LANDMARK EVENT
Gary Fitzsimmons on DP benefits: ‘I don’t believe our community should expect anything less’
District Clerk Gary Fitzsimmons
In today’s print edition we have a story about Parkland hospital’s decision to begin offering domestic partner benefits — and Dallas County’s decision not to. In the story we quoted openly gay Dallas County District Clerk Gary Fitzsimmons, who criticized the Commissioners Court for failing to adequately study the cost of DP benefits before opting not to offer them due to the budget shortfall. Below is the full text of an email Fitzsimmons sent me about the issue:
It is certainly gratifying that the Parkland Board of Managers has included DP benefits to cover LGBT employees. They join the most progressive public and private institutions in Dallas County in providing such benefits.
I asked former County Judge Jim Foster, a gay man, to direct Dallas County HR and the Budget Office to begin studying this issue and analyzing costs for such an initiative back in 2007. I was hoping that this information would be available to the new members of the court who took office in January 2011. Unfortunately, Mr. Foster failed to do so.
I visited with the new members of the court in January of this year and made the same request. It is therefore disappointing to me to find out that the court has not yet directed county staff to study this issue in a systematic way. The figures provided by the Dallas County public liaison were prepared “off-the-cuff” in response to an inquiry from the Dallas Voice. This is totally unacceptable.
This issued, because it does involve the potential expenditure of funds, should be studied and analyzed. County staff should prepare a report based on a review of the financial impact encumbered by other jurisdictions and private corporations that provide DP benefits.
I understand that there might not be a majority vote at this moment among members of the court; however, we will never get one as long as the court is not provided sufficient information to make an informed decision.
Amending the Dallas County civil service statute to include protection for LGBT employees is great and admirable. But of course it is largely symbolic and it has little potential financial impact. Supporting an initiative that would have a financial impact in order to bring equality to the Dallas County workplace is where the rubber meets the road. I don’t believe our community should expect anything less.
Parkland adds DP benefits; Dallas County won’t
County Judge Clay Jenkins, left, and District Clerk Gary Fitzsimmons
Fitzsimmons slams commissioners for failing to study issue
JOHN WRIGHT | Online Editor
wright@dallasvoice.com
The domestic partners of gay and lesbian employees at Parkland hospital will soon have access to health benefits, after the facility’s Board of Managers voted this week to approve a proposal first put forward nearly four years ago.
The Board of Managers voted 6-0, with one member abstaining, to offer DP benefits to gays and lesbians who are among the Parkland Health & Hospital System’s 9,400 employees.
The addition of DP benefits at Parkland, which takes effect Jan. 1, is expected to cost $696,635 in fiscal year 2012. But Dr. Lauren McDonald, who chairs the Board of Managers, said offering the benefits will make the hospital more competitive for workers and improve the quality of care it provides to patients.
“I think if anything it eventually enriches us as opposed to costing us money,” McDonald said after the vote, adding that DP benefits have been “a long time coming.”
In September 2007, McDonald pulled a proposal to add DP benefits from the Board of Managers’ agenda at the last minute, citing opposition from “ultra-right wing, homophobic” board members.
Parkland is Dallas County’s public hospital, and the Board of Managers is appointed by the Commissioners Court, which was then controlled by Republicans.
“We opted at the time not to even bring it up,” McDonald told Dallas Voice in 2008. “If you have a vote that’s negative, you send a message.”
After Democrats took control of the Commissioners Court at the start of this year, several new members were appointed to the seven-person Board of Managers. The new members include Dr. Roberto de la Cruz, who is openly gay and made the motion to approve DP benefits on Tuesday.
“It’s a big day,” de la Cruz said after the vote, adding that he trained as an intern at Parkland in the 1990s. “It’s a personal day for me because I come from here.”
The Board of Managers member who abstained from Tuesday’s vote was Jerry Bryant. “I don’t want to discuss it,” Bryant said when asked the reason for his abstention. Bryant was appointed to the Board of Managers by Republican Commissioner Mike Cantrell earlier this year.
Although Parkland is adding DP benefits in 2012, the Commissioners Court has no plans to do so for Dallas County’s roughly 7,000 employees, County Judge Clay Jenkins confirmed this week.
Jenkins, a Democrat who chairs the Commissioners Court and supports offering DP benefits, said he was “very pleased” with the Parkland vote and had lobbied for the change among appointees to the Board of Managers.
“I think that’s the right thing to do for a variety of reasons,” Jenkins said. “We’ve got to recruit and keep the very best staff, and this is an important component of successfully doing that.”
