  • Complaint filed by CPR and WA and national partners regarding Washington State Department of Health & the Northwest Healthcare Response Network’s rationing scheme (3/23/20)
  • Complaint filed by CPR and AL and national partners regarding Alabama’s ventilator rationing scheme (3/24/20)
  • Complaint filed by CPR and KS and national partners regarding Kansas’ Toolkit for COVID-19 (3/27/20)
  • Complaint filed by TN advocates, together with CPR and national partners, regarding Tennessee’s “Guidelines for the Ethical Allocation of Scarce Resources” (3/27/20)
  • Complaint filed by PA advocates regard Pennsylania’s rationing standards of care (4/3/20)
  • Complaint filed by CPR and Utah and national partners regarding Utah’s crisis standards of care (4/6/20)
  • Complaint filed by Disability Rights New York re ventilator rationing policy (4/7/20)

Letters from National Organizations

  • Letter from NCD to HHS OCR Director Roger Severino (3/18/20)
  • Letter from CCD to HHS Secretary Alex Azar and HHS OCR Director Roger Severino (3/20/20)
  • Letter from thirty-two members of Congress to HHS Secretary Alex Azar and U.S. Attorney General William Barr asking them to issue guidance to states (3/25/20)

Letters to Governors and Other State Advocacy

Local advocacy groups have been sending letters to governors on medical treatment rationing and discrimination. Those letters and related responses from governors are included below:

  • Massachusetts
    • Letter from CPR and local partners to Governor Baker on the need for statewide guidelines preventing discriminatory allocation of life-saving medical care (3/26/20)
    • Letter from CPR and local partners to the Massachusetts Health and Hospital Association, the College of Boston Teaching Hospitals, and the Massachusetts Medical Society recommending non-discriminatory triage assessment criteria for use in MA hospitals (4/3/20)
  • California  
    • Letter from Disability Rights California to Governor Newsom (3/16/20)
    • Letter from Disability Rights Education & Defense Fund (DREDF) to Governor Newsom (3/20/20)
    • Governor Newsom’s guidance relating to non-discrimination in medical treatment (3/30/20)
  • Colorado
    • Letter from Colorado Cross-Disability Coalition and CO organizations to Governor Polis regarding needs of the disability community, including non-discrimination in rationing care (3/25/20)
    • Letter from Colorado Cross-Disability Coalition and CO organizations to Governor Polis regarding rationing medical care (4/1/20)
  • Florida
    • Letter from Disability Rights Florida to Governor DeSantis regarding medical rationing (3/30/20)
  • Georgia
    • Letter from Georgia Council on Developmental Disabilities, Georgia Advocacy Office and other stakeholders to Governor Kemp, including about non-discrimination in medical rationing (3/28/20)
  • Illinois  
    • Letter from Access Living to Governor Pritzker regarding medical rationing (3/26/20)
  • Kentucky
    • Letter from Kentucky Protection & Advocacy and stakeholders to Governor Beshear regarding medical rationing (4/7/20)
  • New Jersey
    • Letter from Disability Rights New Jersey to Governor Murphy re medical rationing (4/3/20)
  • New York
    • Letter from Disability Rights New York to Governor Cuomo regarding medical rationing (3/26/20)
  • North Carolina
    • Letter from Disability Rights North Carolina to NC HHS Secretary Cohen regarding medical rationing (4/3/20)
  • Ohio
    • Letter from Disability Rights Ohio to Governor DeWine regarding medical rationing (4/3/20)
  • Oklahoma
    • Letter from Oklahoma Disability Law Center to Governor Stiff regarding medical rationing (3/31/20)
  • Oregon
    • Letter from Disability Rights Oregon to Governor Brown (3/24/20)
  • Pennsylvania  
    • Letter from Disability Rights Pennsylvania to Governor Wolf regarding medical rationing (3/27/20)
    • Governor Wolf’s response (3/30/20)
  • Texas
    • Letter from Disability Rights Texas and TX advocates to Governor Abbott and state leadership re medical rationing of care (4/6/20)
  • Utah
    • Letter from The Disability Law Center to Governor Herbert regarding rationing policies as well as housing, criminal justice, and other programs affected by COVID-19 (3/25/20)
  • Wisconsin
    • Open letter from Disability Rights Wisconsin to health care policy makers in the state (3/26/20) https://www.centerforpublicrep.org/

Resources

Media

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