• No Long-Term Survivability Considerations: Scarce medical resources can no longer be allocated based on patients’ perceived chances of long-term survival. Instead, prioritization is based on patients’ likelihood of surviving to discharge. Long-term survivability is uncertain. As such, it is fraught with speculation, stereotypes, implicit bias, and assumptions about the quality of life and lifespan of people with disabilities.

• Reasonable Modifications Required: North Carolina’s Protocol now requires hospitals to make reasonable modifications to the Sequential Organ Failure Assessment (SOFA) — the tool used to prioritize access to medical treatment —to avoid penalizing people with underlying conditions that are unrelated to their ability to benefit from treatment.

• Reallocation of Personal Ventilators Prohibited: Medical personnel may not reallocate the personal ventilator of a patient who uses a ventilator in their daily life to another patient whom the personnel deem more likely to benefit from the ventilator in receiving treatment.

• Effective Communication Required: Medical personnel must provide effective communication to patients and patient representatives who have disabilities or limited English proficiency as required by federal law.

• Blanket Do Not Resuscitate Orders (DNRs) Prohibited: Providers may not address resource constraints through blanket DRN orders.