HHS Warns States Not To Put People With Disabilities At The Back Of The Line For Care States are preparing guidelines for when there's not enough care to go around. Disability groups are worried that those standards will allow rationing that excludes people with disabilities.

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

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Around the country, doctors are facing a difficult question. If resources are limited, will they be asked to decide whose life will be saved? A federal civil rights office issued some guidance today, and NPR's Joseph Shapiro is here to tell us about it.

Hi, Joe.


MARTIN: So what did you learn? And why did the Department of Health and Human Services think there was a need to issue the guidelines today?

SHAPIRO: Because states right now - they're preparing for a situation where there's not enough care to go around, like a shortage of ventilators. So they're writing crisis of care standards. But disability groups are worried that those standards will allow rationing decisions that are going to exclude people with disabilities and the elderly. And we've seen this happen, right, in Italy, where the - age is already a factor for who gets scarce care like ventilators.

So today, the Office for Civil Rights at the Department of Health and Human Services issued guidance. And those rules emphasize - they say civil rights laws - they still apply in a pandemic. And we have some tape. This is Roger Severino, who heads the HHS Office for Civil Rights.


ROGER SEVERINO: Particularly, we're concerned that crisis standards of care may start relying on value judgments as to the relative worth of one human being versus another based on the presence or absence of disability. We're concerned that stereotypes about what life is like living with a disability can be improperly used to exclude people from needed care.

MARTIN: Joe, were there any specific situations in specific states, for example, that he talked about?

SHAPIRO: Well, he did say his office is open, or it's about to open, investigations of complaints in multiple states. He didn't say which states. But in the last several days, disability groups in four states - Tennessee, Kansas, Washington and Alabama - have filed complaints. In Kansas and Tennessee, groups say state guidelines would allow doctors to deny care to some people with traumatic brain injuries or ones who use home ventilators to help them breathe.

And a group of New Yorkers have - who already use ventilators - they wrote a letter expressing their fears to Governor Andrew Cuomo. These are people that they work and they're active, but they need home or portable ventilators to help them breathe. And they're worried about existing state guidelines that apply if they go to the hospital and they think would allow a hospital to take their personal ventilators and give them to someone else.

MARTIN: So are these guidelines from the federal government the final word on this?

SHAPIRO: They're clear guidelines. They're a warning to states. But there's something else that was buried in the guidelines today that caused some confusion. And then there's a line about something called the Public Readiness and Emergency Preparedness Act, which may protect some health care providers from liability for treatment decisions, that seemed to contradict the message of Roger Severino, the head of the Office for Civil Rights, that civil rights laws still apply.

And he was asked, and he said, it's a matter to be decided by another office, the general counsel at the Department of Health and Human Services. But the overall message today was to tell states, when you come up with rules for allocating scarce resources, do not put people with disabilities, do not put the elderly at the back of the line.

MARTIN: That's NPR's Joe Shapiro. Joe, thank you so much.

SHAPIRO: Thank you.

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