Law Commons^™

“Woman Enough” To Win? An Analysis Of Sex Testing In College Athletics, Brenna M. Moreno

Saint Louis University Journal of Health Law & Policy

In recent years, dozens of bills restricting the rights of transgender, or trans, individuals have been introduced in state legislatures throughout the country. To date, ten states have successfully passed laws prohibiting trans athletes from competing on teams in accordance with their gender identities. For its athletes, the National Collegiate Athletic Association (NCAA), the United States’ largest intercollegiate athletic organization, has pursued a compromise to balance trans inclusion and fair competition. Established in 2011, the NCAA’s conditionally inclusive policy permits trans women—meaning those who were assigned the sex of male but identify as women—to compete on a women’s team only …

The Impact Of Bostock V. Clayton County On Access To Health Care For Lgbtq Persons, Hiba B. Al-Ramahi

Saint Louis University Journal of Health Law & Policy

LGBTQ individuals face countless acts of discrimination in health care insurance and delivery. In spite of this inequality, there are zero LGBTQ-inclusive health insurance protections in over half of the United States. Title VII of the Civil Rights Act (Title VII) and Section 1557 of the Patient Protection and Affordable Care Act (ACA) are two federal statutes that prohibit discrimination, in relevant part, on the basis of sex. Both federal statutes have been greatly impacted by the Supreme Court decision in Bostock v. Clayton County, which interpreted “sex” in Title VII to include gender identity and sexual orientation. This …

Developing A Health Care Workforce That Supports Team-Based Care Models That Integrate Health And Social Services, Jessica Mantel, Mcclain Sampson, David S. Buck, Winston Liaw, Lechauncy Woodard, Jasmine Singh

Saint Louis University Journal of Health Law & Policy

Across the country, health care professionals are joining forces to improve the health care of populations with complex social, financial, and behavioral health needs. One promising approach relies on community-based integrated health teams (CIHTs), or interprofessional teams that integrate a broad range of medical, behavioral health, and social services, offer intensive case management, and link patients to available community resources. Yet whether CIHTs fulfill their potential depends in part on policymakers enacting policies that support CIHTs delivering comprehensive, high-value care to their patients. Drawing on the insights of CIHT professionals shared with the authors, this Article highlights several factors that …

Making Rights Meaningful: Advocating For Simple Changes In Federal Agency Practice To Promote Health Equity, Mary Quandt

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Protecting Patients From Physicians Who Inflict Harm: New Legal Resources For State Medical Boards, Elizabeth Pendo, Tristan Mcintosh, Heidi Walsh, Kari Baldwin, James M. Dubois

All Faculty Scholarship

State medical boards (SMBs) protect the public by ensuring that physicians uphold appropriate standards of care and ethical practice. Despite this clear purpose, egregious types of wrongdoing by physicians are alarmingly frequent, harmful, and under-reported. Even when egregious wrongdoing is reported to SMBs, it is unclear why SMBs sometimes fail to promptly remove seriously offending physicians from practice. Legal and policy tools that are targeted, well-informed, and actionable are urgently needed to help SMBs more effectively protect patients from egregious wrongdoing by physicians.

Past reviews of SMB performance have identified features of SMBs associated with higher rates of severe disciplinary …

What Covid-19 Laid Bare: Adventures In Workers’ Compensation Causation, Michael C. Duff

All Faculty Scholarship

This essay performs a close analysis of workers’ compensation coverage of COVID-19 and arrives at the conclusion that it should not be “impossible” to prove in a legal sense that an employee’s COVID-19 was caused by work. Scientific proof is not the same as legal proof: workers’ compensation law has never required that claims must be supported by irrefutable scientific proof of workplace causation. Yet repeatedly one heard this suggestion during public discussion on workers’ compensation coverage of employees.

Still, there is good evidence that even when workers’ compensation undisputedly covers work-related disease employers seldom pay benefits (and states do …

The Effects Of Missouri's Medicaid Expansion, Chandni Challa

SLU Law Journal Online

A Missouri Supreme Court ordered the Missouri legislature to implement a state constitutional amendment to expand Medicaid. In this article, Chandni Challa argues that this decision will undoubtedly affect the state economy, and based on empirical evidence from Michigan, provide a net benefit.

