HHS-OCR Complaints Re COVID-19 Medical Discrimination

States: Washington, Alabama, Tennessee, Utah, Oklahoma, Connecticut, North Carolina, Oregon, Nebraska, Arizona, DC, Texas

Date Filed: 2020

Agency: U.S. Department of Health and Human Services, Office for Civil Rights

Overview: These complaints concern illegal disability discrimination in medical care that is putting the lives of people with disabilities at imminent risk during the COVID-19 pandemic. The complaints challenge discriminatory crisis standard of care plans, no-visitor policies, and inaccessible testing that violate federal disability rights laws, including the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act (Section 504), and Section 1557 of the Affordable Care Act (ACA).

Crisis Standard of Care Complaints

Washington

Alabama

Tennessee

Utah

Oklahoma

North Carolina

Oregon

Arizona

North Texas

No-Visitor Complaints

Connecticut

MedStar Health (D.C.)

Texas

MHHS Texas

Other Complaints

Inaccessible Testing: Nebraska

HHS-OCR Documents

HHS-OCR Bulletin: Civil Rights, HIPAA, and COVID-19

HHS-OCR Resolution: Alabama

HHS-OCR Resolution: Connecticut

HHS-OCR Resolution: Tennessee

HHS-OCR Resolution: Utah

HHS-OCR Resolution: Texas and North Carolina

HHS-OCR Resolution: Medstar Health

HHS-OCR Resolution: Arizona

FAQs for Healthcare Providers during the COVID-19 Public Health Emergency: Federal Civil Rights Protections for Individuals with Disabilities under Section 504 and Section 1557

Additional Resources

Webinar: Disability Discrimination in the Rationing of Life Saving COVID Treatment: Who Gets Left Behind?

Applying HHS’s Guidance for States and Health Care Providers on Avoiding Disability-Based Discrimination in Treatment Rationing

Evaluation Framework for Crisis Standard of Care Plans 

Evaluation Framework for Hospital Visitor Policies

AADMD Statement on People with IDD and the Allocation of Ventilators During the COVID-19 Pandemic

50 State Crisis Standard of Care Plan Overview

Examining How Crisis Standards of Care May Lead to Intersectional Medical Discrimination Against COVID-19 Patients

Press Releases

Federal Civil Rights Resolution Makes Clear Hospital Visitor Policies Nationwide Must Accommodate Patients with Disabilities During COVID-19 Pandemic

State and National Groups File Federal Complaint Against Nebraska for Inaccessibility of COVID-19 Testing Program

Resolution of Federal Civil Rights Complaint Raises the Bar in Prohibiting Medical Discrimination Against People With Disabilities During COVID-19 Pandemic

COVID-19 Hotspots Arizona and Texas Crisis Standard of Care Plans Challenged by State and National Groups in Federal Complaints

Resolution of Federal Complaint Amidst Nationwide COVID-19 Surge Raises Bar in Prohibiting Blanket DNRs, Medical Discrimination Against People With Disabilities

Amidst Nationwide COVID-19 Surge, Health & Civil Rights Groups Secure Federal Approval of Revised Crisis Standards of Care Guidelines in Texas

NC Increases COVID-19 Medical Rationing Protections for Disabled Patients

Coalition of Civil Rights Groups and Legal Scholars Release Report on Intersectional Medical Discrimination During COVID-19

MedStar Health Agrees to End Discriminatory Treatment of Patients with Disabilities in Federal Resolution

Civil Rights Groups Secure Federal Approval of Revised Crisis Standards of Care in Arizona

Related Media

New York Times: Will Disabled People Be at a Disadvantage for Scarce Coronavirus Treatment?

U.S. News: Rights Groups: Coronavirus Treatment Plan Discriminates

Bloomberg Law: Virus Stokes Discrimination Concerns From Disability Groups (2)

NPR: Disability Groups File Federal Complaint About COVID-19 Care Rationing Plans

NPR: People With Disabilities Say Rationing Care Policies Violate Civil Rights

Seattle Times: People with disabilities would suffer if coronavirus care is rationed, advocates say in civil-rights complaint 

The Appeal: The Coronavirus Pandemic Has Brought Out Society’s Alarming Disregard for People With Disabilities

Bloomberg Law: Alabama’s Virus Ventilator Plan Latest to Draw Ire of Disabled

MyNorthwest: Advocacy group says people with disabilities could get denied COVID-19 treatment

AL.com: Alabama limit on ventilators discriminates against intellectually disabled, advocates claim

ProPublica: People With Intellectual Disabilities May Be Denied Lifesaving Care Under These Plans as Coronavirus Spreads

The Hill: Trump officials say people with disabilities must not be denied lifesaving coronavirus care

NPR: HHS Warns States Not To Put People With Disabilities At The Back Of The Line For Care

NBC News: Ventilators limited for the disabled? Rationing plans are slammed amid coronavirus crisis

New York Times: U.S. Civil Rights Office Rejects Rationing Medical Care Based on Disability, Age

WTVC-TV NewsChannel 9 News: TN disability rights advocates: State regulations discriminate by rationing critical care

New York Times: At the Top of the Covid-19 Curve, How Do Hospitals Decide Who Gets Treatment?

