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Lawsuit filed to block Trump Administration’s ‘Denial of Care’ rule

Trump sought to permit doctors to deny care based on personal religious or moral beliefs

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A lawsuit filed Tuesday in the U.S. District Court for the Northern District of California is challenging the “Denial of Care” Rule issued earlier this month by the U.S. Department of Health and Human Services.

The plaintiffs, which includes the Los Angeles LGBT Center, claim the policy, published Tuesday May 21, is unconstitutional and exceeds HHS’s statutory authority.

The new regulation allows health care workers – doctors, nurses, EMTs, administrators and clerical staff – to deny medical treatment and services to patients because of personal religious or moral beliefs.

Health care facilities that do not comply risk losing federal funding.

According to a press release issued by Americans United for Separation of Church and State, Center for Reproductive Rights, and Lambda Legal, “The regulation will cause mass confusion among health care providers and is completely infeasible to implement. As a result, health care facilities may do away with reproductive and LGBTQ services altogether, leaving millions without access to critical health care.”

“The rule applies to all healthcare facilities that receive federal funding through HHS, which includes most hospitals. Threatened with the loss of all federal funding and facing confusing and unworkable requirements, many health care facilities will face strong incentives to do away with critical health care services for women and the LGBTQ community.”

“The rule could also lead to many LGBTQ patients not fully disclosing their identity and medical history for fear of discrimination, resulting in improper or incomplete care. While marginalized communities are the intended target, the rule is so broad that the religious objections of a health care worker could result in anyone – the elderly, children, and those in critical condition – being denied lifesaving medical care.”

Lambda Legal Senior Attorney Jamie Gliksberg.

“The breadth of the harm this new rule will cause is impossible to exaggerate, and opens up yet another front in the Trump Administration’s assault on civil rights of minorities and already marginalized, vulnerable populations,” Lambda Legal Senior Attorney Jamie Gliksberg said.

“This almost limitless invitation to discriminate will inevitably result in women, LGBT people and religious minorities facing hostile health care workers and denials of medical care at moments of greatest need, where any delay could be fatal,” she also stated.

In the summary of the lawsuit attorneys for the plaintiffs noted;

“The rule “impermissibly favors, prefers, and endorses certain religious beliefs and certain religious denominations over others,” the groups wrote in a summary of the lawsuit:.

The policy “violates patients’ rights to privacy, liberty, dignity, and autonomy” by imposing conditions that unduly burden patients’ access to medically necessary health care and “chills constitutionally protected First Amendment activity, such as a patient’s ability to disclose or express their sexual orientation,” they added.

Plaintiffs include California’s Santa Clara County, the Los Angeles LGBT Center and the D.C.-based Whitman-Walker Health.

This story has been corrected to indicate that Americans United is not a plaintiff in the lawsuit. 

AIDS and HIV

AIDS @40: The White House laughs as gays try to save themselves

Over a third of them have died. It’s known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing […]

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President Ronald Reagan speaking to the American Foundation for AIDS Research May 31, 1987. Five years previously Reagan's White House Deputy Press Secretary Larry Speakes led reporters in a round of laughter over people infected with HIV/AIDS on Oct. 15, 1982 (Photo Credit: YouTube Screen shot via Reagan Library)

By Karen Ocamb | LOS ANGELES – Like so many others in California, lesbian feminist Ivy Bottini had high expectations for the federal government to finally intervene in the growing AIDS crisis after the first congressional committee hearing on the mysterious new disease, chaired by Rep. Henry Waxman, (D-CA) on April 13, 1982.

There was very little press coverage of the hearing — held at the Los Angeles Gay Community Services Center on Highland Avenue in Hollywood. But years later, Dr. Anthony Fauci of the National Institutes of Health recalled a quote reported by the Washington Blade

“I want to be especially blunt about the political aspects of Kaposi’s sarcoma (KS),” Waxman said. “This horrible disease afflicts members of one of the nation’s most stigmatized and discriminated-against minorities….There is no doubt in my mind that if the same disease had appeared among Americans of Norwegian descent, or among tennis players, rather than among gay males, the responses of the government and the medical community would have been different.”