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Introduction, Alexander Williams

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Centering Racial Equity: Disparities Task Forces As A Strategy To Ensure An Equitable Pandemic Response, Dawn M. Hunter, Betsy Lawton

Saint Louis University Journal of Health Law & Policy

COVID-19 has had a stark and severe impact on health, economic stability, housing, and education in communities of color in the United States. As the pandemic has unfolded, the disproportionate number of cases, hospitalizations, and deaths due to COVID-19 among Black, Hispanic and Latinx, and Indigenous people has served as a stark reminder that the systems and structures that lead to these disparities need to be changed in order to achieve equitable outcomes.

This Article assesses efforts by cities, counties, states, and organizations to address the impact of COVID-19 on communities of color through formal task forces or working groups …

Racism, Health Equity, And Crisis Standards Of Care In The Covid-19 Pandemic, Charlene Galarneau, Ruqaiijah Yearby

Saint Louis University Journal of Health Law & Policy

Long-standing and deeply embedded institutional racism, notably anti-Black racism in U.S. health care, has provided a solid footing for the health inequities by race evident in the COVID-19 pandemic. Inequities in susceptibility, exposure, infection, hospitalization, and treatment reflect and reinforce this racism and cause incalculable and preventable suffering in and loss of Black lives. This Article identifies multiple expressions of racism evident in the crisis standards of care (CSC) created by states and health care institutions to guide the ethical allocation of scarce critical care resources including ventilators. Contextualized within the broad landscape of health inequities pre-COVID-19 as well as …

Policies Of Exclusion: The Impact Of Covid-19 On People With Disabilities, Amanda M. Caleb, Stacy Gallin

Saint Louis University Journal of Health Law & Policy

COVID-19 has had a significant impact on marginalized groups and has amplified the social and health inequalities in society, particularly for people with disabilities (PwDs), who are at higher risk of dying from the coronavirus. As such, it is vital that policies and practices include and protect PwDs, yet that is not the case across the United States. In this article, we examine policies related to COVID-19 that have further othered PwDs and that have created practical and theoretical inequity. In looking at public health strategies that are meant to protect the public, we argue that measures such as social …

Seeking Safety While Giving Birth During The Pandemic, Elizabeth Kukura

Saint Louis University Journal of Health Law & Policy

As COVID-19 spread throughout the United States in early 2020, many pregnant people sought alternatives to delivering in a hospital. Midwifery practices offering services at home or in a freestanding birth center reported record numbers of inquiries, including from people looking to transfer care near the end of pregnancy. Whether due to fear of COVID-19 exposure in health care settings or out of a desire to avoid restrictive hospital policies regarding support people and newborn separation, people who had not previously considered home birth were newly drawn to midwifery care and others who had considered a midwife-attended birth redoubled their …

Disability, Access, And Other Considerations: A Title Ii Framework For A Pandemic Crisis Response (Covid-19), George M. Powers, Lex Frieden, Vinh Nguyen

Saint Louis University Journal of Health Law & Policy

This Article examines how plans for emergency medical rationing during the COVID-19 pandemic may discriminate against those with disabilities. More specifically, this Article lays out the obligation of state and local governments under Title II of the ADA in creating and enforcing equitable and fair rationing plans during this COVID-19 crisis. For example, ventilator shortages are a common occurrence. The ADA, similar to other civil rights laws, operates so that a person with a disability is not denied a ventilator or other resources because of his/her disability. One reason that a person with a disability may be denied limited medical …

Covid-19, Doctors, And The “Realities Of Prison Administration” Part I: The Realities Of A Subject Matter Expert, Fred Rottnek