The Atlantic: Americans With Disabilities Are Terrified

Vox: “We’re being punished again”: How people with intellectual disabilities are experiencing the pandemic

Washington Post: Who gets a shot at life if hospitals run short of ventilators?

ABC: People with disabilities call for assurances of COVID-19 care

Daily Beast: In These States, the Disabled Could Go to the Back of the Ventilator Line

The Center for Public Integrity: State Policies May Send People With Disabilities to the Back of the Line for Ventilators

cheddar: Alabama Cuts Policy That Made it Harder for Disabled Coronavirus Patients to Get Ventilators

AL.com: Alabama disavows plan to limit ventilators for disabled during shortages

Alabama Political Reporter: Feds resolve complaint over “discriminatory” Alabama emergency ventilator policy

Bloomberg Law: Alabama Takes Down Allegedly Discriminatory Ventilator Guidance (1)

The Hill: Alabama removes controversial ventilator guidelines that denied coronavirus care to disabled

Nashville Post: Group files complaint against state triage guidance to HHS

Forbes: The Disability Community Fights Deadly Discrimination Amid The COVID-19 Pandemic

NPR: People With Disabilities Fear Pandemic Will Worsen Medical Biases

BMJ: US ventilator crisis brings patients and doctors face-to-face with life-or-death choices

CT News Junkie: Disability Rights Groups File Complaint With Office of Civil Rights

New York Times: Coronavirus Crisis Exacts Toll on People With Disabilities

Eyewitness News 3: Formal discrimination complaint filed on behalf of people with disabilities

Disability Scoop: Hospital No-Visitor Policies Endanger People With Disabilities, Advocates Say

CNN: How hospitals make tough ethical calls about which lives to save during a pandemic

Hartford Courant: Advocates want parents of people with intellectual disabilities to be excused from Connecticut’s no-visit rule at hospitals during the coronavirus crisis

NPR: Federal Government Asked To Tell Hospitals Modify Visit Bans

The CT Mirror: Hospital visitor bans fail disabled patients, complaint says

U.S. News: Hospitals Ordered to Allow Support for Disabled Patients

CT News Junkie: Connecticut Settles Disability Complaint Over Hospital Visitation

Hartford Business Journal: CT, Hartford HealthCare resolve civil rights complaint over visitor restrictions

Bloomberg Law: Disabled Allowed Support Visitors in Connecticut Hospitals (1)

Hartford Courant: State issues order allowing people with disabilities companions in hospital settings, settling civil rights complaint

New York Times: Connecticut Hospitals Ordered to Allow Visitors for Patients With Disabilities

Disability Scoop: Hospitals Told To Allow Visitors For Individuals With Disabilities

U.S. News: Coronavirus Crisis Exacts Toll on People With Disabilities

Lincoln Journal Star: Disability Rights Nebraska files complaint over Test Nebraska access

Bloomberg Law: Tennessee Updates Virus Plan After Disability Groups Protest

New York Times: Who Gets Lifesaving Care? Tennessee Changes Rules After Federal Complaint

AZ Central: Disability rights groups file federal complaint about ‘medical rationing’ in Arizona

KJZZ: Disability And Civil Rights Groups File Formal Complaint Vs. Arizona Over Crisis Standards Of Care Plan

Forbes: Disabled Discriminated Against By Crisis Health Plans, Groups Charge In Federal Complaints

NBC DFW: Pandemic Triage Guidelines Violate Federal Law, Discriminate: Complaint

New York Times: Should Youth Come First in Coronavirus Care?

Politico: Trump administration steps in as advocacy groups warn of Covid ‘death panels

AP News: Utah sets pandemic safeguards for people with disabilities

Salt Lake Tribune: Utah revises emergency plans to protect people with disabilities

The Hill: How an unexpected collaboration led Utah to amend its discriminatory triage plan

Open Minds: COVID, Rationing, & Consumers With Disabilities: Where Are We?

NPR: As Hospitals Fear Being Overwhelmed By COVID-19, Do The Disabled Get The Same Access?

