Patient Centered Care: Equal Health Care Rights for All Americans

While different patients may need different treatments, rights and privileges should be equal.  This week, we’re taking big steps forward to improve the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) patients and their loved ones. 

Couples take a vow to be with each other in sickness and in health, and it is unfortunate that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need. Hospital visits from loved ones are key to a patient’s recovery.  And patients should be able to focus on their recovery process without worrying about whether their loved one will be admitted to their hospital room.  With this in mind, we’ve released 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. The guidance also addresses the enforcement of other rules that govern the right of patients to choose who will help make medical decisions on their behalf should they become incapacitated. This 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.

These rules set forth standards that all Medicare- and Medicaid-participating hospitals must meet.  They include a requirement that hospitals 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 consent to visitation at any time.  These rules apply to all patients of hospitals, even if they aren’t covered by Medicare or Medicaid.  

But improving LGBT health doesn’t stop there.  In a first-of-its-kind award, we recently awarded $248,000 to the Fenway Institute to create a National Training and Technical Assistance Center to help community health centers improve the health of LGBT communities.  This award is an important step in our continuing effort to ensure that health care services are available to all people, recognizing that different groups of people have distinct health care needs.

Fenway will work to:

• Recruit leading experts in LGBT health to lead seminars for  and provide consultation to health center staff;
• Develop curricula specifically targeted to LGBT populations; and
• Work closely with state primary care associations to maximize the geographic reach of the project.

These developments will help ensure that all patients, regardless of their sexual orientation or gender identity, will be treated with the respect and dignity they deserve.  They further empower patients and their families to make medical decisions that are best for them. The patient comes first – and, going forward, all patients who need care should be able to receive it in a safe, welcoming, and respectful environment.

Kathleen Sebelius is Secretary of the Department of Health and Human Services.