HHS rules Medicare must provide gender affirmation surgery

Official portrait of the Secretary of Health & Human Services Sylvia Mathews Burwell

HHS Secretary Sylvia Mathews Burwell

The Department of Health and Human Services ruled that a private insurance company that provides coverage under the Medicare Advantage program must cover a transgender person’s gender affirmation surgery. Charlene Lauderdale, a 55-year-old Texan covered by United Healthcare through Medicare Advantage, filed the lawsuit.

HHS lifted a ban on transition-related coverage in May 2014, but didn’t specify how that would apply to gender-affirming surgery.

HRC Legal Director Sarah Warbelow called it “a tremendously important step towards helping ensure that transgender people who rely on Medicare are no longer denied access to the basic, yet crucial, medical care they need.”

In September, HHS issued rules that insurers couldn’t deny coverage for trans-related healthcare. This ruling, however, is the most specific interpretation the department has issued.

Lauderdale is a former airport operations officer for the Houston aviation department, according to her Facebook page.

—  David Taffet

HHS to add LGBTs to data collection categories

HHS Secretary Kathleen Sebelius

Section 4302 of the Affordable Care Act already requires the U.S. Secretary of Health and Human Services (OK, so maybe not Secretary Sebelius herself, but her department) to “ensure that any federally conducted or supported health care or public health program, activity or survey collects and reports data, to the extent practicable, on race, ethnicity, sex, primary language and disability status, as well as other demographic data on health disparities as deemed appropriate by the Secretary.”

Today, Secretary Kathleen Sebelius announced new draft standards for collecting the required data, AND that she is adding LGBT populations to the demograhpic on which her office will collect data, in an effort to help health care providers better identify and address the “health disparities afflicting these communities,” according to a press release sent out this morning.

Under this new plan, HHS will integrate questions on sexual orientation into national data collection efforts by 2013, and to begin the process of collecting data on gender identity. Secretary Sebelius will also convene a series of roundtables with a variety of experts to come up with the best plan for efficiently collecting the data on LGBTs.

The end result will, hopefully, help eliminate disparities in health care these targeted populations face.

—  admin

President’s 2012 budget ‘could have been worse’

President Barack Obama

Although Obama’s proposal isn’t everything LGBT and HIV leaders want, they say it is better than what is likely to come out of the House

LISA KEEN | Keen News Service

There was relatively little for the LGBT and HIV communities to complain about in the proposed Fiscal Year 2012 budget released by President Barack Obama on Monday, Feb. 14. And given the president’s proposed five-year freeze in non-essential domestic spending, there were some sighs of relief.

Not that everything is hunky dory. There is no increase for the federal government’s program to fight bullying and LGBT youth suicide. Some HIV funding doesn’t keep up with the numbers of people needing help. And there was a significant slash to Community Development Block Grants, upon which many LGBT community health centers rely.

And the budget statements released with the proposed dollar figures had a healthy dose of bureaucratic double-speak. A three-page fact sheet specific to HIV programs says the budget “authorizes HHS to transfer 1 percent of HHS domestic HIV program funding (approximately $60 million) to support cross-cutting collaborations in areas such as increasing linkages to care and developing effective combinations of prevention interventions.”

But overall, community leaders seem pleased with the proposal.

David Stacy, deputy director of the Human Rights Campaign, said he’s generally pleased with President Obama’s proposal.

“In a budget where the president is proposing a five-year spending freeze, it’s great to see the administration is able to recognize HIV/AIDS as a priority for funding and to provide at least modest increases,” said Stacy. He also said HRC is also pleased to see modest increases in the budget for the Department of Justices for implementation of the new federal hate crimes law.

Lorri L. Jean, co-chair of Centerlink, a national organization of centers around the country which provide health services and other programs to the LGBT and HIV communities, said even the five-year freeze is not as scary as it sounds.

“The freeze in discretionary spending is at a level that is already much higher than under the previous administration,” said Jean. And with the tough economic climate in recent years, she said, LGBT centers “have taken our share of hits.”

But Jean said she thinks the federal government, under the Obama administration, has become more sophisticated in how it distributes program money.

“Instead of spreading money around a wide array of funders, some of which can’t produce results,” said Jean, “the federal government has gotten better at choosing organizations that can deliver.

“As worried as I am about all of it,” she continued, “it’s different now with our community than under the Bush administration. We’ve got an executive branch that is open to and significantly supportive of LGBT concerns being included in the funding streams. The difference is like night and day.”

Carl Schmid, deputy executive director of The AIDS Institute and one of about 40 HIV and LGBT leaders briefed about the budget at the White House on Monday, said he was pleased with the budget.

“We realize the resources of the federal government are severely constrained, therefore, under today’s fiscal environment, we are pleased the president has maintained his commitment to HIV/AIDS programs and even proposed some minimal increases,” Schmid said. “While the proposed funding levels are far from what is needed to provide the necessary care and treatment for people with HIV/AIDS or to significantly reduce the number of new infections, The AIDS Institutes appreciates the budget requests and now urges the Congress to show a similar level of support.”

Log Cabin Republicans are a stark exception to the LGBT and HIV communities’ relative comfort level with the president’s proposal. R. Clarke Cooper, Log Cabin’s national executive director, criticized the proposal for failing to cut more.

