N.C. equality group weighs in on Medicare/Medicaid rule change

Original presidential memo regarding changes had cited similar, LGBT-inclusive rules in North Carolina

RALEIGH, N.C. — North Carolina’s statewide LGBT education and advocacy organization is one of several groups weighing in on proposed rule changes for hospital visitation.

On April 15, President Barack Obama issued a memorandum instructing Secretary of Health and Human Services Kathleen Sebelius to begin the process of adopting new rules requiring equal and inclusive patient visitation policies for hospitals accepting Medicare or Medicaid funding. Any rule change would effect nearly every hospital in the country.

Obama’s original memorandum cited North Carolina’s inclusive policies, in place since 2008 and due in part by the advocacy for such changes by Equality North Carolina.

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“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,” Ian Palmquist, Equality North Carolina executive director, said in a release. “Change flows up from the states, not down from Washington, DC.”

Palmquist’s group is one in a coalition of state equality organizations and national groups adding their recommendations to new rule proposals. Other groups include the National Coalition for LGBT Health and national LGBT legal and advocacy groups.

The North Carolina organization provided on Aug. 27 their public comments via letter to Donald Berwick, administrator of the Centers for Medicare & Medicaid Services at the U.S. Department of Health and Human Services.

In the letter, Equality North Carolina cited several reasons why LGBT patients and families often fail to receive equitable treatment from hospital staff.

“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,” the letter reads. “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.”

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The letter continued, “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.”

Equality North Carolina also stressed the importance of and need for more inclusive language in any new policies or regulations. The proposed rule requires hospitals to “(e)nsure that all visitors designated by the patient (or representative, where appropriate) enjoy visitation privileges that are no more restrictive than those that immediate family members would enjoy.”

While thanking administrators’ “objective behind this provision,” Equality North Carolina said such language “is actually confusing and can be seen as disparaging to existing LGBT families.” They suggested a more direct and clear policy, writing, “A better way would be to use the same list of protected categories mentioned above and have the rule: ‘ensure that all visitors designated by the patient (or representative, where appropriate) enjoy full and equal visitation privileges regardless of race, color, national origin, religion, sex, sexual orientation, gender identity, disability, marital status, family composition, or primary language.'”

The group concluded by thanking the Centers for Medicare & Medicaid Services for the opportunity to engage them in discussions on rule proposals and said they 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.”

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Posted by Matt Comer

Matt Comer previously served as editor from October 2007 through August 2015 and as a staff writer afterward in 2016.