A new proposed rule would keep medical providers funded by the U.S. Department of Health and Human Services (HHS) from discriminating against people with disabilities.
The rule would prohibit making medical decisions based on outdated stereotypes, or on formulas that value the lives of people with disabilities less than others. It also would improve accessibility in many areas, including medical equipment like scales and exam tables.
The rule updates critical parts of Section 504 of the Rehabilitation Act of 1973. Section 504 prohibits discrimination in federally funded programs against otherwise qualified people on the basis of disability.
Major Provisions
In a nutshell, here’s what the rule says.
Medical Treatments
The rule seeks to address “pervasive discrimination on the basis of disability in accessing medical care, which leads to significant health disparities and poorer health outcomes for individuals with disabilities.”
To do so, it prohibits HHS-funded medical providers from making medical treatment decisions based on biases or stereotypes about people with disabilities. These include, for example, judgments that someone with a disability will be a burden on others.
Treatment Assessment Methods
The rule prohibits HHS-funded medical providers from assessing the value of a given medical treatment in a discriminatory way – for example, by valuing the life of a person with a disability less than someone else’s life.
Child Welfare Programs and Activities
The rule prohibits discrimination in areas like parent-child visitation, reunification services, child removals and placements, guardianship, parenting skills programs, foster and adoptive parent assessments, and in- and out-of-home services.
Web and Mobile Accessibility
The rule defines what accessibility means for web and mobile applications. It also provides specific technical standards for compliance with Section 504 – the same standards as those currently proposed under the Americans With Disabilities Act.
Accessible Medical Equipment
HHS notes that a lot of medical equipment is inaccessible to people with disabilities, such as exam tables that are too high and can’t be lowered, mammography machines that require a person to stand, and weight scales that don’t accommodate wheelchairs. The rule establishes enforceable standards for making this equipment accessible.
Community Integration
The rule calls for providing appropriate community-based services to people with disabilities, if they want those services and if that desire can be reasonably accommodated.
ADA Compliance
The rule also updates Section 504 of the Rehabilitation Act to make it more consistent with the ADA. Updates include:
Service animals: HHS-funded providers must permit the use of trained service dogs except under certain circumstances.
Facilities and equipment maintenance: Accessible facilities and equipment must be properly maintained.
Mobility devices: HHS-funded providers must allow people to use manually powered mobility devices such as wheelchairs in areas where other people walk, and to use powered mobility devices under certain circumstances.
Retaliation and coercion: HHS-funded providers may not retaliate against someone for filing a complaint or objecting to something that’s unlawful under Section 504.
Building standards: HHS-funded providers that build new facilities or alter existing ones must comply with U.S. Justice Department accessibility standards.
Praise for Proposed Rule
Disability rights groups across the U.S. say the rule would implement long-overdue protections against discrimination for people with disabilities.
“The proposed rule would end the use of formulas that discount a person’s life because of a disability and ensure that people with disabilities have access to critical healthcare services and devices,” the National Disability Rights Network (NDRN) says in a statement. “During the Covid pandemic, our members, the protection and advocacy agencies, saw firsthand the discrimination people with disabilities experienced, discrimination that in some tragic cases led to permanent harm and even death.”
For example, it says that early in the pandemic, hospitals took life-saving medical equipment away from people with disabilities to give to other patients.
“People with disabilities should not be denied medical treatment because a lower value is placed on their life because they have a disability,” the NDRN says. “It is discrimination, plain and simple, that is rooted in stigma, ableism, and a misconception about the quality of life of Americans with disabilities. NDRN fully supports these proposed regulations and encourages swift enactment.”
Maria Town, president of the American Association of People with Disabilities, says in a statement that the proposed rule is nothing short of “lifesaving” and would improve health equity for people with disabilities.
“Despite the fact that people with disabilities are more reliant on our health care and human services systems and experience some of the greatest healthcare costs, our healthcare system routinely discriminates against disabled people in a multitude of ways,” she says. “From inaccessible doctors’ offices and examination equipment, to a lack of access to effective communication, to physicians who believe that people with disabilities have an inherently lower quality of life than those without disabilities and base treatment decisions off of this inaccurate bias.”
Comments on the proposed rule are due by Nov. 10. TwP