The undersigned LGBT organizations are deeply disappointed that the Department of Health and Human Services (HHS) has announced it will not add explicit nondiscrimination protections for LGBT and other consumers to Medicaid's Home- and Community-Based Services (HCBS) program. Our organizations along with the National Senior Citizens Law Center, have urged HHS over the past three years to adopt these protections to ensure low-income older adults and people with disabilities can receive needed services and supports without fear of refusal, harassment, or other discrimination because of who they are. The protections were not included in a final rule issued last week to strengthen standards for the long-running program.
HHS seemingly based its decision to reject these LGBT protections, which have been included in other HHS programs, on the notion that general nondiscrimination protections already exist. Despite being made aware of the critical need for explicit LGBT consumer protections, as well as protections on the basis of religion, marital status, and source of payment, HHS simply stated in a new HCBS regulation that these protections were "not necessary."
HHS's surprising statement that protections for LGBT seniors are "not necessary" is contradicted by reports from the Institute of Medicine and the Agency for Healthcare Research and Quality, which have found that discrimination against LGBT people in health settings is widespread. A survey of providers, LGBT consumers, and family members conducted with the National Senior Citizens Law Center found that most believed anti-LGBT discrimination was a problem in long-term care settings and many had witnessed discrimination. Failure to include explicit protections undermines efforts prevent anti-LGBT discrimination in home- and community-based care.
We call on HHS to take immediate action to ensure the health and safety of LGBT seniors and people with disabilities by addressing discrimination based on sexual orientation and gender identity in amended rule or guidance. We also strongly urge HHS to take action to address anti-LGBT discrimination in other health care settings, particularly hospitals and nursing homes. While we urge LGBT consumers who face discrimination in any health setting, including home- and community-based services, to file complaints with HHS on the ground of sex discrimination, explicit LGBT protections are needed to prevent mistreatment and denials of care.
Human Rights Campaign
National Center for Transgender Equality
National Gay and Lesbian Task Force
Services and Advocacy for GLBT Elders (SAGE)