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APHA Scientific Session and Event Listing

Ruqaiijah A. Yearby, JD, MPH, Institute for Health Law, Loyola University Chicago School of Law, 25 E. Pearson, Chicago, IL 60611, 312-915-6446, ryearby@luc.edu

Born in the era of Jim Crow, elderly African-Americans remain subject to racial segregation in the long-term care system. Recent empirical studies show that elderly African-Americans have been delayed in transfer to nursing homes, denied admission to quality nursing homes, and relegated to substandard nursing homes. Government officials have likened these practices to the discriminatory practices perpetrated during Jim Crow, but have done little to put an end to these practices. In its history of thirty-seven years, the U.S. Department of Health and Human Services Office of Civil Rights (“OCR”), responsible for prohibiting racial discrimination, has never terminated a nursing home proven to have racially discriminated. Moreover, OCR does not collect racial data or admission flow data, regulate nursing home's admission practices, or survey the racial makeup of nursing homes as required by law. Without collecting data or regulating admission practices, OCR cannot prevent the racial discrimination in nursing homes that prevents elderly African-Americans from obtaining equal access or quality. To fulfill the promise of racial equality and quality care, there are several legal and public health solutions. First, elderly African-Americans can file a suit under Medicaid against the federal government for failing to provide access to quality nursing homes. Second, elderly African-Americans can bring a false claims action against nursing homes that provide substandard care and receive government funding. Finally, the federal government can codify penalties for racial discrimination, aggressively terminate facilities that fail to integrate and provide substandard quality care, and increase reimbursement rates for nursing home care.

Learning Objectives:

• Define current problems with racial disparities and quality of care in the long-term care system; Become familiar with the legal and public health structure to address these issues; Learn strategies for providing an effective solution to the problem; Identify public health resources that support these solutions.

Keywords: Access to Health Care, Elderly

Presenting author's disclosure statement:

Any relevant financial relationships? No