CBS DFW: Revised Pandemic Rationing Plan Protects Disabled Texans From Being Sent To Back Of Line For Ventilators

The Federalist: Elderly And Disabled People Should Not Be Put At The Back Of The Line For COVID Care

Texas Standard: Revised Health Care Guidelines Protect Texans With Disabilities From Discrimination, If Rationing Occurs

NPR: HHS Civil Rights Office Tackles Health Care Discrimination Of People With Disabilities

CNN: Many doctors have negative perceptions of patients with disabilities — and that impacts quality of care, study finds

NPR: MedStar Health Changes COVID-19 Protocols Following Discrimination Complaint

Bloomberg Law: Arizona Amends Virus Care Standards to Protect Disabled Patients

AZ Central: Arizona revises its standards on pandemic ‘medical rationing’ after federal complaint

Associated Press: Arizona revises health standards around ‘medical rationing’

The Center for Public Integrity: Once Again, Some States are Choosing who Gets COVID-19 Care

Washington Post: MedStar Agrees to Deal in Federal Discrimination Case

Connecticut Coalition for Justice in Education Funding, Inc. v. Rell

State: Connecticut

Filed: 2017

Court: Supreme Court of Connecticut

Overview: The brief argued that the requirement that the state adopt standards that focus its special education efforts on students “who can profit from some form of elementary and secondary education,” rather than “spend fruitlessly on some at the expense of others,” violates the IDEA, which mandates that all students with disabilities be provided a free appropriate public education in the least restrictive environment. The brief focused on research demonstrating that even students with the most severe disabilities can learn and often exceed expectations, the legislative history of the IDEA making clear that all students with disabilities are guaranteed the right to an education, and the fact that failure to educate these students violates the ADA’s integration mandate which has been vital in ensuring that people with disabilities have access to opportunities that allow them to live in the community, learn in general education settings, obtain post-secondary education, and work in integrated jobs at competitive wages.

Excerpt: “The IDEA’s mandate that schools must educate all students with disabilities extends to children with an array of cognitive, physical, sensory, health, and alertness disabilities – those known as having a ‘profound’ disability because they have variable patterns of reflexive movements, minimal or inconsistent responses to stimuli, small response repertories, few voluntary behaviors, and/or variability in alertness and orienting. The obligation extends to these students because they are able to benefit from education, including education in the general curriculum; they are able to master functional and academic skills; they are able to learn and make progress in academic, functional, and developmental domains; and they are able to do so when educated with children without disabilities. Indeed, the science of educability does not justify educators, or any other persons, in assuming that a student’s current cognitive or communicative skills are fixed or absolute and thus represent the highest level of the student’s capacity.”

Case Documents

Amicus Brief: Connecticut Coalition for Justice in Education Funding, Inc. v. Rell

CT Supreme Court Opinion

Related Media

Press Release: “The Arc Responds to Connecticut Court Ruling on Education and Access for Children with Disabilities

The Arc Blog: “Good Outcome in Connecticut School Funding Case

Hartford Courant: “Parents Of Special Needs Children Join Appeal Of Education Funding Decision

In Re Elijah C.

State: Connecticut

Filed: 2016

Court: Connecticut Supreme Court

Overview: The brief supported a mother with intellectual disability and schizophrenia whose parental rights were terminated by the state’s child welfare agency, despite the agency failing to provide necessary accommodations to the mother throughout the process. The brief argued that termination of parental rights and neglect proceedings are “programs, services, and activities” that must comply with Title II of the ADA.

Excerpt: “Parents with intellectual and psychiatric disabilities face profound challenges when their government accuses them of unfitness. Though nine decades have passed since Justice Holmes upheld the forced sterilization of “mental defectives”…we are not so far removed from Holmes’ bias: Ten states still permit the involuntary sterilization of persons with disabilities; some in language that echoes Holmes’ disdain for its subjects. In Connecticut, parents with intellectual and psychiatric disabilities confront more than just a legacy of discrimination: They also contend with a know-it-when-you-see-it reunification standard and case law that forbids consideration of the ADA. Holding that compliance with the ADA is mandatory in termination and neglect proceedings will remove these two barriers to fair and accurate assessment of the parental fitness of persons with intellectual and psychiatric disabilities.”

Status: In 2017, the Court held that the mother was unable to benefit from reunification efforts. The Court further held that “it is the law of this state that child welfare proceedings are subject to the provisions of the ADA insofar as they involve the services, programs, or activities of any stage agency…the department’s failure to make reasonable modifications to its services, programs or activities to accommodate a parent’s disability would likely preclude a finding…that the department’s reunification efforts were reasonable under the circumstances…We therefore continue to encourage trial courts to look to the ADA for guidance in fashioning appropriate services for parents with disabilities.”

Case Documents

Amicus Brief: In Re Elijah C.

Connecticut Supreme Court Opinion