Talk About Sexual Violence: A Conversation Guide for Health Care Providers

/in /by Pam Katz

The U.S. Bureau of Justice Statistics reports that people with intellectual/developmental disabilities (IDD) are sexually assaulted seven times more than those without disabilities. Transgender and gender non-conforming individuals also face high rates of sexual violence.

It is critical that healthcare professionals and their patients talk openly about sexual violence and abuse prevention.

Suggestions offered here are designed to facilitate conversations about sexual violence and provide patients with a safe environment in which to share their experiences and get the support they need.

Talk About Sexual Violence: A Conversation Guide for Patients With Disabilities

/in , /by Pam Katz

Every day, people with intellectual/developmental disabilities (IDD) are sexually abused.

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people also face high rates of sexual violence.

It is important that you talk openly with your medical providers about sexual abuse and abuse prevention.

This guide has suggestions to help you share your experiences with medical providers.

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

/in , , , , , /by Pam Katz

Black, Indigenous and People of Color, disabled people, higher weight people and older adults have historically experienced and continue to experience discrimination by medical professionals. In health care settings, members of these communities face pervasive negative biases and inaccurate assumptions about their value, quality of life, capacity to communicate and make decisions, and likelihood of survival.

During the COVID-19 pandemic, these biases can have serious and even deadly consequences. Such biases may be exacerbated when hospitals are faced with scarce resources and must make decisions about which critically ill patients should receive treatment. The “crisis standards of care” which are used by many states and hospitals to make these decisions, have too often reflected these biases. It is crucial that these standards be tailored to avoid unlawful discrimination.

This guide provides: (1) an explanation of what crisis standards of care are and how they may perpetuate discrimination; (2) the principles that should apply to crisis standards of care to prevent discrimination; (3) the civil rights laws that apply to the use of crisis standards of care; and (4) recommended strategies to ensure the non-discriminatory application of crisis standard of care guidelines.

Talk About Sexual Violence Phase 3 Introduction

/in , , , , , /by Pam Katz

Now in its third year, the Talk About Sexual Violence project will build on its success by not only preparing health care professionals to have much-needed conversations about sexual violence with people with IDD, but to know how to use a supported decision-making lens that supports victim-centered approaches. This flyer gives an overview of the Phase 3 project focus and related information.

The Arc Maryland v. Baltimore City et al

/in , , , , /by Pam Katz

State: Maryland

Filed: 2021

Court: U.S. District Court for the District of Maryland

Plaintiff: The Arc Maryland

Defendants: Baltimore City, Queen Anne’s County, Carroll County, Garrett County, Somerset County, Talbot County

Counsel: The Arc, Disability Rights Maryland, Brown & Barron LLC

Overview: The Arc Maryland filed a federal lawsuit alleging that six jurisdictions in Maryland, including Baltimore City, discriminate against people with IDD by denying them opportunities to access COVID-19 vaccinations inconsistent with the State’s Executive order and Vaccination Plan. This discrimination puts lives at stake and violates the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.

While vaccination sites must offer vaccines to the public in accordance with Maryland’s state vaccination plan, the five counties and Baltimore City exclude individuals with IDD in their list of who is eligible, preventing those with IDD from accessing vaccinations.

It is well established that COVID-19-related fatality rates among people with IDD who test positive for COVID-19 are nearly three times greater than the mortality rates among the general population who are positive for the virus. People with IDD also face heightened risk because many rely on caregivers or direct support professionals who provide assistance with activities of daily living, for which social distancing is often not possible. Frequently, such caregivers serve multiple people raising risks of transmission. Despite advocacy from The Arc Maryland, people with IDD are not getting equal access to vaccines, compelling the need for the lawsuit.

