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Top Questions of Employers - Sexual Orientation and Gender Identity Law

Client Alert

One month ago, the United States Supreme Court, in Bostock v. Clayton County, determined that federal law (Title VII of the Civil Rights Act of 1964) protects employees on the basis of sexual orientation or gender identity.  Our earlier post discussed the full decision.  The purpose of this article is to share and address the Top Questions of Employers since that decision was rendered.

Q:  What do we tell our employees?

In strictest terms, the Bostock decision evaluated Title VII, which generally means it only applies to employers who have 15+ employees working 20+ weeks per year.  Also, Bostock only prohibits terminations because of sexual orientation or gender identity.

In practice, however, federal, state, and local courts, laws and agencies have broadly been protecting individuals on the basis of sexual orientation or gender identity for decades.  Remind your employees that the Anti-Discrimination Policy in your handbook prohibits any harassment or discriminatory conduct on the basis of sexual orientation or gender identity.  This includes hiring, firing, promotions, discipline, raises, bonuses, and other terms and conditions of employment.  It’s the same strict prohibition against conduct relating to race, creed, color, alienage or national origin, ancestry, citizenship status, religion, marital status, veteran or military status, age, sex, pregnancy, disability, or genetic information.

The final recommendation is to remind employees that “I was joking” is not a defense to a harassment claim.  Jokes regarding sexual orientation or gender identity are prohibited in the workplace.

Q:  What do we do about bathrooms and changing rooms?

As everyone knows, the main reason I decided to attend law school was to concentrate on the complexities of bathroom law.  Now, after practicing law for 20 years, it’s finally my time to shine.

The general recommendation is that employees should be permitted to use the restrooms consistent with their gender identities.  The Bostock decision specifically avoided this question, but it has been addressed elsewhere.  The Occupational Safety and Health Administration’s (OSHA’s) Guide to Restroom Access for Transgender Workers includes, as a Core Principle, that all employees, including transgender employees, should have access to restrooms that correspond to their gender identity.

Likewise, the Equal Employment Opportunity Commission (EEOC) has regularly guided employers to allow employees to use restrooms and locker rooms based upon the employee’s gender identity, regardless of sex at birth and regardless of the status of any sex-reaffirmation procedures.

Finally, over a dozen states and cities already have laws/codes requiring gender-neutral restrooms.

Exceptions from the general recommendation may exist based upon unique circumstances (i.e., religion or protective gear), but they are limited and require analysis of the totality of the circumstances.   

Q:  What do we do about dress codes?

We generally begin answering this question with our own question: Do you enforce a dress code policy, let alone a sex-specific dress code policy?  Usually, the answer is “no.” Employers can implement gender-specific dress codes if they are not arbitrarily enforced and do not favor one gender over another.  Employers are permitted to maintain sex-specific dress codes and grooming standards when they involve a bona fide occupational qualification (BFOQ) reasonably necessary to the regular operation of the business.  The real question is what to do about dress codes based on gender identity and expression.   

Again, the Bostock decision did not address dress codes, even though one of the underlying cases included an issue of an employer refusing to allow an employee to dress according to her gender identity and expression.  However, the EEOC and state and local courts and laws have initiated the trend to protect employees’ rights to dress according to their gender identity and expression.

Our recommendation is to implement a gender-neutral dress code. A concise policy requiring employees to “appear for work dressed professionally in clean attire or risk being sent home to change” can be enough.  If an employer implements a detailed policy, then we offer the same general recommendation: employees should be permitted to dress consistent with their gender identities and gender expression.

Q:  Anything else we need to know?

The protections for employees on sexual orientation and gender identity will continue to expand, and that expansion is expected to be at the state and local levels.  The protections are unique to each jurisdiction and subject employers to a variety of requirements.  For example, the New York City Human Rights Law requires employers to use the name, pronouns, and titles with which an employee identifies, regardless of the person’s sex assigned at birth, anatomy, gender, medical history, appearance, or the sex indicated on the person’s identification.  It is important for all employers to review their federal, state, and local obligations on a regular basis for each of their locations.