But Jenkins noted that the county is facing a $35 million budget shortfall this year and already plans to cut $5.6 million in employee health care costs — under a proposal that’s set to be voted on by the Commissioners Court next Tuesday, Aug. 30.
Jenkins said he hopes to look at adding DP benefits next year, when the county’s budget shortfall is expected to be smaller. He added that the Parkland board’s vote will “put the county in a better position to favorably consider doing this.”
“I will use the empirical data that arises from that decision in crafting a plan for the county,” Jenkins said.
District Clerk Gary Fitzsimmons, who’s openly gay, said a plan for the county to offer DP benefits should already have been crafted.
Fitzsimmons said he met with the newly elected members of the Commissioners Court —Jenkins and Dr. Elba Garcia — in January and asked them to initiate a study of the cost of offering DP benefits.
But when Dallas Voice inquired about the status of the DP benefits initiative earlier this month, it became clear that no such study had been conducted. Instead, a county spokeswoman provided the newspaper with “off the-cuff” figures, Fitzsimmons said.
The Commissioners Court voted in April to add sexual orientation and gender identity to the county’s employment nondiscrimination policy. But Fitzsimmons called that move “largely symbolic” and said it has little potential financial impact.
“It’s not enough to expect our elected officials to support equality in the workplace when it doesn’t cost them,” Fitzsimmons said. “They need to support equality in the workplace when it does cost them.”
BREAKING: Parkland adds DP benefits
Dr. Roberto de la Cruz
The domestic partners of gay and lesbian employees at Parkland hospital will soon have access to health benefits, after the facility’s Board of Managers voted Tuesday to approve a proposal first put forward four years ago.
The Board of Managers voted 6-0, with one member abstaining, to offer DP benefits to gays and lesbians who are among the Parkland Health & Hospital System’s 9,400 employees.
The addition of DP benefits, which takes effect Jan. 1, is expected to cost $696,635 in fiscal year 2012. But Dr. Lauren McDonald, who chairs the Board of Managers, said the benefits will make Parkland more competitive and improve its quality of care.
“I think if anything it eventually enriches us as opposed to costing us money,” said McDonald, adding that DP benefits have been “a long time coming.”
McDonald also chaired the Board of Managers in September 2007, when a proposal to add DP benefits was pulled from the board’s agenda at the last minute due to political pressure. Parkland is owned by Dallas County, and the Board of Managers is appointed by the Commissioners Court, which was then controlled by Republicans.
After Democrats took over control of the Commissioners Court at the start of this year, several new members were appointed to the seven-person Board of Managers.
They include Dr. Roberto de la Cruz, who is openly gay and made the motion to approve DP benefits on Tuesday.
“It’s a big day,” de la Cruz said after the vote, adding that he trained as an intern at Parkland in the 1990s. “It’s a personal day for me because I come from here.”
The Board of Managers member who abstained from Tuesday’s vote was Jerry Bryant. “I don’t want to discuss it,” Bryant said when asked the reason for his abstention.
Dallas County unlikely to add DP benefits
County Judge Clay Jenkins
Faced with a $35 million budget shortfall, Dallas County is unlikely to begin offering benefits to the domestic partners of gay and lesbian employees as part of its 2012 budget, a county spokeswoman said last week.
County Judge Clay Jenkins, who chairs the Commissioners Court, has said he supports offering domestic partner benefits. The Commissioners Court, which has a Democratic majority for the first time in decades, voted earlier this year to add LGBT employees to the county’s nondiscrimination policy.
But Dallas County spokeswoman Maria Arita said last week it costs the county an additional $3,552 for every spouse added to an employee’s health insurance. And according to the Dallas Morning News, the county is already proposing to cut $5.6 million in employee health care costs in 2012.
“It really does come down to dollars and cents,” Arita told Instant Tea. “He [Jenkins] likes equality in the workplace in every way for every employee. There’s just no equivocating about that, plain and simple, and if it were possible to offer all benefits to all employees … then he would do that.”
Jenkins is scheduled to discuss the issue further in an interview with Instant Tea on Wednesday.
The city of Dallas has offered DP benefits since 2004, and Fort Worth added them last year.
Who decides what’s medically necessary?
Mara Keisling
Trans advocate says trans health benefits are about what medical treatments are necessary, not about cost or personal beliefs
TAMMYE NASH | Senior Editor
nash@dallasvoice.com
Say the phrase “transgender health benefits,” and most people immediately think insurance coverage that pays at least some of the costs of sexual reassignment surgery. But there’s a lot more to it than that.
The problem, said National Center for Transgender Equality Executive Director Mara Keisling, is that issues of medical treatment are being made by accountants rather than by doctors. And trans-phobia is playing a role in too many of those decisions.
