A ‘prone team’, wearing personal protective equipment, prepares to turn a COVID-19 patient onto his stomach in an intensive care unit at a hospital in Stamford, Connecticut. (John Moore/Getty Images/TNS)
Federal officials remind medical professionals nationwide that denying treatment because a person has a disability is often illegal, even if resources are scarce.
In advice released late last week, the U.S. Department of Health and Human Services’ Office of Civil Rights advises providers that civil rights protections for persons with disabilities “remain in full effect” amid the COVID pandemic -19.
“Our civil rights laws stand no matter what, including disasters or emergencies, and it’s critical that we work together to ensure fairness in everything we do for all patients,” said Health and Human Services Secretary Xavier Becerra. “The pandemic has brought to light the disparities in our healthcare system and provided us with a new opportunity to address them in a meaningful way. Protecting people with disabilities from discrimination in crisis situations is a critical part of this work, and we continue to assess our department-wide operations to ensure accessibility.
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Health care providers covered by Section 504 of the Rehabilitation Act or Section 1557 of the Affordable Care Act cannot refuse or limit people’s participation in programs or services based on of a disability, the guidelines state. This may include hospitalization, long-term care, intensive treatment and intensive care as well as the administration of COVID-19 tests, medical supplies and medications.
In addition, officials noted that federal civil rights laws apply to state crisis care standards plans and other efforts to ration scarce resources. Since the start of the pandemic, the HHS Office for Civil Rights has stepped in to address concerns from advocates in several states that crisis standards of care plans discriminate against people with disabilities.
The new guidelines, which are presented in the form of frequently asked questions, include examples of scenarios health care providers might find themselves in and explain how civil rights laws would apply.
When resources are scarce during a public health emergency such as the pandemic, the guidelines state that health care providers “should analyze the patient’s specific ability to benefit from the treatment sought, without stereotyping or prejudice about disability, including including harmful biases and quality of care assessments”. life, or judgments about a person’s relative “worth” based on the presence or absence of disabilities. »
However, people can be denied care if it is unlikely to be effective given their particular situation, according to the guidelines.
“During a public health emergency like the COVID-19 pandemic, biases and stereotypes can impact decision-making when hospitals and other providers are faced with limited resources,” said Lisa J. Pino, director of the HHS Office for Civil Rights. “OCR will pursue strong enforcement of federal civil rights laws that protect people with disabilities from discrimination, including where crisis care standards are in effect. »
Maria Town, president and CEO of the Americans with Disabilities Association, said disability advocates have been pushing for this kind of advice since the pandemic began.
“While we wish these guidelines had been released sooner, the FAQs released by the department will provide healthcare providers and patients with disabilities with vital information to ensure that no person with a disability is denied necessary care during a crisis, a fear that continues to be all too real as we enter the third year of the pandemic,” she said.