Tennessee reaches agreement on rationing medical care

Published 12:37 pm Monday, June 29, 2020

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NASHVILLE (AP) — Federal officials announced Friday they have reached a resolution with Tennessee over complaints filed by disability advocates who were concerned that people with disabilities could be denied life-saving treatment like ventilators because of the coronavirus crisis.
Tennessee’s disability advocates and their national counterparts raised the issue here and at the federal level in March after discovering a 2016 state document called “Guidelines for the Ethical Allocation of Scarce Resources,” the Chattanooga Times Free Press reports.
They charged the Tennessee document would allow health care providers to exclude people with disabilities from critical care, including ventilators, in violation of the Americans with Disabilities Act.
Gov. Bill Lee’s administration, which inherited the document, was taken by surprise, and Lee soon said his administration did not intend to rely on it or implement it. On Friday, officials announced that Tennessee agreed to update its crisis medical standards of care to ensure the state does not discriminate against people based on disability or age by rationing their care.
The complaint against Tennessee was brought by a coalition of national disability advocates, including The Arc and the Center for Public Representation, together with Tennessee advocates led by Disability Rights Tennessee and the Civil Rights Enforcement and Education Center.
The Tennessee agreement is the fourth such coronavirus-era agreement struck with a state following complaints filed by disability advocacy groups, the U.S. Department of Health and Human Services’ Office for Civil Rights said.
“We commend Tennessee for updating its policies to ensure that hospitals do not deny life-saving care during a crisis based on stereotypes about disabilities or other impermissible factors,” the federal office’s director, Roger Severino, said in a statement. “Our civil rights laws reflect the principle that we are all created with equal dignity and worth.”
Advocates say the agreement sets “key precedent-setting changes” in Tennessee’s policy. For instance, people can no longer be excluded from medical treatment based solely on a diagnosed disability or because an individual might require more time or resources to recover due to a disability.
Advocates also say that under the new rules, Tennessee is “the first state to explicitly eliminate longer-term survivability as a consideration in treatment decisions, changing its guidance for medical personnel to consider only ‘imminence of mortality.'”
Another change prohibits the reallocation of personal ventilators of a patient who uses a ventilator in their daily life to another patient deemed more likely to benefit from it. It’s another first for the federal office, advocates said.
“Today’s resolution makes clear that policies common in many states’ medical rationing plans … constitute illegal disability discrimination,” said Alison Barkoff, director of advocacy at the Center for Public Representation.

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