Latest Updates Coronavirus (COVID-19) - Disability Issues in Review 3-30-20
Read about the latest updates on how Coronavirus (COVID-19) may effect you.
Latest Updates Coronavirus (COVID-19)
The Office of Civil Rights Warns States About Discriminatory Denial of COVID-19 Treatment for People with Disabilities
The Office for Civil Rights issued an advisory letter this weekend acknowledging that it enforces laws which prohibit discrimination on the basis of disability in Health and Human Services funded health programs or activities. Specifically, they said “These laws, like other civil rights statutes OCR enforces, remain in effect. As such, persons with disabilities should not be denied medical care on the basis of stereotypes, assessments of quality of life, or judgments about a person’s relative “worth” based on the presence or absence of disabilities. Decisions by covered entities concerning whether an individual is a candidate for treatment should be based on an individualized assessment of the patient based on the best available objective medical evidence."
Governor Newsom, California Department of Health Care Services, Department of Managed Health Care and the California Department of Public Health put out a joint bulletin also reminding health care professionals of their obligation under state law to provide equal access to health care to people with disabilities, treatment of Medi-Cal beneficiaries diagnosed with COVID-19 and guidance from the Code of Medical Ethics.
DRC and disability advocates sound the alarm warning health care professionals against discriminatory practices that deny treatment to people with disabilities. https://www.disabilityrightsca.org/post/disability-rights-california-calls-upon-state-policy-makers-and-medical-providers-to-act-now
Trump Questions the Need for Ventilators While People Wait in Peril
This week the administration’s guidance on ventilators has moved from the ridiculous to desperate. The State of New York asked for 30,000 ventilators but FEMA has only agreed to send 400. The President claimed he did not believe New York’s demand for 20,000-30,000 ventilators was really necessary. He questioned why there was a need for so many when in the past hospitals typically only required 1 or 2. After advising states to find their own ventilators, this week the Surgeon General wrote an open letter to health care workers advising them to ventilate two patients with one mechanical ventilator, as a last resort.
Federal Government Broadens Access to Health Care for COVID-19 Care
The federal government helped healthcare providers combat and contain the spread of 2019 Novel Coronavirus Disease (COVID19) by authorizing the Centers for Medicare and Medicaid Services to temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements. Formally known as “1135 waivers”, these modifications include:
- Skilled Nursing Facilities (SNF) services without a qualifying 3 day hospital stay; and for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period;
- Waiver of conditions of participation or other certification requirements;
- Waiver of program participation and similar requirements;
- Waiver of preapproval requirements;
- Access to emergency Medical Treatment and Labor Act (EMTALA); and
- Waiver of limitations on payment for health care items and services furnished to Medicare Advantage enrollees by non-network providers.
DRC provides information to the public on Changes to Medi-Cal Services because of COVID-19, Access to Treatment, Free Testing and Telephonic State Hearings. https://www.disabilityrightsca.org/post/coronavirus-healthcare
State of California Fails to Protect Renters
Governor Gavin Newsom issued Executive Order N-37-20 which claims to place a moratorium on evictions, but in actuality leaves renters vulnerable during the worst possible time. The Order extends the deadline to respond to an unlawful detainer summons from five court days to sixty, if the complaint is based on nonpayment of rent and the tenant can establish that they previously paid rent, provided notice of inability to pay, and show verifiable documentation of the reason.
The Order fails because:
- A landlord may still file an eviction for nonpayment of rent during the state of emergency.
- A tenant will have to file a document – likely an answer – within the regular five days specified within CCP 1167 in order to avoid default judgment.
- In order to prove that they could avail themselves of these protections – they would have to obtain documentation that may be difficult to obtain with a statewide shutdown order – signed employer letters, letters of termination, etc.
- Because a landlord is likely to seek default judgment before the sixty-day extension of the answer period, this Order does not provide any protection for tenants.
- The order does not specify the time period in which tenants could pay back-rent.
- Also starkly missing are no-fault evictions which will only exacerbate the pandemic.
DRC provides plain language analysis of the State’s order on housing which makes it clear there is no blanket moratorium on evictions, and links to city and county housing relief plans. https://www.disabilityrightsca.org/post/coronavirus-housing
$2 Trillion CARES Act Stimulus Lacks Sufficient Funding for People with Disabilities
The CARES Act signed into law this week includes:
- Protection for all people, including people on means-tested and other disability programs, like Social Security Disability (SSDI), Supplemental Security Income (SSI), and Medicaid, are eligible for rebates and emergency income relief provided in the CARES Act;
- Small business loans for non-profit Medicaid providers;
- Education funding, including for the provision of special education services;
- Extended Money Follows the Person (MFP) funding and spousal impoverishment provisions through November 30, 2020;
- Provision allowing direct support professionals like regional center and IHSS providers to assist people with disabilities during a short-term stay; and
- More funding for housing for people with disabilities, nutrition assistance, Centers for Independent Living (CILs), and some aging programs.
The bill DID NOT:
- Protect the Individuals with Disabilities Education Act (IDEA) and Rehabilitation Act from state waivers that would deny students special education services during the crisis;
- Provide more funding for Medicaid HCBS;
- Provide more funding or support for personal care attendants (PCAs) and direct support professionals (DSPs);
- Include coverage of family members of adults with disabilities who step in when other supports become unavailable because of the crisis;
- Permanently reauthorize Money Follows the Person;
- Not specify 90-day refills of prescriptions and medical supplies for Medicaid, CHIP, or private insurance and also does not include people with disabilities who rely on controlled;
- Recognize direct care workers as essential personnel so they can travel and access personal protective equipment (PPE); and
- Direct the US Department of Health and Human Services’ Office of Civil Rights to issue guidance about illegal disability discrimination in rationing of COVID-19 treatment and care.
For full analysis view here: https://www.disabilityrightsca.org/post/coronavirus-stimulus-federal-aid
State Authorizes Restrictions on Admissions and Release for Eligible Residents in State Hospitals and Developmental Centers
Gov. Newsom issued Executive Order N-35-20 authorizing the Department of State Hospitals and the Department of Developmental Services discretion to indefinitely stop admissions and discharge of residents in state hospitals and developmental centers due to the COVID-19 crisis.
State hospital patients subject to involuntary psychiatric holds retain the right to treatment in the least restrictive environment. To forgo discharge of a patient who is otherwise eligible for a less restrictive level of care violates that patient’s statutory rights.
Developmental centers are the placement of last resort when there are no community supports that can meet the needs of a person with developmental or intellectual disability. Any moratorium on new admissions places these individuals at significant, ongoing risk. The moratorium on admissions heightens the need for additional planning for appropriate placement if the developmental center is not an option. Residents who are eligible for release should be able to continue to use Section 4800 of the Welfare and Institutions Code, which requires DDS to assist the individual to file a petition for habeas corpus with the appropriate court.
DRC explains state hospital appeal process for residents who want to challenge discharge or admissions decision.
DRC offers planning tools for regional center consumers who have vendors and in-home service providers. https://www.disabilityrightsca.org/post/coronavirus-regional-centers