Medicare steps up enforcement of equal visitation and representation rights in hospitals

Rules finalized last year empower patients to designate their own visitors, including same-sex partners

Today, the Department of Health and Human Services (HHS) announced new guidance to support enforcement of rules that protect hospital patients’ right to choose their own visitors during a hospital stay, including a visitor who is a same-sex domestic partner. These rules, finalized by the Centers for Medicare & Medicaid Services (CMS) in November, apply to all hospitals that participate in Medicare and Medicaid. The guidance also supports enforcement of the right of patients to designate the person of their choice, including a same-sex partner, to make medical decisions on their behalf should they become incapacitated.

"Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need," said HHS Secretary Kathleen Sebelius. "We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”

The rules updated the Conditions of Participation (CoPs), which are the health and safety standards all Medicare- and Medicaid-participating hospitals and critical access hospitals must meet, and apply to all patients of those hospitals even if they are not on Medicare or Medicaid. Among other things, the CoPs require hospitals to explain to all patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, a domestic partner (including a same-sex domestic partner), or another type of visitor, as well as their right to withdraw such consent to visitation at any time.

Existing CoPs also protect the rights of hospital patients to have representatives who can act on their behalf. HHS has updated the guidance for these rules to emphasize that hospitals should give deference to patients’ wishes concerning their representatives, whether expressed in writing, orally, or through other evidence, unless prohibited by state law. The guidance issued today is intended to make it easier for family members, including a same-sex domestic partner, to make informed care decisions for loved ones who have become incapacitated.

CMS today sent a letter to State Survey Agencies, which conduct on-site inspections of hospitals on behalf of CMS. The letter highlights the equal visitation and representation rights requirements and directs SSAs to be aware of the guidance when evaluating hospitals' compliance with CoPs.
“This announcement is another step toward equal rights for all Americans, and it is another step toward putting the patient at the center of our health care system,” said CMS Administrator Donald M. Berwick, M.D. “All patients should be afforded the same rights and privileges when they enter our health care system, and that includes the same opportunity to see their significant other.”

In other news of interest to the LGBT community, the Health Resources and Services Administration (HRSA), another agency of the Department of Health and Human Services, today announced a $248,000 grant to the Fenway Institute** to create a National Training and Technical Assistance Center to help community health centers improve the health of lesbian, gay, bisexual and transgender (LGBT) populations.

For more information on the CMS rules issued in November, please visit: http://www.hhs.gov/news/press/2010pres/11/20101117a.html

For the letter sent to State Survey Agencies, please visit: http://www.cms.gov/SurveyCertificationGenInfo/PMSR/list.asp#TopOfPage.

Posted by The National Task Force. Reposted at keystothecloset@blogspot.com

Same-sex Parenting Case to Ohio Supreme Court

Updates: Case Number 2010 - 0276 (Re: Lucy Kathleen Mullen) - See oral arguments at Ohio Supreme Court - more.

Here is the case that is referred to in the testimony in Re: Lucy Kathleen Mullen.  Case Number 2001 - 0625 (Teri J. Bonfield and Shelly M. Zachritz) - See oral arguments at Ohio Supreme Court  - more.

Goodbye, Mom and Dad. Hello, Parent One and Parent Two.

By Mary Beth Sheridan and Ed O'Keefe Washington Post Staff Writers

Parent One, Parent Two to replace references to mother, father on passport forms

Friday, January 7, 2011; 11:47 PM

The State Department has decided to make U.S. passport application forms "gender neutral" by removing references to mother and father, officials said, in favor of language that describes one's parentage somewhat less tenderly.

The change is "in recognition of different types of families," according to a statement issued just before Christmas that drew widespread attention Friday after a Fox News report.

The announcement of the change was buried at the end of a Dec. 22 news release, titled "Consular Report of Birth Abroad Certificate Improvements," that highlighted unrelated security changes.

The new policy is a win for gay rights groups, a vocal and financially generous Democratic voting bloc that has pushed for the change since Barack Obama began his presidential transition in late 2008. The decision follows last month's vote to end the military's "don't ask, don't tell" policy, which gay leaders consider one of their biggest victories in years.

Fred Sainz, vice president of the Human Rights Campaign, a gay rights advocacy group, called the news "a positive step forward for all American families. It was time that the federal government acknowledged the reality that hundreds of thousands of kids in this country are being raised by same-sex parents."

Tony Perkins, president of the Family Research Council, blasted it as reflecting the "topsy-turvy world of left-wing political correctness." "This is clearly designed," he said in a statement, "to advance the causes of same-sex 'marriage' and homosexual parenting without statutory authority, and violates the spirit if not the letter of the Defense of Marriage Act," the federal law that defines marriage as between one man and one woman.

He called on Congress to take action.

It was not immediately clear whether a similar change would be made to all federal documents. But after Secretary of State Hillary Rodham Clinton announced in 2009 that partners of gay American diplomats would be eligible for benefits accorded to spouses, the rest of the U.S. government followed suit.

In 2000, Clinton was the first wife of a president to march in a gay-pride parade, and as secretary of state she has advocated on behalf of gay rights. In a speech in June she said the United States "was elevating our rights dialogues with other governments and conducting public diplomacy to protect the rights of lesbian, gay, bisexual and transgender persons."

Rosemary Macray of the State Department Bureau of Consular Affairs shrugged off complaints of political correctness and described the switch as an unremarkable bureaucratic tweak. "Really, there have been so many changes in the last 10 or 15 years with reproductive technology and the like, and so this is

why it is important for us to accurately reflect families in these applications," she said.

The DS-11 form is required of first-time passport applicants and children younger than 16. The change will go into effect Feb. 1 and will be part of an already-scheduled revision of passport forms, Macray said.

"It's not going to really involve any expense to taxpayers," she said.

sheridanm@washpost.com ed.okeefe@washingtonpost.com