“Our nation is at a breaking point and the president’s budget proposal simply isn’t a serious response to the challenges facing our country today,” Cooper said.  “The American people are facing a federal debt of over $14 trillion dollars, and the president needs to join with Congress to make significant cuts.”

Interpreting the budget proposal

Obviously, interpreting budget proposals is as much art as it is math. And understanding a budget proposal requires seeing not only the number of dollars the proposal puts forth but also how that number compares with the current fiscal year.

The complication this year is that Congress has yet to finalize its budget for Fiscal Year 2011, so budget figures put forth for FY 2012 are being compared against budget figures approved for FY 2010.

Here are some of those numbers for the LGBT and HIV communities:

• Successful, Safe, and Healthy Students — this is a consolidation of several programs, including the Safe and Drug-Free Schools program headed up by openly gay Assistant Secretary Kevin Jennings in the Department of Education. Programs under this office are addressing such issues as anti-gay bullying and suicide among LGBT youth. The budget proposal for FY 2012 is $365 million, which represents no increase from FY 2010.

• Suicide prevention — Funding for suicide prevention work under the National Institutes for Health call for a significant increase, from only $2 million in FY 2010 to a proposed $18 million in FY 2012. Not all this research is specific to LGBT-related suicide.

• AIDS Drug Assistance Program (ADAP) — this program, to help low income people with HIV to obtain life-saving medications, is being increased by $105 million over FY 2010. With more than 6,000 people on waiting lists to receive such assistance, notes Schmid, the increase is “far from what is adequate.”

“If we have long wait lists now, just imagine what the situation will be like next year with no increases in funding,” added Schmid.

• Community Development Block Grants — Jean, who is co-chair of Centerlink, an organization of more than 200 LGBT community health centers around the country, says “a lot” of centers depend on this funding and the president’s proposal to slash 7.5 percent of that funding (from FY 2010 levels) “will have an impact,” she says.

• AIDS Prevention — the proposal calls for increasing the Centers for Disease Control and Prevention budget by $58 million to support the National HIV/AIDS Strategy goal of reducing HIV infections.

• Breast cancer research — the president’s budget estimates spending about $778 million on breast cancer research in FY 2012. This is a slight increase over FY 2010’s $763 million.

• AIDS research — the president’s proposal calls for $3.2 billion to be spent on HIV/AIDS research in Fiscal 2012. This compares to $3.1 billion expected to be spent in FY 2011.

• Hate crimes law enforcement — the Fiscal Year 2012 budget calls for a $2 million increase over FY 2010 in the Department of Justice’s Community Relations Service which is mandated with enforcement of the Matthew Shepard Hate Crimes Prevention Act.

What’s to come

“Things certainly could have been much worse,” said HRC’s David Stacy, “and they probably will be much worse once Congress begins its deliberations.”

The House and Senate budget committees will now begin to hold hearings to examine various aspects of President Obama’s proposal and will begin drafting a “budget proposal” for Congress to approve.

House Republicans have indicated they believe even deeper cuts are necessary in domestic spending, and LGBT and HIV leaders are clearly concerned about what will happen to the president’s proposal once the Republican-dominated House begins its deliberations.

“I am more worried about what Republicans in the House might do,” said Jean.

Schmid said the Republican proposals for deeper cuts will “seriously exacerbate the crisis” in ensuring that people with HIV infection and low incomes can receive lifesaving medications. He noted that Republicans call for no increase in ADAP funding and are still trying to eliminate an increase of $25 million appropriated for FY 2011.

Michael Ruppal, executive director of The AIDS Institute, issued a statement Tuesday, Feb. 15, saying The AIDS Institute “urges the Congress to reject those reckless cuts and consider the long term human and societal impacts of their decisions.”

© 2011 by Keen News Service. All rights reserved.

This article appeared in the Dallas Voice print edition Feb. 18, 2011.

—  John Wright

HHS teams with SAGE

Michael  Adams, executive director of SAGE
Michael Adams, executive director of SAGE

Health and Human Services Secretary Kathleen Sebelius and the Administration on Aging have awarded Services &  Advocacy for Gay, Lesbian, Bisexual & Transgender Elders (SAGE) a three-year, $900,000 grant to create the nation’s only national resource center on LGBT aging.

The National Technical Assistance Resource Center for LGBT Elders will assist communities across the country in their efforts to provide services and supports for older LGBT people.  The Resource Center will provide training to aging service providers and LGBT agencies nationwide, and will offer critically important educational tools to LGBT older people.

“Agencies that provide services to older individuals may be unfamiliar or uncomfortable with the needs of this under-served population,” said Health and Human Services Secretary Kathleen Sebelius. “The Resource Center will provide information, assistance and resources for both mainstream aging organizations and LGBT organizations and will provide assistance to LGBT individuals as they plan for future long-term care needs.”

SAGE is the nation’s oldest and largest organization serving LGBT older adults. In creating the Resource Center, SAGE will forge a partnership with 10 organizations with expertise in a wide range of areas including mainstream aging, LGBT aging, culture change and competency and program evaluation.

“The creation of a National Technical Assistance Resource Center for LGBT Elders is a monumental step forward for the LGBT community,” said Michael Adams, executive director of SAGE. “SAGE is extremely gratified to be given this opportunity to create and oversee the Resource Center in close cooperation with the Administration on Aging.”pro-dota2продвижение сайта youtube

—  David Taffet