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Crisis Standards of Care in Illinois Hospitals

 

January 19, 2022 | by Bridget Hayman

The Omicron Variant and Limited Hospital and Healthcare Resources: Your Rights as a Person with a Disability

The number of Omicron cases in Illinois has begun to stabilize, but hospitalization numbers remain high. When patient numbers are high, hospitals use policies called ‘crisis standards of care’ to regulate how hospital services and resources are given to patients. These standards are especially important when hospital services and resources are limited, such as when a hospital’s beds are almost completely filled or the majority of ventilators are being used by patients.

The State of Illinois has guidance for crisis standards of care that all hospitals in our state must follow. Last year, Access Living and Equip for Equality successfully worked with the State of Illinois to ensure this guidance does not discriminate against people with disabilities who need hospital care. As a result, the state updated its guidance. That guidance, updated in November of 2021, is available here.

Here are the main things people with disabilities and advocates need to know about Illinois’ guidance for crisis standards of care:

  • Where necessary, State policy may also permit a support person to accompany a person to the hospital even if the hospital limits visitors due to COVID-19. A support person could be an interpreter, or an assistant, aide, or family member.
  • A hospital cannot deny treatment or prioritize limited resources, such as beds or ventilators, based on judgments that some individuals have a higher quality or value of life than others, or have greater social value in comparison to others.
  • A hospital cannot deny treatment or services to someone solely because the person has a preexisting physical or mental disability.
  • When a hospital has limited resources, such as beds or ventilators, and it must decide who should receive these limited resources, its decision must be based on how likely a person will survive in the short term (e.g. survive, recover, and be able to successfully leave the hospital after receiving treatment). In other words, the hospital’s decision cannot be based on a person’s age, disability, whether the person is expected to live a long life, or whether a person will need to be hospitalized longer due to the person’s disability.
  • A hospital’s decisions about the use of limited resources, and in particular its decisions regarding the allocation of limited resources such as beds or ventilators, should be made by a team of hospital workers called the triage team, rather than by a single individual. To ensure a decision is fair, the triage team should not include any hospital worker treating the patient in question. Additionally, if a patient disagrees with the decision of the triage team, the patient should be able to challenge the decision by asking other hospital staff to review the decision.
  • A hospital cannot pressure a person with a disability to agree to the removal of life-saving measures, or to agree to forego life-saving treatment.
  • A hospital cannot have a blanket policy to remove or withhold life-saving treatment from a person with a disability.
  • Hospitals may not impose blanket Do Not Resuscitate (DNR) policies, or make treatment contingent to signing a DNR.

Here is the full, detailed State policy on Illinois hospitals crisis standards of care.