For additional information, please contact Jeffrey C. Miller, jcmiller@bmdllc.com 216.658.2323, or any member of the Labor and Employment Team of Brennan Manna & Diamond LLC.


HIPAA Business Associate Agreements: Why These Contracts Matter

No one loves drafting, reading or negotiating HIPAA Business Associate Agreements (BAAs). Yet many of us need to do so, and some of us do so daily. They are often boring, dense and technical, but BAAs are important from both a legal and a business perspective, and they deserve our attention. Failure to enter a BAA when one is required can constitute a HIPAA violation that results in substantial liability, as demonstrated by certain recent Department of Health & Human Services (HHS) settlements.1 A business associate who makes a disclosure that is not authorized by the applicable BAA or required by law can be subject to civil and, in some cases, criminal penalties. Further, parties are often presented with BAAs that contain onerous one-sided indemnification and other provisions that can be devasting to an organization in the event of a HIPAA breach. The significance of a BAA is often not fully understood by the parties until something goes wrong (e.g., a HIPAA security incident or breach, an Office of Civil Rights (OCR) audit or a fracture in the relationship between the parties) and, at that point, there is limited opportunity to mitigate legal and business risk. Ideally, attention should be given at the commencement of the business associate relationship, when the parties are able, to thoughtfully addressing regulatory requirements, planning and preparing for potential adverse events and appropriately allocating risk among the parties. As with most healthcare regulatory compliance initiatives, a proactive approach with respect to BAAs is preferable. This article provides a broad overview of certain BAA requirements and some practical negotiating tips for the parties involved.

“I’m Out Of Here!” Now What?

We all know that the healthcare industry is experiencing a wave of integration. This trend has been evident for many years. Fewer physicians are willing to assume the legal, financial and other business risks associated with owning their own practices. More and more physicians, including anesthesiologists, are becoming employed by large physician groups, health systems and national providers. This shift necessarily involves not only entry into new employment arrangements but also the termination of existing relationships. And those terminations are often governed by written employment agreements, state and federal healthcare laws and employer benefit plans and other policies and procedures. Before pursuing their next opportunity, physicians should pause for a moment and first attend to the arrangement that they are leaving. Departing physicians need to understand their legal rights and obligations when leaving their current employment relationships in order to avoid unintended consequences and detrimental missteps along the way. Here are a few words of practical advice for physicians contemplating an exit from their current employment arrangements.

Investment Training for the Second and Third Generations

Consider this scenario. Mom and Dad started the business from the ground up. Over the decades it has expanded into a money-making machine. They are able to sell the business and it results in a multimillion-dollar payday for their labors. The excess money has allowed Mom and Dad to invest with various financial advising firms, several fund management groups, and directly with new startups and joint ventures. Their experience has made them savvy investors, with a detailed understanding of how much to invest, when, and where. They cannot justify formation of a full family office with dedicated investors to manage the funds, but Mom and Dad have set up a trust fund for the children to allow these investments to continue to grow over the years. Eventually, Mom and Dad pass. Their children enjoy the fruits of their labors, and, by the time the grandchildren are adults, Mom and Dad's savvy investments are gone.

Provider Relief Funds – Continued Confusion Regarding Reporting Requirements and Lost Revenues

In Fall 2020, HHS issued multiple rounds of guidance and FAQs regarding the reporting requirements for the Provider Relief Funds, the most recently published notice being November 2, 2020 and December 11, 2020. Specifically, the reporting portal for the use of the funds in 2020 was scheduled to open on January 15, 2021. Although there was much speculation as to whether this would occur. And, as of the date of this article, the portal was not opened.

Ohio S.B. 310 Loosens Practice Barrier for Advanced Practice Providers

S.B. 310, signed by Ohio Governor DeWine and effective from December 29, 2020 until May 1, 2021, provides flexibility regarding the regulatorily mandated supervision and collaboration agreements for physician assistants, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners working in a hospital or other health care facility. Originally drafted as a bill to distribute federal COVID funding to local subdivisions, the healthcare related provisions were added to help relieve some of the stresses hospitals and other healthcare facilities are facing during the COVID-19 pandemic.