Making Health Care Equality a Reality

“There are few moments in our lives that call for greater compassion and companionship  than when a loved one is admitted to the hospital,” wrote President Obama to Kathleen Sibelius, secretary of the U.S. Department of Health and Human Services, in an April 2010 memo that outlined his view of visitation and decision-making rights of LGBT family members. The memo was inspired in part by the sad story of Langbehn and Pond.

Following a period of public review, Health and Human Services acted on the president’s wishes, and in January federal regulations went into effect that granted patients more control over their medical decisions. More specifically, all hospitals that accept federal money in the form of Medicare and Medicaid are now required to allow patients to designate who can visit them and who is authorized to make key medical decisions on their behalf, regardless of whether that person is a blood relative or legally recognized spouse.

“This policy impacts millions of LGBT Americans and their families. The president saw an injustice and felt very strongly about correcting this and has spoken about it often over the years,” said White House deputy director of public engagement Brian Bond on the White House blog.

For the HHS to establish that discrimination is not only unacceptable but illegal is a major win for LGBT Americans because it’s the first time they have received federal recognition of the fundamental right to choose which loved ones they can lean on during hospitalization.

But these new rules, though a big step forward, do not obviate the aims of the Healthcare Equality Index, including the need for cultural competency training, which involves educating hospital staff on LGBT-specific issues such as terminology, history, and health risks as well as the applicable local and state laws affecting LGBT people in regard to health care. (While it is not mandatory for all employees to take this training, the HRC requires that it be offered to all personnel—from physicians and technicians to administrative staff — in order for the to facility to receive credit.)

Also, says Fred Sainz, the HRC’s vice president of communications and marketing, the new HHS regulations address these LGBT issues only in hospitals. “In the future we want to increase participation by nursing homes, assisted living facilities, hospice, and home health care agencies,” he says. “So there is still a lot of work for the HEI to do.” The index will “continue as a leading resource for health care administrators who want to follow not only the letter of the law but also live up to the spirit of the law.”