OCR Supplies Technical Help to the State of Arizona to Guarantee Disaster Requirements of Care Shield Towards Age and Incapacity Discrimination

The United States Department of Health’s Office of Human Rights (OCR) has resolved a complaint against the state of Arizona regarding its Crisis Standards Policy (“CSC”). The complaint was filed by the Arizona Center for Disability Law, the Arc of Arizona, the Arizona Center for Law in the Public Interest, the Native American Disability Law Center, and a number of national and local advocacy groups on disability and aging. OCR provided technical assistance and, through a collaborative process, revised the Arizona state guidelines to reflect legal requirements and best practices related to the needs of people with disabilities and older adults. These efforts build on the continued work of OCR to ensure non-discrimination during COVID-19.

As a result of this work, Arizona has issued an updated CSC plan that includes:

• Prohibiting the use of a patient’s long-term life expectancy as a factor in the allocation and reallocation of scarce medical resources;
• Prohibition of using categorical exclusion criteria, instead an individualized assessment based on the best available objective medical evidence;
• Prohibition of using resource intensity and duration as criteria for the allocation or reallocation of scarce medical resources. This protects patients who require additional treatment resources because of their age or disability from receiving lower priority life-saving care because of those needs.
• Include appropriate changes in the use of clinical tools to assess the likelihood of short-term survival, if necessary for accurate use in patients with underlying disabilities;
• Introduce new safeguards against providers who induce patients to consent to withdrawal or withhold life support to clarify that patients may not be pressured to make certain advanced care planning decisions or that patients may consent to a particular advanced care planning decision need to continue receiving services from an institution; and
• Inclusion of language to ensure that long-term ventilator users are protected from having a ventilator they bring with them being taken to a hospital for removal to be passed on to someone else.

“The productive collaboration between OCR, local stakeholders who filed the complaint, and the state of Arizona led to the development of plans to help ensure that older adults and people with disabilities have non-discriminatory access to during this public health emergency Preserve medical resources, “said Robinsue Frohboese. Deputy Director of the HHS Civil Rights Office. “The COVID-19 pandemic has posed significant challenges to our health systems, but the basic principles of non-discrimination remain. All people should be treated with dignity and respect and must not be denied access to resources simply because of their person. “

The new Arizona CSC guidelines can be found at https://www.azdhs.gov/covid19/documents/healthcare-providers-sdmac/covid-19-addendum.pdf.

For more information on how OCR protects civil rights during COVID-19, please visit https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/index.html.

Learn more about non-discrimination based on gender, race, color, national origin, age and disability; Conscience and freedom of religion; The laws on protecting the privacy of health information and filing a complaint with OCR can be found at www.hhs.gov/ocr.

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May 25, 2021, 4:32 PM GMT

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