Saint Louis University Journal of Health Law & Policy

COVID-19 is still novel. As scientists continue racing to characterize the virus and its mutations, promote behavioral change, and optimize treatment and vaccination strategies, public policy makers shift their attention from one high priority population to the next. These spotlights have converged on one truism of the pandemic: COVID-19 infection, and all its sequelae, have magnified long-established social and structural inequities in U.S. institutions—including practices in jails, prisons, and detention facilities. While these facilities were recognized as early incubators of the virus, the response of the facility administrators and local leaders were at best uneven and at worst nonexistent. When …

Retaining Medicaid Covid-19 Changes To Support Community Living, Elizabeth Edwards, David Machledt, Jennifer Lav

Saint Louis University Journal of Health Law & Policy

The impact of COVID-19 on people with disabilities in institutional settings, like nursing facilities, has garnered significant attention. But people receiving comparable services in the community have also been affected significantly. States used several emergency authorities in efforts to facilitate access to and stabilize these Medicaid home and community-based services (HCBS), including behavioral health services. Although states made different policy choices within those authorities, many states expanded the provider pool, increased HCBS provider rates, decreased onerous utilization controls and other barriers to care, expanded telehealth, and added new community-based services. These state policy responses have resulted in new services or …

Covid-19, Courts, And The “Realities Of Prison Administration” Part Ii: The Realities Of Litigation, Chad Flanders

Saint Louis University Journal of Health Law & Policy

Lawsuits challenging prisons and jails for not doing enough to stop the spread of COVID-19 among inmates have faced mixed results in the courts: wins at the district court level are almost always followed by losses (in the form of stays of any orders to improve conditions) at the appeals court level or at the Supreme Court. This short Article tries to explain why this is happening and makes three comparisons between how district courts and appeals courts have analyzed these lawsuits. First, district courts and appeals courts tend to emphasize different facts in their decisions. District courts focus more …

Lessons Learned From Community-Driven Responsiveness During Covid-19, Amanda Harris, Brittini "Ree Belle" Gray, Ciearra Walker, Melinique Walls Castellanos

Saint Louis University Journal of Health Law & Policy

People of color are suffering and dying from COVID-19 at greater rates than the general population. Additionally, population-level health interventions can worsen health disparities by failing to reach already underserved populations. In response, PrepareSTL, a collaborative, community-led campaign, aims to reach communities of color in St. Louis with accessible information and resources to stop the spread of the coronavirus among the target audiences and help these communities survive the virus’s adverse social and economic impacts. This study (1) analyzes factors contributing to the success of PrepareSTL as a community-led and equity-centered response to COVID-19 and (2) identifies lessons from the …

Examining Sociodemographic Data Reporting Requirements In State Disease Surveillance Systems, Samantha Bent Weber, Amanda Moreland, Rachel Hulkower, Tara Ramanathan Holiday

Saint Louis University Journal of Health Law & Policy

Law plays an important role in the collection of data related to disease and injury in a population. A robust system of laws sets out requirements for the collection, analysis, and dissemination of disease reporting data from local, state, territorial, and federal public health institutions. Occurrence of disease, including outbreaks of novel infectious agents like coronaviruses, influenza viruses, and others that have arisen in recent years, often require epidemiologists and others to understand not only the etiology and specific context of diseases and conditions, but also the trajectory of their spread among and across communities. Capturing sociodemographic data is critical …

Skirting The Law: Medicaid Block Grants And Per-Capita Caps In A Pandemic, Laura D. Hermer

Saint Louis University Journal of Health Law & Policy

To what extent can an administration abridge Medicaid’s entitlement status by administrative fiat? In the final year of the Trump administration, just before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) sought to push the outer bounds of this question by announcing the Healthy Adult Opportunity (HAO) initiative. It invited states to submit § 1115 demonstration applications to cover individuals not eligible for Medicaid benefits under the state’s Medicaid plan—meaning, in many cases, the Affordable Care Act’s (ACA’s) Medicaid expansion population. Spending on those populations would be capped, not by purporting to waive federal law regarding matching …