Neither the city of Dallas, the city of Fort Worth, Dallas County nor Tarrant County offer fully inclusive health care benefits for their employees. But they are not alone.
According to reports, when city officials in Portland, Ore., voted unanimously earlier this month to offer transgender health care benefits, the city became only the third local government in the nation to do so. San Francisco city and county — one combined government — was first, and Oregon’s Multanomah County was second.
In the business world, the odds are a little better for trans employees looking for adequate insurance coverage. According to the Human Rights Campaign, in 2009, 22 percent of the Fortune 100 companies offered trans-inclusive health benefits, while such benefits were offered by 7 percent of Fortune 500 companies, and 3 percent of Fortune 1,000 companies.
Still, those numbers are dishearteningly low. And sometimes, even when a trans person thinks they are covered, insurance companies — whether in an attempt to cut costs or out of anti-trans bigotry — will find a way to deny claims.
“A lot of insurance plans exclude what they call ‘transition-related care,’” Keisling said. “That can mean a lot of different things, but they all have similar implications.”
“Transition-related care” can be divided into two parts, Keisling said: the costs directly related to gender reassignment surgery, and the other treatments and services that are related, things like checking hormone levels, lab tests, and mental health services associated with the transition process.
“Even someone who has fully transitioned probably still needs to get her hormone levels checked on a regular basis. And insurance companies will deny those claims by saying they are ‘transition-related,’” Keisling said.
This is also the issue of sex-specific care, she continued. After transitioning, a trans woman will qualify for regular mammograms, but not for regular prostate exams — which she still needs, too.
And a lot of trans men face similar difficulties, Keisling said. “A trans man might need a pap smear or some other kind of gynecological care, and they are often told no, insurance won’t cover that,” she said.
She described another case in which a trans man was told by his doctors that he was facing serious gynecological problems and needed to have a hysterectomy. Because he was trans, however, insurance wouldn’t pay.
“Insurance said, ‘No. We don’t pay for sex-change operations. The doctors said this is transition surgery. This is a medically-necessary procedure.’ But they wouldn’t pay,” she said.
But in some cases, the discrimination is even more blatant.
“The insurance for federal government employees specifically excludes coverage for the costs of [gender reassignment surgery], but there have been a number of cases where that was used to exclude coverage of any type for transgenders,” Keisling said.
“I know of a federal employee who was told insurance wouldn’t pay for care for her son’s broken arm because she was transgender. Another trans woman who was anemic and needed transfusions was told insurance wouldn’t cover the treatments because she had ‘transsexual blood,’” she said.
“The list goes on and on. I know another trans woman who was playing for a woman’s softball team and broke her arm during a game,” Keisling continued. “She went to the hospital, had the X-rays and got her arm set. Then the insurance company turned around and denied the claim. They said if she weren’t transsexual, she wouldn’t have been out there playing for a women’s team and she wouldn’t have broken her arm.”
When it comes to these “really egregious stories” that are “so clearly wrong,” Keisling said, the victims can hire lawyers and get remedies through the courts. Still, she said, “You have to know what to do, how to get things fixed.” And court cases aren’t cheap, either.
Still, things do seem to be changing for the better, at least when it comes to federal employees, Keisling said. Federal officials recently issues a letter to employees stressing that when it comes to the exclusionary language in the insurance policy, “surgery means just that — surgery, not pre-operative care or post-operative care. And they stressed that this isn’t a change. They aren’t just now saying that. That has always been the rule. They just want to make sure people know the rule and follow it.”
Officials with the Veterans Administration also sent a similar letter regarding insurance coverage for transgender veterans.
But the message doesn’t seem to be filtering down to lower levels of government. For instance, mayoral runoff candidates in both Dallas and Fort Worth have said that when it comes to the question of health benefits for transgender city employees, they have to study the issue more before deciding where they stand. And for three of them — Mike Rawlings and David Kunkle in Dallas and Betsy Price in Fort Worth — it comes down to a question of costs.
Jim Lane, the other Fort Worth mayoral candidate, said at a recent candidate forum that as it had been explained to him in terms of Vietnam veterans suffering from post-traumatic stress syndrome: In the 1970s, most people dismissed claims of post-traumatic stress. But as medical science has advanced, post-traumatic stress has become acknowledged as a serious problem that requires medical-necessary treatment.
That, Keisling said, is what it all comes down to: What is medically necessary? And who gets to answer that question?
“We want the insurance to cover things that are medically necessary. We are not asking them to cover things that are not medically necessary,” she said. “Boob jobs are not in the medically necessary category. Electrolysis treatments, fertility treatments — those things are not medically necessary.”