The gay San Francisco newspaper The Sentinel published a very short brief on April 16 entitled “House Holds Cancer Hearings” about “the gay cancer.” The paper quoted an unnamed subcommittee staffer saying the CDC, “which is coordinating research on the baffling outbreak, ‘should not have to nickel and dime’ for funds.” The brief appeared next to a column written by gay nurse Bobbi Campbell, who wrote about going to The Shanti Project to get emotional support for his KS. 

Bottini’s take-away from the Waxman hearing was that no one really knew how AIDS was transmitted. She was upset. Her friend Ken Schnorr had died just before the hearing and Bottini had to explain to Ken’s distraught mother that he had not been abused at the hospital — the purple bruises on his body were KS lesions.

After weeks of governmental inaction, Bottini called Dr. Joel Weisman, Schnorr’s gay doctor, to update the community at a town hall in Fiesta Hall in West Hollywood’s Plummer Park. Weisman had sent gay patients to Dr. Michael Gottlieb and was one of the co-authors on the first CDC public report about AIDS on June 5, 1981.  

Bottini later recalled how gay men often thanked her for saving their lives at that packed town hall. Bottini subsequently founded AIDS Network LA, to serve as a clearing house for collecting and disseminating information. But not everyone bought the science-based premise that AIDS was transmitted through bodily fluids — including Bottini’s friend Morris Kight, prompting a deep three-year rift.

Nonetheless, groups offering gay men advice on how to have safe sex started emerging, as did peer groups forming for emotional, spiritual and healthcare support. The Bay Area Physicians for Human Rights, Houston’s Citizens for Human Equality and the new Gay Men’s Health Crisis in New York City published pamphlets and newsletters

Panic and denial were wafting in tandem through gay Los Angeles, too. In Oct. 1982, friends Nancy Cole Sawaya (an ally), Matt Redman, Ervin Munro, and Max Drew convened an emergency informational meeting at the Los Angeles Gay Community Services Center on Gay Related Immunodeficiency Disease (GRID, soon to be called AIDS) delivered by a representative from San Francisco’s Kaposi’s Sarcoma Foundation.  

“My friends and I were in New York in 1981, hearing stories among friends coming down with this mysterious disease. We realized that back home in L.A. there was no hotline, no medical care, and no one to turn to for emotional support,” Redman told The Advocate’s Chris Bull on July 17, 2001 for a story on the 20th anniversary of AIDS. “For some reason I wasn’t really scared. It was so early on that no one could predict what would happen.”

That quickly changed when the friends realized there was no level of governmental help forthcoming. They set up a hotline in a closet space at the Center, found 12 volunteers and asked Weisman to train them on how to answer questions, reading off a one-page fact sheet. The idea was to “reduce fear” and eventually give out referrals to doctors and others willing to help. 

AIDS Project Los Angeles organizers (Photo courtesy of APLA)

The four also reached out to friends to raise money, netting $7,000 at a tony Christmas benefit to fund a new organization called AIDS Project Los Angeles. They set up a Board of Directors with Weisman and longtime checkbook activist attorney Diane Abbitt as Board co-chairs. They gaveled their first Board meeting to order on January 14, 1983 with five clients. The following month, APLA produced and distributed a brochure about AIDS in both English and Spanish. 

Four months later, in May, APLA and other activists organized the first candlelight march in Los Angeles at the Federal Building in Westwood and in four other cities. The LA event was attended by more than 5,000 people demanding federal action. The KS/AIDS Foundation in San Francisco was led by people with AIDS carrying a banner that read “Fighting For Our Lives.” When the banner was unfurled at the National Lesbian and Gay Health Conference that June by activists presenting The Denver Principles, the crowd cried, with a 10-minute ovation. 