Rights Not Fundamental: Disability And The Right To Marry, Gabriella Garbero

Saint Louis University Journal of Health Law & Policy

Disabled people have long been systematically excluded from marriage, despite its personal, religious, cultural, and symbolic importance, and despite it being treated as a fundamental right in other contexts. This exclusion has been perpetuated by arcane laws that require Social Security and Medicaid beneficiaries to include their spouse’s income and assets in eligibility calculations. Since eligibility is contingent upon very little income and very few assets, couples who marry and intend to keep benefits are forced to live far below the poverty line in order to meet income and asset criteria, and many people are unable to make such a …

Enforcing The “Safe And Sanitary” Environment Standard Within U.S. Detention Facilities To Save Children’S Lives, Anam A. Khan

Saint Louis University Journal of Health Law & Policy

Overcrowding and unsanitary conditions within Customs and Border Protection (CBP) detention facilities are ideal for the transmission of infectious disease among CBP detainees. This is a dangerous problem. Between 2018 and 2019, at least six children died after acquiring infectious diseases while detained at CBP facilities. Migrant children are particularly vulnerable because their immune systems are not fully developed and due to the negative impact of trauma and stress have on their immune systems. Infectious disease promulgation within CBP facilities also puts the American public at risk because of the potential for transmission beyond CBP facilities. Employees who are regularly …

Table Of Contents

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Masthead

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Foreword, Elizabeth Pendo

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Protecting Patients From Physicians Who Inflict Harm: New Legal Resources For State Medical Boards, Elizabeth Pendo, Tristan Mcintosh, Heidi A. Walsh, Kari Baldwin, James M. Dubois

Saint Louis University Journal of Health Law & Policy

State medical boards (SMBs) protect the public by ensuring that physicians uphold appropriate standards of care and ethical practice. Despite this clear purpose, egregious types of wrongdoing by physicians are alarmingly frequent, harmful, and under-reported. Even when egregious wrongdoing is reported to SMBs, it is unclear why SMBs sometimes fail to promptly remove seriously offending physicians from practice. Legal and policy tools that are targeted, well-informed, and actionable are urgently needed to help SMBs more effectively protect patients from egregious wrongdoing by physicians.

Past reviews of SMB performance have identified features of SMBs associated with higher rates of severe disciplinary …

Barriers To Medical Board Discipline: Cultural And Organizational Constraints, Elizabeth Chiarello

Saint Louis University Journal of Health Law & Policy

Medical boards are responsible for disciplining physicians who inflict egregious harm on their patients, yet they often fail to do so. This Article develops a cultural and organizational framework for explaining why boards so often fail to discipline physicians. The framework highlights three types of barriers that impede board action: (1) input barriers that prevent hospitals and clinics from reporting harm to boards, (2) processing barriers that prevent boards from taking sufficient action against physicians who do harm, and (3) output barriers that prevent boards from sharing information about physicians who do harm with other disciplinary agencies like other medical …

Diversity From The Perspective Of Corporate Boards And Lawyer Disciplinary Boards, Lissa L. Broome, John M. Conley

Saint Louis University Journal of Health Law & Policy

This Article addresses the organizing question of this symposium—whether diversifying state medical boards (SMBs) would improve their effectiveness in disciplining doctors—by drawing on the comparable experiences of corporate boards of directors and lawyer disciplinary boards. Reexamining our own qualitative study of corporate board diversity conducted several years ago, we find that almost of all of the arguments for board diversity raised in the business literature or our own interviews also tend to support diversity on SMBs. Reviewing the legal profession’s experience with the diversity question on lawyer disciplinary boards, we find that many of these arguments have also been recognized, …

State Peer Review Laws As A Tool To Incentivize Reporting To Medical Boards, Nadia N. Sawicki

Saint Louis University Journal of Health Law & Policy

State medical boards have been stymied in their ability to take disciplinary action against physicians who engage in serious misconduct, in part because hospitals and other health care organizations rarely report such misconduct. This Article offers a proposal for incentivizing hospital reporting of physician misconduct, inspired by an existing but flawed model in the federal Health Care Quality Improvement Act. This Article proposes that state legislatures link state medical practice act reporting requirements with state laws establishing an evidentiary privilege for peer review activities.