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LGBTQIA+ Patients and Discrimination in Healthcare

Client Alert
June 6, 2024

In early April, the Kaiser Family Foundation released a study outlining the challenges that LGBT adults face in the United States related to healthcare.[1] According to the study, LGBT patients are “twice as likely as non-LGBT adults to report negative experiences while receiving health care in the last three years, including being treated unfairly or with disrespect (33% v. 15%) or having at least one of several other negative experiences with a provider (61% v. 31%), including a provider assuming something about them without asking, suggesting they were personally to blame for a health problem, ignoring a direct request or question, or refusing to prescribe needed pain medication.”[2]

Additionally, the study showed that LGBT patients were more likely to have negative health care experiences in the past three years that caused their health to get worse and were less likely to seek care.[3] Lower income patients, as well as those who are younger, or are women, reportedly experience higher rates of discrimination and unfair treatment than older, male LGBT patients.

Avoiding Discrimination
Providers can take steps to make healthcare more inclusive for the LGBTQIA+ community, which includes lesbian, gay, bisexual, transgender, queer, intersex, and asexual individuals.

First, implementing an intake protocol to quickly identify LGBTQIA+ individuals can promote patient-centered care and foster an inclusive environment for all patients. For example, providers can include prompts such as gender history, sexual orientation, gender identity, and sex assigned at birth. Further, the method for collecting the information should be considered. Typically, utilizing a registration desk is least preferred by patients, however, other ideas include capturing information on paper or laminated forms with dry erase markers, electronic check-ins from the patient’s home, self-check-ins at the healthcare facility, or going over information in a private setting with a medical assistant, nurse, or other provider.

Additionally, gender and LGBTQIA+ status is considered protected health information (PHI) under HIPAA. Therefore, intake forms should include confidentiality and privacy language, and medical staff should be equipped to discuss HIPAA protections with patients to help them understand the security of their sensitive information.

Providers should also consider implementing training to identify and treat the unique health needs of LGBTQIA+ patients. Trainings can focus on improving patient-provider communication, enhancing patient-centered, compassionate care, and creating a safer and more inclusive environment.

The Joint Commission’s Field Guide recommends the following practices:

  1. Integrate unique LGBTQ+ patient needs into new policies or modify existing policies
  2. Review nondiscrimination and visitation policies, revise the definition of family
  3. Demonstrate ongoing commitment to inclusivity for LGBQT+ patients and families
  4. Develop a mechanism for reporting discrimination or disrespectful treatment[4]

Lastly, providers should ensure they are complying with local, state, and federal laws related to discrimination. Relevant federal laws to be aware of include the Public Health Services Act, which among other prohibitions, prohibits discrimination on the basis of age, race, color, national origin, disability, religion, or sex in programs, services, and activities funded by Preventative Health and Health Services Block Grants;[5] Section 1557 of the Affordable Care Act, which prohibits discrimination against individuals on the basis of race, color, national origin, sex, age and disability in covered health programs or activities; and the Emergency Medical Treatment and Labor Act (EMTALA), which requires Medicare-participating hospitals with emergency departments to provide medical screening examinations to any individual who comes to the emergency department and requests examination, regardless of ability to pay or insured status.[6]

If you have any questions regarding caring for LGBTQIA+ patients and avoiding discrimination, please don’t hesitate to contact BMD Health Law Group Member Jeana M. Singleton at jmsingleton@bmdllc.com or 330-253-2001, or BMD Attorney Rachel Stermer at rcstermer@bmdllc.com or 330-253-2019.  

[1] Kaiser Family Foundation, “LGBT Adults’ Experiences with Discrimination and Health Care Disparities: Findings from the KFF Survey of Racism, Discrimination, and Health” (Apr. 2, 2024) https://www.kff.org/racial-equity-and-health-policy/poll-finding/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health/. 

[2] Id.

[3] Id.

