Policies, Guidance, Reports, and Expert Perspectives

HHS Civil Rights guidance: Racial and Ethnic Discrimination in Covid-19 treatments will threaten Federal funding – On Monday, July 20, the Department of Health and Human Services Office of Civil Rights issued guidance warning recipients of Federal funds, including state and local agencies, hospitals, and other health care providers, that unlawful discriminatory practices in treatment during the Covid-19 pandemic constitute violations of Title VI of the Civil Rights Act. The guidance states that these providers should:

• Adopt policies to prevent and address harassment or other unlawful discrimination on the basis of race, color, or national origin.
• Ensure – when site selection is determined by a recipient of HHS funds – that Community‐Based Testing Sites and Alternate Care Sites, are accessible to racial and ethnic minority populations. For example, to support this end, recipients may consider making walk‐in testing sites available in urban areas where racial and ethnic minority populations may not have access to vehicle transportation, or providing home visitation testing in rural areas where transportation is a challenge for racial and ethnic minorities.
• Confirm that existing policies and procedures with respect to COVID‐19 related services (including testing) do not exclude or otherwise deny persons on the basis of race, color, or national origin.
• Ensure that individuals from racial and ethnic minority groups are not subjected to excessive wait times, rejected for hospital admissions, or denied access to intensive care units compared to similarly situated non‐minority individuals.
• Provide ambulance service, non‐emergency medical transportation, and home health services – if part of the program or services offered by the recipient – to all neighborhoods within the recipient’s service area, without regard to race, color, or national origin.
• Appoint or select individuals to participate as members of a planning or advisory body, which is an integral part of the recipient’s program, without exclusions on the basis of race color, or national origin.
• Assign staff, including physicians, nurses, and volunteer caregivers, without regard to race, color, or national origin. Recipients should not honor a patient’s request for a same‐race physician, nurse, or volunteer caregiver.
• Assign beds and rooms, without regard to race, color, or national origin. For multi‐bed rooms, recipients should not grant a patient’s request to exclude a roommate of a particular race; and for single‐bed rooms, recipients should assign patients in a non‐discriminatory manner.
• Make available to patients, beneficiaries, and customers information on how the recipient does not discriminate on the basis of race, color, or national origin in accordance with applicable laws and regulations.

Rent freezes are ending – and a wave of evictions will sweep America – This article written by national housing policy expert (and IU McKinney School of Law distinguished alumna) Emily Benfer discusses how between 20-28 million American renters risk eviction in the near future due to challenges arising during the Covid-19 epidemic. The rise in job losses and furloughs, reopening of court systems, expiration of state- and local temporary eviction moratoria, and the end of federal unemployment assistance all contribute to place a large share of America’s renters at risk. The impending eviction “avalanche,” which has a disproportionate adverse effect on Latinx and Black populations, “will bury entire communities and result in a cascade of additional losses to financial well-being, health and housing opportunities.”

The Mask Debate: From communication to politics to human compassion to enforcement – A well-written article from the Roanoke (VA) Times discussing the complex web of issues surrounding mask wearing in the United States. The Surgeon General has stated his opposition to a national mask mandate. Public health law expert Lindsay Wiley (among others, including the author of this blog post) has stated that state and local authorities have strong legal bases for putting mask requirements in place.

Report: Ethical Guidance on Access to Drugs in Covid-19 Reponse – a national advisory group of health care ethicists and other experts convened by the Hastings Center released this guidance on the therapeutic and palliative treatment decisions during Covid-19. Building on the Hasting Center’s Ethical Framework for Health Care Institutions and Guidelines for Institutional Ethics Services Responding to the Coronavirus Pandemic the new report:

• features lessons from the initial Covid-19 surge, including the consequences of drug shortages;
• describes the symptom relief needs of Covid-19 patients and the ethical mandate to provide palliative care during public health emergencies;
• identifies emerging ethical challenges in the allocation of new or experimental therapeutic drugs used in the treatment of Covid-19 patients;
• discusses Covid-19 epidemiological data reflecting population-level vulnerabilities produced by inequality, and how to draw on data to develop equitable approaches to drug allocation, and
• demonstrates how to discuss and develop ethically sound policies and processes for health care institutions and regional collaborations involving health care providers and state and municipal health policymakers, with further resources.

In the Courts

Florida teachers union sues state Education Department to block school Coronavirus reopening mandate – Teachers claim the emergency order requiring schools reopen in August with in-person instruction, issued by the state’s Education Commissioner, violates a state Constitutional provision that the state assure the safety of schools.

Kentucky Supreme Court stops all challenges against Governor’s Emergency Orders – instead of having an array of challenges to the Governor’s executive authority move through various lower state courts (including a challenge filed by the state’s Attorney General), the state Supreme Court determined it will decide the constitutionality of the Governor’s use of emergency powers on such issues as mandating masks in public, limiting occupancy inside certain businesses and allowing public K-12 schools to have more than 10 days of nontraditional instruction like remote learning.

California Federal Judge Denies Churches’ Emergency Order Request Challenging Governor’s Executive Order Preventing Singing and Chanting during Services – the complaint must go through normal procedural steps, and the case is expected to be heard by the court in August.

Michigan Federal Judge Denies Movie Theaters’ Challenge to Governor’s Executive Order 

Arizona Federal Judge upholds Governor’s executive order closing gyms and fitness centers in state

New Mexico Supreme Court upholds Governor’s authority to keep indoor dining closed under emergency order

Longreads Worth Your Time

Health Justice Strategies to Combat the Pandemic: Eliminating Discrimination, Poverty, and Health Inequity During and After COVID-19 – by Emily A. Benfer, Seema Mohapatra, Lindsay F. Wiley & Ruqaiijah Yearby (forthcoming in Yale Journal of Health Policy, Law, and Ethics)

Reopening K-12 Schools During the Covid-19 Pandemic: Prioritizing Health, Equity, and Communities – Consensus study report via National Academies Press (report available free as pdf with registration)

Evidence-based Practice for Public Health Emergency Preparedness and Response – Consensus study report from National Academies of Sciences, Engineering and Medicine evaluates emergency response practices (also see JAMA Summary here)