FOR IMMEDIATE RELEASE: April 15, 2010
Michael Cole | Michael.Cole@hrc.org | Phone: 202-216-1553 | Cell: 202-716-1651
WASHINGTON, D.C. – Today, President Obama signed a presidential memorandum taking important steps to protect the visitation and healthcare decision-making rights of lesbian, gay, bisexual and transgender (LGBT) people. This important action was inspired by last year’s New York Times profile of the tragic experience of partners Lisa Pond and Janice Langbehn. Despite having an advanced healthcare directive, Janice, and the couple’s children, were kept from Lisa’s bedside as she lay dying. Lambda Legal represented Janice in a lawsuit against Jackson Memorial Hospital in Miami and worked with them to revise their policies in the wake of the tragedy. As part of its ongoing efforts to promote executive actions which would improve the lives of LGBT Americans, the Human Rights Campaign worked with White House and Department of Health and Human Services staff in support of today’s memorandum.
“Discrimination touches every facet of the lives of lesbian, gay, bisexual and transgender people, including at times of crisis and illness, when we need our loved ones with us more than ever,” said HRC President Joe Solmonese. “No one should experience what befell the Pond-Langbehn family, and the President’s action today will help ensure that the indignities Janice and her children faced do not happen to another family.”
According to today’s announcement, the memorandum directs the Secretary of Health and Human Services (HHS) to promulgate a regulation requiring all hospitals that receive federal Medicare and Medicaid funding – nearly every hospital in America – to allow patients to designate who may visit them and prohibiting discrimination in visitation based on a number of factors, including sexual orientation and gender identity. In addition, the memorandum calls on the Secretary to issue new guidance and provide technical assistance to hospitals to help them comply with existing federal regulations that require them to respect individuals’ advanced healthcare directives and other documents establishing who should make healthcare decisions for them when they are unable to do so. Finally, the memorandum directs HHS to conduct a larger study of the barriers LGBT people and their families face in accessing healthcare.
In addition to efforts to address these and other issues facing LGBT people through executive and legislative action, the HRC Foundation has worked for several years to encourage hospitals and other healthcare providers to adopt pro-LGBT policies and practices. Since 2007, the Foundation, in a joint effort with the Gay and Lesbian Medical Association, has published the Healthcare Equality Index (HEI), a rating of healthcare facilities based on five main policy criteria: patient non-discrimination, visitation, decision making, cultural competency training and employment policies and benefits. In 2009, ten facilities reported LGBT-inclusive policies and practices for every one of the 10 HEI rated criteria. The 2010 HEI will be released in the coming weeks.
The Human Rights Campaign is America’s largest civil rights organization working to achieve lesbian, gay, bisexual and transgender equality. By inspiring and engaging all Americans, HRC strives to end discrimination against LGBT citizens and realize a nation that achieves fundamental fairness and equality for all.
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The White House
Office of the Press Secretary
Presidential Memorandum - Hospital Visitation
MEMORANDUM FOR THE SECRETARY OF HEALTH AND HUMAN SERVICES
SUBJECT: Respecting the Rights of Hospital Patients to Receive Visitors and to Designate Surrogate Decision Makers for Medical Emergencies
There are few moments in our lives that call for greater compassion and companionship than when a loved one is admitted to the hospital. In these hours of need and moments of pain and anxiety, all of us would hope to have a hand to hold, a shoulder on which to lean -- a loved one to be there for us, as we would be there for them.
Yet every day, all across America, patients are denied the kindnesses and caring of a loved one at their sides -- whether in a sudden medical emergency or a prolonged hospital stay. Often, a widow or widower with no children is denied the support and comfort of a good friend. Members of religious orders are sometimes unable to choose someone other than an immediate family member to visit them and make medical decisions on their behalf. Also uniquely affected are gay and lesbian Americans who are often barred from the bedsides of the partners with whom they may have spent decades of their lives -- unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.
For all of these Americans, the failure to have their wishes respected concerning who may visit them or make medical decisions on their behalf has real onsequences. It means that doctors and nurses do not always have the best information about patients' medications and medical histories and that friends and certain family members are unable to serve as intermediaries to help communicate patients' needs. It means that a stressful and at times terrifying experience for patients is senselessly compounded by indignity and unfairness. And it means that all too often, people are made to suffer or even to pass away alone, denied the comfort of companionship in their final moments while a loved one is left worrying and pacing down the hall.
Many States have taken steps to try to put an end to these problems. North Carolina recently amended its Patients' Bill of Rights to give each patient "the right to designate visitors who shall receive the same visitation privileges as the patient's immediate family members, regardless of whether the visitors are legally related to the patient" -- a right that applies in every hospital in the State. Delaware, Nebraska, and Minnesota have adopted similar laws.
My Administration can expand on these important steps to ensure that patients can receive compassionate care and equal treatment during their hospital stays. By this memorandum, I request that you take the following steps:
1. Initiate appropriate rulemaking, pursuant to your authority under 42 U.S.C. 1395x and other relevant provisions of law, to ensure that hospitals that participate in Medicare or Medicaid respect the rights of patients to designate visitors. It should be made clear that designated visitors, including individuals designated by legally valid advance directives (such as durable powers of attorney and health care proxies), should enjoy visitation privileges that are no more restrictive than those that immediate family members enjoy. You should also provide that participating hospitals may not deny visitation privileges on the basis of race, color, national
origin, religion, sex, sexual orientation, gender identity, or disability. The rulemaking should take into account the need for hospitals to restrict visitation in medically appropriate circumstances as well as the clinical decisions that medical professionals make about a patient's care or treatment.
2. Ensure that all hospitals participating in Medicare or Medicaid are in full compliance with regulations, codified at 42 CFR 482.13 and 42 CFR 489.102(a), promulgated to guarantee that all patients' advance directives, such as durable powers of attorney and health care proxies, are respected, and that patients' representatives otherwise have the right to make informed decisions regarding patients' care. Additionally, I request that you issue new guidelines, pursuant to your authority under 42 U.S.C. 1395cc and other relevant provisions of law, and provide technical assistance on how hospitals participating in Medicare or Medicaid can best comply with the regulations and take any additional appropriate measures to fully enforce the regulations.
3. Provide additional recommendations to me, within 180 days of the date of this memorandum, on actions the Department of Health and Human Services can take to address hospital visitation, medical decisionmaking, or other health care issues that affect LGBT patients and their families.
This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
You are hereby authorized and directed to publish this memorandum in the Federal Register.
BARACK OBAMA
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