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November 18, 2010 Posted

CMS requires hospitals to respect visitation rights for same-sex couples

The Centers for Medicare & Medicaid Services (CMS) issued new rules that require most hospitals to grant visiting rights to gay and lesbian partners and allow them to make medical decisions regarding their partner's care.

President Obama in April ordered HHS Secretary Kathleen Sebelius to develop new regulations to ensure more inclusive hospital visitation standards (see related coverage in the April 16 Daily Briefing). HHS proposed the rules in June (see related coverage in the June 24 Daily Briefing) and received approximately 7,600 "overwhelmingly favorable" comments from health care stakeholders, with unanimous support from hospital groups.

The final rule requires hospitals participating in Medicare and Medicaid to maintain written policies regarding patients' visitation rights and the conditions under which medical staff can restrict visitors' access to patients for clinical reasons. All visitors chosen by the patient, or a representative for the patient, must be granted "full and equal" visitation rights consistent with the patient's wishes, regardless of their relation to the patient, according to the final rule.

The rule follows reports of hospitals denying some patients visits from their same-sex partners and adopted children. "[T]hese rules make it easier for hospitals to deliver on some of the fundamental tenets of patient-centered care-care that recognizes and respects the patient as an individual with unique needs," said CMS administrator Don Berwick. "Basic human rights-such as your ability to choose your own support system in a time of need-must not be checked at the door of America's hospitals," Sebelius said

(HHS release, 11/17

May 2007: Ann Fonfa, founder of the Annie Appleseed Project writes: I have just been appointed to the new Lesbian, Gay, Bisexual and Transgender (LGBT) National Advisory Council of Komen for the Cure which addresses the breast health needs and issues among lesbian, gay, bisexual and transgender persons. (See announcement below)

I am extremely honored by this and intend to represent our community to the best of my abilities.

I welcome your input and ideas. I like to think I can make a difference.

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Some years ago, Suzanne Haynes,a researcher at NCI (National Cancer Institute) speculated and created a computer model as to risk factors for lesbians. This was probably the first time something like this was done.

The New York Times printed this information. It stated all the suggestions as fact. This was the bulk of what was said:

Lesbians are at higher risk due to smoking, drinking, being overweight and not having children.

While it may be true, especially in the past, that lesbians were more likely to smoke or drink than other women, this is NOT a scientific study in any way.

Many lesbians have children and many Americans are overweight. (NOTE:when cancer strikes in Africa or Asia, the women are thin, malnourished, bear five children on average and breastfeed them all. This confounds our notions of risk factors anyway).

6/01 I had the pleasure of meeting and talking to Suzanne Haynes who is now with the Office of Womens Health, HHS. She is really dedicated to finding information for lesbian health issues. She spoke at the first National Lesbian Health Conference held in San Francisco this month. NCI has issued a call for research in lesbian health. Grant money is now available.

The issues for lesbians, as I see it, are primarily about access to health care and the difficulties after diagnosis.

Access to health care issues are the same in cancer as all other health care. Dealing with the uninformed or homophobic is always difficult. Many lesbians walk away or do not start health care due to fears and barriers encountered at the doctor's office or clinic.

There are lesbian-run health clinics in some cities which simplifies things.

Problems after diagnosis are much more complex. Doctors may not allow non-family members to 1)be in the room at critical times 2)make decisions (even with health proxies, this can be difficult) 3)or be regarded as the partner.

Sometimes family is the problem. Other family members may resent the partner, may be angry at the woman who is ill, etc.

Grieving is also a difficulty. It is often misunderstood or under-recognized. A grieving widow from a lesbian relationship MUST get to a sympathetic group or counselor to express her feelings. And this may be a difficulty in some locations.

There are other issues.

Health Links for LGBT Community

Many LGBTI health links

The Mautner Project
Adephi Lesbian Breast Cancer Support Group
Gay Men's Health LINKS
For Religious LGBT Youth - Message from Bishop Gene Robinson

It Gets Better!

LGBT Advisory Council for Susan G. Komen for the Cure

June 20, 2007

The Mautner Project

Services for lesbians w/cancer and their partners/caregivers

One woman's short story

Fear of homophobia complicates a decision

Quality of Life and Coping study

Quality of Life study to begin

Psychosocial Intervention with Primary Bca Pts
Lesbians/Heterosexuals with Breast Ca:Experiences
Singer Melissa Etheridge Says Med MJ Helped Chemo
Lesbian-sensitive health clinics:Scotland

11/99 news article

Improving Cancer Screening Among Lesbians Over 50
Patterns of Breast Ca Screening Among Lesbians At Risk
Unmarried Women Feel Misunderstood:Straight or Gay!
Cancer Institute of New Jersey

Screening and information for lesbian, bisexual and transgendered

At Greater Risk for Some Cancers?

April 2001, American J of Public Health

Teenage Lesbians Worst Rates of Smoking
Rainbow Circle & Outreach

Philadelphia-based Linda Creed Breast Cancer Foundation

Discussion on Lesbians with Breast Cancer Project

Book Review:Coming Out of Cancer

Chicago Free Press, 11/00

National Coalition for LGBT Health

Press Release, 11/00

Gay & Lesbian Elders: Health Discrimination

4/03 The Genontologist

Polycystic Ovarian Syndr:  Lesbians

Euro Soc of Human Repro & Embryology, 6/03

Healthcare from a Chicana Lesbian's Point of View

National Latina Health Organization Winter, 1995

Health Behaviors, Status & Access:Lesbians/Bi-sexual/Hetero
"Dinosaur Doc" Play about Unenlightened doctor,lesbian pts

June 29, 2004 Author Michele Forsten

Obits of Prominent Lesbians Dead of Cancer

March 17, 2005 and other obits

Laurel Hester, NJ Police Lieutenant Won Domestic Partnerships
Elizabeth Maguire, 47, Editor, Ovarian Cancer
Eve Kosofsky, Queer Studies, Writer, Age 58
Barbara Gittings, 74, Prominent Gay Rights Activist Since 50s, Dies
Joint Statement: AMA & GLMA:  LGBT Issues to be included

Press Release, March 15, 2005

AMA President Addresses GLMA Conference, 2005
Transgender Issues

Associate Press article, 5/06

Lesbian and Transgender ACS Project
Obit: Sylvia Rivera Gender Variant Activist
Simple Things a Practitioner Can Do ( make LGBT more welcome)

Ask your practitioner to take these steps

CA Supreme Court Rules on Religiously Biased Healthcare
The Safeguards Project & LGBT Health Res Ctr

LINK to Philadelphia, PA Mission: "enhance the health of lesbian, gay, bisexual, & transgender individuals & communities".

"Taking Inventory" - from a weekly breast cancer support group

Michele Forsten, February 2008 The Advocate and PlanetOut Inc

Focus on Lesbian Health

By Kathleen DeBold,

March/April 2007

Survey - Bisexual Women in Poorest Health Public Health, June 2010

Underestimation of Relative Risks Standardized Incidence Ratios  AIDS-Related Ca

Annals of Epidemiology March 2008,

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