Gender transition, though, is different. And, Keisling said, the American Medical Association agrees.
“The American Medical Association has said that transition-related health care is medically necessary. It is not experimental. It is not optional. It is medically necessary,” she said. “And we don’t want insurance companies deciding what is medically necessary. We don’t want city council members deciding what’s medically necessary. We want doctors making those decisions.”
The issue of cost, Keisling said, should not be an issue at all.
In fact, according to HRC’s website on transgender health care, “the annualized costs to the employer of providing insurance coverage for transgender-related care are typically minimal” and even “negligible for medium-sized to larger employers.”
The HRC website notes that the best available data on cost comes from the city of San Francisco and San Francisco County, and only limited data is available even then, since trans benefits are a relatively recent occurrence there.
“The cost of services per employee per year was minimal, with costs per insured per year averaging between $0.77 and $0.96: less than a dollar per year per enrollee,” according to information on the HRC website, which is based on the report San Francisco Transgender Benefit: Actual Cost and Utilization (2001-2006). “The precise number of claimants is uncertain since for most years the data is reported by claim and not by claimant. Thus the average dollars per claimant per year ranged between $3,194 and $12,771. The average five-year cost per claimant was between $15,963 and $63,853 for the period from 2001-2006.”
Keisling said, “Does it cost money to offer these benefits? Sure. But the truth is, it will save more money in the long run. With the proper benefits, people get to be healthy, physically and mentally, and that has an undeniable impact on the quality of the work they do.
“The real problem is that when people think of transition and treatment for transgenders, they think of it as something dirty,” Keisling added. “But it’s not dirty. It’s not shameful. It’s just like any other kind of medical care. This is about medical treatments that are medically necessary and that’s it. That whole debate over ‘medically necessary’ is done. It’s over.
“Now the businesses are starting to fall in line, and even the federal government. Now it’s time for the cities, for the counties to get on the stick and start offering their employees the benefits they deserve.”
A long road still lies ahead in the fight for equality
Pride Month celebrates our accomplishments, but an East Texas funeral service reminds us that we have a long way to go
RAFAEL McDONNELL | Special Contributor
This is national Gay Pride Month. In the 40-plus years since 1969 and the Stonewall Rebellion, there have been significant changes for lesbian, gay, bisexual and transgender people, and it’s important to celebrate our accomplishments.
Take a look at what has happened in the last year:
The federal government took the first steps toward repealing the “don’t ask, don’t tell” policy which bans open military service by gays and lesbians. Federal officials also unveiled new guidelines on how hospitals should deal with LGBT patients and their families.
Closer to home, DFW International Airport and Dallas County added policies to protect their LGBT employees from employment discrimination, and Dallas ISD adopted a comprehensive anti-bullying policy that protects all students regardless of sexual orientation, gender identity or gender expression.
I’m happy to say Resource Center Dallas played key roles in these local accomplishments.
In addition, public attitudes are changing. A Gallup poll released last month shows more than half the people surveyed now find gay and lesbian relationships, in the words of the survey, “morally acceptable.” The poll also showed half the people surveyed support marriage equality; up from 26 percent in 1996.
Much of this growth is attributed to people under the age of 35, and a change of attitude among men.
With all of these positive developments, we could become complacent. We could think the heavy work is done. At times, I’ve allowed myself to fall into this self-congratulatory trap.
Then I hear a story, as I did over Memorial Day weekend, which jars me back to the reality that our lives are precarious. It reminded me that there are far too many hearts and souls whose attitudes toward us have not changed.
At a funeral for a gay acquaintance of mine in East Texas, the minister delivered an anti-gay message from the pulpit, as did a relative of the deceased. In fact, the relative said he did not accept his brother’s sexual orientation in life, and wouldn’t in death.
Think about that for a minute. Can you imagine what the LGBT friends of the deceased must have felt, hearing those words in that setting?
This happened in 2011, a short drive from Dallas/Fort Worth. It stunned me, and reminded me of several recent events that together show the path for full inclusion remains bumpy.
When a state representative tries to eliminate funding for LGBT resource centers on Texas public college campuses, we have a long way to go. When a state senator attempts to restrict the rights of transgender Texans to marry, we have a long way to go.
When criminals target people because of their real or perceived sexual orientation, gender identity or gender expression, we have a long way to go. When LGBT people can still be fired from their jobs because of who they are or who they love, we have a long way to go.
When there are laws labeling our relationships and partnerships as less than legal and equal, we have a long way to go. When LGBT seniors face discrimination in long-term care facilities, we have a long way to go.
