Civil rights complaint targets rationing of health care in Idaho


BOISE (AP) – Seniors’ advocacy group has filed civil rights lawsuit against Idaho over state guidelines on “standards of care in crises” for hospitals overwhelmed with patients in the middle of the coronavirus pandemic.

The Justice in Aging group on Tuesday asked the US Department of Health and Human Services to investigate Idaho’s healthcare rationing plan – claiming it discriminates against the elderly and especially black adults and older Native Americans using factors such as age to prioritize which patients may have access. to vital care.

“Seniors face a serious risk of discrimination, resulting in death,” because of Idaho’s crisis standards, Justice for Aging lawyers wrote in their letter of complaint.

Other states have faced similar complaints in recent months. Since the start of the pandemic, public health officials in Arizona, Utah and North Texas have changed their crisis care plans amid complaints from Justice in Aging and other advocacy organizations rights of persons with disabilities and civil rights.

Idaho activated crisis care standards earlier this month after a wave of COVID-19 patients depleted available resources at most hospitals in Idaho.

Crisis care standards are designed as ethical and legal guidelines for rationing health care, directing scarce resources like intensive care unit beds or ventilators to the patients most likely to survive. When resources are scarce, other patients may be treated with less effective methods or, in extreme cases, benefit from pain relief and other palliative care.

Idaho Department of Health and Welfare spokesman Greg Stahl said on Friday that the department was not aware of the complaint.

“The Patient Care Strategies for Rare Resource Situations document is based on ethical obligations that include the duty to care, the duty to manage resources, distributive and procedural justice, and transparency,” Stahl wrote in an email to the ‘Associated Press. “This guiding principle is that all lives have value and that no patient will be discriminated against on the basis of disability, race, color, national origin, age, sex, sex or the exercise of conscience and religion. “

But Justice in Aging said the standards discriminate by using patients’ remaining “years of life” as a tie-breaker if two generally similar patients need the same resources.

“The decisive language in Idaho is not limited to situations where there are large age differences between the two people in need of care. According to his terms, it would be applied in situations where there may be very little difference, such as a 60-year-old man and a 61-year-old man, ”Justice in Aging attorneys wrote at the Bureau of Health and Human Services. social. Acting Director of Civil Rights Robinsue Frohboese.

The letter added: “When they are so clinically similar that they require a tie-breaker, it would lead to an absurd and ageist result to deny the 61-year-old man treatment simply because he only has a year more.”

Idaho’s standards also include a “sequential organ failure assessment” or “SOFA” score to help physicians determine the likelihood of patients surviving illness or injury.

The score takes into account the functioning of the main organ systems of the patients. But attorneys for Justice for Aging say recent studies by researchers at Yale University indicate it’s not an accurate measure of survival in black adult patients.

Using age as a tiebreaker violates the Federal Age Discrimination Act of 1975 and the Affordable Care Act, said Regan Bailey, director of litigation for Justice for Aging.

Individual patient assessments in the guidelines already take into account the impact of aging on the human body, Bailey said, and using it again as a baseline is essentially counting twice the age at the expense of older patients. aged.

“We want the state not to include age as a stand-alone factor,” and move away from SOFA scores, Bailey. “We are concerned about the continued reliance on a tool that has been shown to disproportionately remove black people from life-saving care. “

Several entities were involved in the development of Idaho’s crisis plan, including a Disaster Medical Advisory Committee, the Board of Medicine, the Idaho State Independent Living Council, officials from the Attorney General’s office of the ‘Idaho and the Department of Health and Welfare, Stahl said. So far, tiebreakers have not been used in Idaho, he said.

“The need for a tie-breaker should be very rare,” Stahl wrote.

The number of coronaviruses in Idaho continued to rise, leading to record hospitalization rates. And the state’s coronavirus vaccination rates remain among the lowest in the country, with only about 51% of eligible residents fully vaccinated.

Hospitals and healthcare providers struggle to treat everyone, with new patients sometimes staying on stretchers for days as doctors desperately try to find enough beds and other resources.

Hospital officials have also reported that the mechanical systems their hospitals use to deliver oxygen to hospital rooms are also struggling to keep up with the high demand from the massive influx of COVID-19 patients.

According to the Idaho Department of Health and Welfare, more than 760 coronavirus patients were hospitalized statewide as of September 20, including 202 people in intensive care unit beds.


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