Case Documents

Complaint

Motion for a Temporary Restraining Order

Related Media

Press Release: Vaccine Discrimination: Disability Advocacy Groups File Federal Lawsuit Alleging 6 Maryland Jurisdictions Discriminate in Vaccine Process

Baltimore Sun: Maryland organization that supports people with disabilities sues five counties and Baltimore City, alleging vaccine discrimination

The Maryland Daily Record: 6 Md. jurisdictions sued over vaccine eligibility for people with disabilities

The Garrett County Republican: Garrett County sued over vaccine info for people with disabilities

The Cumberland Times-News: Organization alleges vaccine discrimination

National Journal: Disability communities face barriers to COVID-19 vaccines

Baltimore Sun: Maryland disability rights group dismisses lawsuit against Baltimore City and three of five counties for alleged vaccine discrimination

Wisconsin Legislature v. Palm

/in , , , /by Pam Katz

State: Wisconsin

Filed: April 29, 2020

Court: Wisconsin Supreme Court

Overview: National and state disability and aging groups filed an amicus brief explaining the heightened risks to people with disabilities and older adults during the COVID-19 pandemic in a case challenging Wisconsin’s stay-at-home order. The brief argued that should the order be enjoined, more Wisconsinites will inevitably contract the virus and people with disabilities and older adults will experience life-threatening consequences at a far higher rate than the rest of the population. This will, in turn, overwhelm an already overburdened healthcare system (dealing with limited supplies of crucial equipment), which will disproportionately harm people with disabilities and older adults who face an exponentially higher risk of contracting the virus in a life-threatening capacity that requires hospitalization.

Excerpt: “The spread of COVID-19 is especially dangerous to people with disabilities and older adults for several reasons. First, for health-related reasons, people with disabilities and older adults are at greater risk of serious complications and death if exposed to the virus. Second, they are more likely than other adults to live in congregate settings, such as group homes or nursing homes where COVID-19 rates of infection and fatality have been disproportionately high and will only worsen if the Order is enjoined. Third, people with disabilities and older adults, whether living in congregate or community-based settings, often require assistance from a workforce that cannot maintain social distance while supporting them in their daily lives. The nationwide shortage of personal protective equipment (“PPE”) puts both staff and those they are supporting at higher risk of contracting the virus, which will only be exacerbated if the Order is enjoined. Fourth, people with disabilities and older adults are at greater risk of being denied life-saving medical treatment if an uncontrolled outbreak forces rationing of medical care, due to the likelihood of discrimination. Finally, people with disabilities and older adults are more likely to live in poverty and experience homelessness, which is an additional risk factor for contracting COVID-19. For all these reasons, risks to the lives of persons with disabilities and older adults would only be heightened if this Court were to enjoin the State’s efforts to reduce the spread of COVID-19.”

Case Documents

Amicus Brief

Related Media

Press Release: Over 30 Groups File Amicus Brief in Wisconsin Regarding Heightened COVID-19 Risks to People with Disabilities & Older Adults

Milwaukee Journal Sentinal:
Wisconsin Supreme Court strikes down Wisconsin’s stay-at-home order that closed businesses to limit spread of coronavirus

New York Times: Wisconsin Supreme Court Strikes Down Stay-at-Home Order

HHS-OCR Complaints Re COVID-19 Medical Discrimination

/in , , , , , , , , , , , , , , /by Pam Katz

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 I/DD 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

Doe v. Trump

/in , , , , /by Pam Katz

State: Oregon

Filed: February 6, 2020

Court: Ninth Circuit Court of Appeals

Overview: This brief supports the preliminary injunction of the Presidential Proclamation on the Suspension of Entry of Immigrants Who Will Financially Burden the United States Healthcare System as discriminatory against people with disabilities. The brief argues that the Proclamation attempts to replace the multi-factor public charge test provided by Congress with a single-factor test based exclusively on whether a visa applicant has “approved” health insurance to determine if they will be a “financial burden.”

Excerpt: “The Proclamation would re-impose these discriminatory barriers, requiring immigrants to provide proof of health insurance coverage through ‘approved’ plans that are not accessible for most people with disabilities due to medical underwriting, pre-existing condition exclusions, and other requirements. The purported goal of the Proclamation is to reduce the costs of uncompensated care, yet it excludes health insurance options available to individuals with disabilities that have been shown to reduce these costs, including subsidized Affordable Care Act (“ACA”) marketplace health plans and Medicaid. The Proclamation thus acts as a de facto bar to entry for immigrants with disabilities without any rational link to its alleged purpose.”

Case Documents

Amicus Brief