When we are treated unequally under federal programs like Social Security and Medicaid, we have a long way to go.
This is not meant to be a bucket of cold water on a festive, celebratory time. We’ve shown over and over again in the years since Stonewall that we have created communities, forged alliances and literally moved mountains to affect positive change for the LGBT community. We’ve rallied over the people we’ve lost and the temporary setbacks dropped in our path by lawmakers.
Rather, I think we should use Pride Month as an opportunity to look forward as well as back. Our pride in being who we are, regardless of sexual orientation, gender identity or gender expression, isn’t limited to 30 days every year, or a parade in the early fall. It’s pride in how we live our lives and how we work to fulfill the promise of equality for those who come after us.
Remember, this promise of equality is — for us — only a theoretical promise. To achieve equality, much more needs to be done, and each one of us must play a part.
Rafael McDonnell is strategic communications and programs manager for Resource Center Dallas and a former broadcast journalist. Email him at rmcdonnell@rcdallas.org.
The gay Facebook drama behind Rob Schlein’s endorsement of Wade Emmert for GOP chair
Rob Schlein
Dallas County Republican precinct chairs will meet tonight to choose a successor to Jonathan Neerman, who’s arguably been the most LGBT-inclusive leader in the local GOP’s history. The two candidates to replace Neerman are civil attorney and former county judge candidate Wade Emmert, and the tea party-affiliated former president of the Park Cities Republican Women, Debbie Georgatos.
As chair, Neerman publicly advocated for including groups like Log Cabin Republicans in the local party, in an effort to grow the base and try to stem the Democratic tide of the last five years. Naturally, this led to criticism of Neerman by social conservatives, and now the race to replace him has become the subject of some major gay Facebook drama. LCR President Rob Schlein is accusing Georgatos’ supporters gay-baiting in the campaign against Emmert, whom Schlein is now publicly endorsing.
It all started when Dallas County Commissioner Maurine Dickey canceled her scheduled appearance at next week’s monthly meeting of the gay GOP group. To replace Dickey, Schlein invited both Emmert and Georgatos to speak at the meeting — win or lose tonight’s election. “Both spoke about broadening the party so another ‘test’ was to see which candidate would have the courage to commit to openly speak to Log Cabin before a vote. I wanted to see whose actions would meet their words,” Schlein writes.
Schlein said he was impressed that Emmert immediately accepted the invitation. As for Georgatos, she replied to Schlein as follows: “I am sorry–that date is not possible on my caliber [sic]–and my life is crazy–let’s talk after the 17th (after i get a good night’s sleep). I am telling all the different clubs asking that i need to sort out my calendar after the 17th.”
We’re cynically concocting reasons about why Maurine Dickey bailed on Log Cabin Republicans
Rob Schlein
On Tuesday we told you that Dallas County Commissioner Maurine Dickey, who recently voted against transgender discrimination protections for Dallas County employees, was slated to appear at this month’s monthly meeting of Log Cabin Republicans Dallas. We have no idea whether Dickey saw our post — she doesn’t return our calls — but for whatever reason she has apparently cancelled the appearance. Log Cabin President Rob Schlein reports on Facebook:
Maurine Dickey’s office just emailed me with regrets they can’t make our May 23 meeting. The cynics will obviously concoct reasons…stay tuned for an article in the Voice! I have sent requests to both DCRP Chair candidates to speak (Wade Emmert and Debbie Georgatos.) By then, we will know the victor and hopefully be one of the first Republican clubs to hear from our new leader.
Maurine ‘Trans Fat’ Dickey to visit Log Cabin
Fresh off her vote against transgender protections for Dallas County employees, Commissioner Maurine Dickey is slated to visit the LGBT group Log Cabin Republicans Dallas this coming Monday. Above is an online invite from the group, which doesn’t mention Dickey’s vote against trans protections, or her previous statements comparing being transgender to being overweight (thus the headline). Dickey has said she feels the addition of “sexual orientation” to the county’s nondiscrimination policy was “overdue” — despite the fact that she was absent for a vote on that amendment in March. But she opposed the transgender protections in April because she didn’t want to add any more “special protected classes.” In the wake of her vote, 53 percent of respondents in a Dallas Voice online poll said they think the LGBT community should boycott Dickey’s Barbecue Pit, the restaurant chain she owns with her husband. We’ve been trying to determine whether Dickey’s — which bills itself as the largest barbecue chain in the U.S. — includes LGBT employees in the company’s nondiscrimination policy, but thus far we haven’t had any luck. The Log Cabin meeting is set for 6:30 p.m. at Mattito’s Mexican Cafe 3011 Routh St. in Dallas.
