HHS seeks comments on policy to improve equity in dialysis, transplantation
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HHS is seeking comment on future rulemaking aimed at improving equity in access to dialysis care and organ transplantation, according to a press release from the department.
The new policies will focus on “identifying potential system-wide improvements that would increase organ donations, improve transplants, enhance the quality of care in dialysis facilities, increase access to dialysis services and advance equity in organ donation and transplantation,” according to the HHS.
Critical to these system-wide improvements is the close, collaborative relationship among Organ Procurement Organizations (OPOs), donor hospitals, transplant programs and dialysis facilities to ensure that organs are successfully recovered and transplanted, according to the release.
“Today’s announcement supports the president’s executive orders to advance health equity and improve health outcomes for people in need of a life-saving transplant and dialysis,” Xavier Becerra, HHS Secretary, said. “We want to hear from diverse stakeholders, especially the patients and their families. Your feedback is essential to our work in ensuring equal access to vital resources.”
People of color have higher rates of high blood pressure, diabetes, obesity and heart disease, all of which increase the risk for kidney disease, according to the HHS, while Black individuals are almost four times more likely, and Latino individuals are 1.3 times more likely, to have kidney failure compared with white individuals in the United States.
“Despite the higher risk, data shows that Black and Latino patients on dialysis are less likely to be placed on the transplant waitlist and have a lower likelihood of transplantation,” according to the release.
Due to these stark inequities, the department is asking for specific ideas on advancing equity within the organ transplantation system, particularly on potential changes to the health and safety standards for transplant programs, dialysis facilities and OPO operations.
“Organ donation is a precious gift, and we owe it to recipients, donors, those awaiting organs and their loved ones to ensure our transplantation system is safe, efficient and equitable,” Chiquita Brooks-LaSure, CMS Administrator, said in the release. “We are seeking input on ways to improve organ donation and transplantation and are committed to engaging all stakeholders throughout our policy development process. This effort is extremely important for supporting organ transplants for communities of color, individuals with disabilities and other historically underserved populations.”
For more information, click here. Comments must be submitted by Feb. 1.
Perspective
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Charlie Thomas, LCSW, ACSW, FNKF
In January 2021, President Biden issued several executive orders addressing the need to improve equity in health care.
The orders included better support for health care in underserved communities, preventing and combating discrimination on the basis of gender identity or sexual orientation and ensuring equitable response to the pandemic.
In this current information request from HHS, the department expresses a commitment to the president’s orders by advancing equity for all, including people of color and others who have been historically underserved, marginalized and adversely affected by persistent poverty and inequality. These efforts extend to ensuring equity in the organ transplant system for all racial and ethnic groups and people with disabilities.
It is well documented that Black/African American and Hispanic/Latino patients on dialysis are less likely to be placed on the transplant waitlist and have lower rates of transplantation. In addition, inequity exists for people with disabilities. A 2019 report from the National Council on Disability found that people with disabilities are frequently denied equal access to organ transplants based solely on their disability status. Transplant professionals often assume that people with disabilities, especially those with intellectual disabilities, will have worse outcomes after transplantation. The information request from HHS notes individuals with disabilities can have equally positive outcomes, and the disability should have little impact on the individual’s ability to adhere to post transplant care if they receive adequate support.
These inequities exist despite numerous federal and state prohibitions on discrimination based on race, color, national origin and disability.
HHS is asking the public for specific ideas on advancing equity within the organ transplant system. The public should welcome this invitation from CMS to help make the transplant system more equitable.
Reference:
www.ncd.gov/newsroom/2019/NCD-bioethics-series-organ-transplant
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