United Counseling Service is taking the health of our clients, staff and families extremely seriously. To ensure the continued safety of our staff, clients and families, we are closely monitoring and following the Vermont Department of Health and Centers for Disease Control recommendations.
UCS is working diligently to monitor the status of the Coronavirus Disease (COVID-19) and to stay aprised of and implement the current recommendations to ensure the health and well being of our clients, staff, providers and community.
UCS’ procedures and protocols affected by COVID-19 are changing rapidly, and we will do our best to communicate those to you in an effective, efficient manner.
We ask that if you are coughing and have a fever please consider a phone appointment with your provider. We are here for you 24/7/365 and are dedicated to providing high-quality services to those that need us. For help, call 802-442.5491.
Information about COVID-19 is readily available on-line. We recommend the following resources for reputable, up-to-date information.
MEDICAL DECISIONS DURING THE PANDEMIC- References for Individuals and Guardians
Know Your Rights to Medical Care COVID-19
Know Your Rights Guide to Surviving COVID-19 Triage Protocols
GUARDIAN’S HANDBOOK – A Guide to the Responsibilities of Guardians of Adults with Mental Disabilities
Making Medical Decisions for Someone Else
Medical Decision-Making for Persons Under Guardianship (from the Vermont Ethics Network)
- A person whose right to make medical decisions has been restricted due to a guardianship who has the capacity to make a specific medical decision retains the right to make that decision [3075(b)].
- A health care agent appointed in an advance directive has exclusive authority to make medical decisions over a guardian [see 3069(b), §3075(c), §3075(d)].
- Guardians appointed by the Probate Court must seek prior approval from the court in the following circumstances [3075(g)]:
- When the person under guardianship objects to the decision;
- When the court had previously ordered the decision would not be made without a hearing;
- Before withholding/withdrawing life sustaining treatment other than antibiotics (unless under an advance directive), except in an emergency (when the decision needs to be made before a court decision could be made); or
- Before consenting to a DNR (do-not-resuscitate) order (unless under an advance directive), except in an emergency (when the clinician certifies in writing that the patient is likely to experience a cardiopulmonary arrest before the court’s order can be obtained).
- A guardian must honor instructions in an individual’s advance directive even if there is no health care agent and the guardian is making the decision.
- When making medical decisions for a person under guardianship, the guardian must first try to determine what the person would decide if they were able (substituted judgement). If this is not known, the guardian would then make a decision based on what is in the individual’s best interest.
Best Practices and Legal Requirements for Health Professionals Caring for People with Disabilities
From the VT Developmental Disabilities Council letter to Self-Advocates, Advocates and Families dated 4/9/2020, regarding hospital triage plans:
“As you are aware, the allocation of scarce resources like ventilators has been an issue nationally for people with disabilities. In Vermont, we are fortunate that our state Crisis Standard of Care Plan (the State Plan) does not contain language that explicitly discriminates against people with disabilities, as is the case in some other states. [NOTE: the Disability Law Project at Vermont Legal Aid has asked for some clarification of language to the State Plan under Patient Strategies, No. 6 for Mechanical Ventilation (page 52). This important request is still pending.]
Statewide protection is strengthened by a March 28, 2020 Bulletin from the Office of Civil Rights at the US Agency of Health and Human Services that makes clear “obligations under laws and regulations that prohibit discrimination on the basis of race, color, national origin, disability, age, sex, and exercise of conscience and religion in HHS-funded programs.”
The State Plan, however, is not the only document that informs decisions about the allocation of resources. Hospitals have their own internal policies, including policies specific to Covid-19, that are intended to map to the State Plan.
In recent conversations with the Vermont Ethics Network and the Vermont Association of Hospitals, the DD Council learned that there was some concerning language in the otherwise sound UVM Health Network’s “Plan for Ethical Allocation of Hospital Beds and Mechanical Ventilators During the Covid-19 Epidemic.” Specifically, the document included “severe baseline cognitive impairment” as an exclusion criteria for a triage protocol for critical care during an influenza pandemic (Appendix A, criteria D). This was intended to refer to cases of neurological impairment due to end-stage disease processes like dementia or stroke. The DD Council’s concern was that a plain language reading of this criteria could include intellectual disability. Working with the Ethics Network and the Vermont Hospital Association, we were able to have this concern heard quickly by decision-makers at the UVM Network, and as a result, the objectionable language has been removed entirely from the triage protocol.
Bennington Vermont HELP MAP – Community Resources for people who need assistance with finding food, shelter, medical, financial or other help in Bennington, Vermont. Click here to view the map.