[4] The Joint Commission, “Meeting the Needs of the LGBTQ+ Community – Then and Now” (June 25, 2023) https://www.jointcommission.org/resources/news-and-multimedia/blogs/advancing-health-care-equity/2022/06/meeting-the-needs-of-the-lgbtq-community/#:~:text=The%20Joint%20Commission's%20Field%20Guide,policies%20or%20modify%20existing%20policies. 

[5] 42 USC § 300w-7.

[6] 42 USC § 1395dd.

LGBTQIA+Protecting LGBTQ CommunityHealth LawHealthcareJeana SingletonRachel Stermer
Client Alert

Ramping Up – A Quick Guide to Pressing COVID-19 Employment Law Issues

November 19, 2020As the country continues to grapple with a global pandemic that now seems to be never-ending, businesses everywhere are waking up to realize that the calming of the COVID-19 employment issues over the summer has come to an end. As cases rise exponentially in all 50 states as we head into the winter months, the number of employment issues related to COVID-19 will also increase dramatically. For these reasons, it is important that we return to the employment law basics that were covered this prior spring, while highlighting the many lessons we have learned along the way. As COVID-19 matters and concerns continue to hinder the working environment of every business, it is important that you reference this review to guide you through these tough issues and questions.Client Alert

Your Workplace Under Biden

November 9, 2020This is my favorite recurring post – Predictions of How a New Administration Will Affect Your Workplace. Four years ago, we accurately called the emasculation of the 2016 proposed FLSA Overtime Rules (the salary exemption threshold was set at $35,568 in 2019, rather than $47,476 as proposed), we forecasted a conservative shift of the NLRB and its results (a roll-back of employee rights, social media policy evaluations, and joint employer rules), and we nailed the likelihood of multiple conservative appointments to the United States Supreme Court and its long-term effects (although I completely failed to predict that my ND classmate Amy Coney Barrett would fill the final vacancy during the Trump administration). This time, the L+E Practice of BMD has decided to make it a group effort at predicting what will happen, what probably happen, and what might happen under President Biden. As always, please save this in your important files and pull it out four (or eight) years from now to judge our accuracy.Client Alert

HHS Provider Relief Funds Reporting Requirements: Important Updates Every Provider Should Know

November 4, 2020HHS continues to revise its reporting requirements for the use of the Provider Relief Funds. Providers with more than $10,000 in Provider Relief Fund payments must report on the use of the funds through December 31, 2020. The reporting window will begin on January 15, 2021 and providers must complete reporting obligations for FY 2020 by February 15, 2021 through a portal designed by HHS. However, providers that have unexpended funds as of December 31, 2020, will have an additional 6 months to use the remaining funds through June 30, 2021. These providers must submit a second and final report no later than July 31, 2021.Client Alert

Should I Apply for Phase 3 Funds? Important Considerations Every Provider Should Know

November 2, 2020On October 1, 2020, the Department of Health and Human Services (“HHS”) announced an additional $20 billion in new funding for providers through a Phase 3 distribution. Importantly, providers that previously received HHS Provider Relief Funds or already received payments of approximately 2% of annual revenue from patient care are eligible to apply. Eligible providers have until November 6, 2020 to apply for these Phase 3 Funds. However, the question from providers continues to be: Should I Apply for Phase 3 Funds?Client Alert

CISA Ransomware Practices

October 29, 2020On October 28, 2020, the United States Cybersecurity and Infrastructure Security Agency (CISA) issued an alert warning of imminent threats to US hospitals and healthcare providers. The specific threat involves RYUK Ransomware attacks. RYUK is a novel ransomware that goes undetected by commercial anti-virus/malware detection programs. Once deployed, RYUK encrypts all data and disables systems. In short, it cripples all functionality down to phone systems and automated doors. Healthcare providers should alert their employees to remain hyper-vigilant and report any suspicious activity seen in email or on networks. It has been reported healthcare providers in New York, Pennsylvania and Oregon have been targeted in the last 48 hours. If your organization encounters issues, BMD can assist in mobilizing a response team and has contacts with forensic IT firms that are familiar with RYUK. It is advisable to engage professionals with experience dealing with this specific threat.
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