Equality NC Comments on Proposed Federal Hospital Visitation Updates

Along with a coalition of statewide equality groups, the National Coalition for LGBT Health, national LGBT legal and advocacy groups, and other health-specific organizations, Equality NC provided public comments on proposed federal regulations requiring all hospitals receiving Medicare and Medicaid funding to adopt policies that protect the visitation rights of all patients, including LGBT people.

Via memorandum on April 15, President Obama required Secretary of Health and Human Services Kathleen Sebelius to begin the process of adopting rules that require hospitals that accept Medicare or Medicaid — nearly every hospital in the country — to adopt visitation policies similar to ones that we have in place in North Carolina and to study other ways to ensure LGBT people get fair and equal access to health care.

Equality NC Executive Director Ian Palmquist said, "This demonstrates once again that work we're doing on the ground at the state and local level is having an impact beyond our borders. Change flows up from the states, not down from Washington, DC."

Suggested changes in the comment letter included revisions that create a single standard for all people on:

• Protected categories in patient visitation 
• Inclusive language in patient visitation policies
• Informing patients of their rights
• Protecting the right of LGBT patients to designate a representative
  
• Cases requiring written documentation for visitation
• Restrictions on visitation
• Application of rules to critical access hospitals and other health care facilities
• Technical assistance in compliance
  

This is an excerpt from the comment letter submitted:

The stories of heartbreaking and insulting treatment around hospital visitation are unbelievably common among LGBT people:                                                               

• Individuals being unable to visit their partners of 20 or 30 years because they are not viewed as "family;"

• Hospital staff arbitrarily dismissing legal documentation proving a couple’s relationship because it is issued by another state; and

• LGBT people consistently being forced to prove their connection to a patient, while no questions are asked when a heterosexual person simply identifies him or herself as a spouse, sibling, or parent.

Sometimes, these tragedies get public attention, such as the incident in Florida involving Janice Langbehn and her partner Lisa Pond. But the vast majority of these injustices go unnoticed or unreported because of the lack of recourse for victims.

There are several reasons for this disparate treatment of LGBT patients and their families.

One reason is the small number of states that extend legal relationship recognition to same-sex couples, whether through marriage, domestic partner registries, or civil unions. A

second reason is the inconsistent way same-sex marriages, domestic partnerships, and civil unions are recognized by other jurisdictions. A same-sex couple can be lawfully married in Iowa, for example, but lose that legal status when they cross into any adjoining state.

Still another reason is the way in which so many LGBT people create and sustain family – which due to a history of familial estrangement and legal discrimination for the community is through bonds of affection and affinity rather than blood or formal “legal” status.

The overarching problem to date has been the lack of uniform guidance for hospitals and other health care facilities protecting the right of patients to designate visitors and ensure that advance health care directives (“AHDs”) and other similar legal documents are respected. As a result, hospitals and their staffs deal with these situations in vastly different ways that are often profoundly harmful to LGBT people.

These reasons highlight why the [proposed, LGBT-inclusive] Rule is so important, so praiseworthy, and so long-overdue.

In conclusion, we again thank you and the CMS for the careful thought that went into the Rule and the areas where comments were specifically requested. We are confident the final rule will be a significant step forward in improving the way all patients, their visitors, and their families – especially LGBT patients, their visitors, and their families - are treated by Medicare- and Medicaid-participating facilities. We thank you again for the opportunity to comment on this Rule.

Equality NC is proud to have made North Carolina a trailblazer for LGBT-inclusion in equal access to healthcare within the state, and now, the country.

You can support the efforts of Equality NC by making a donation today.