Photograph Courtesy of APLA

“If the word ‘empowerment’ hadn’t yet been a part of the health care lexicon, it was about to be,” HIV/AIDS activist Mark S. King wrote in POZ. The group took turns reading a document to the conference they had just created themselves, during hours sitting in a hospitality suite of the hotel. It was their Bill of Rights and Declaration of Independence rolled into one. It would be known as The Denver Principles, and it began like this:

‘We condemn attempts to label us as ’victims,’ which implies defeat, and we are only occasionally ’patients,’ which implies passivity, helplessness, and dependence upon the care of others. We are ’people with AIDS.’”

While The Denver Principles were injecting self-empowerment into the growing movement of people with AIDS, the Reagan administration was infecting America through mass media association of homosexuality, AIDS and old myths of sexual perversion. Ronald Reagan was keenly aware of his anti-gay evangelical base, appointing Gary Bauer as a domestic policy advisor. Bauer was a close associate of James Dobson, president of the powerful Religious Right group Focus on the Family.

Reagan also picked anti-abortion crusader C. Everett Koop as Surgeon General — which turned into a mini-scandal when Koop agreed that sexually explicit AIDS education and gay-positive materials should be federally funded for schools. “You cannot be an efficient health officer with integrity if you let other things get in the way of health messages,” Koop told the Village Voice. Koop was slammed by the Moral Majority’s Rev. Jerry Falwell and other anti-gay evangelicals. 

But perhaps one most egregious examples of the Reagan administration’s homophobic callousness towards people with AIDS came from the persistent laughter emanating from the podium of White House Deputy Press Secretary Larry Speakes.

On Oct. 15, 1982, less than four weeks after Reps. Henry Waxman and Phillip Burton introduced a bill to allocate funds to the CDC for surveillance and the NIH for AIDS research, reporter Lester Kinsolving asked Speakes about the new disease called A.I.D.S..

Kinsolving: Larry, does the President have any reaction to the announcement — the Center for Disease Control in Atlanta, that AIDS is now an epidemic and have over 600 cases? 

SPEAKES: What’s AIDS? 

Kinsolving: Over a third of them have died. It’s known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing that one in every three people that get this have died. And I wondered if the President is aware of it? 

SPEAKES: I don’t have it. Do you? (Laughter.) 

Kinsolving: You don’t have it. Well, I’m relieved to hear that, Larry. (Laughter.) I’m delighted. 

SPEAKES: Do you? 

Kinsolving: No, I don’t….In other words, the White House looks on this as a great joke? 

SPEAKES: No, I don’t know anything about it, Lester. What – 

Kinsolving: Does the President, does anybody in the White House know about this epidemic, Larry? 

SPEAKES: I don’t think so. I don’t think there’s been any – 

Kinsolving: Nobody knows? 

SPEAKES: There has been no personal experience here, Lester. 

The exchange goes on like that. For another two years. On World AIDS Day, Dec. 1, 2015, Vanity Fair debuted a 7:43 documentary directed and produced by Scott Calonico about that 1982 exchange between Kinsolving and Speakes. But Calonico also found audio of similar exchanges in 1983 and 1984 for his film, “When AIDS Was Funny.”

Karen Ocamb is the Director of Media Relations for Public Justice, a national nonprofit legal organization that advocates and litigates in the public interest. The former News Editor of the Los Angeles Blade, Ocamb is a longtime chronicler of the lives of the LGBTQ community in Southern California. 

This is Part 4 of a series of 5 articles on AIDS @40.

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Coronavirus

California unveils digital COVID-19 vaccination records

Californians will enter into a state-owned website their name, date of birth and email or phone associated with their vaccine records

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Photo Credit: County of Los Angeles

SACRAMENTO – Officials announced Friday that the state is providing Californians with a newly created way to access their coronavirus vaccination records in a digital format.

Dr. Erica Pan, the state’s epidemiologist told reporters the new tool allows residents access to their COVID-19 vaccination records from the state’s immunization registry and includes the same information as the paper cards issued by the Centers for Disease Control and Prevention.

To access the information, Californians will enter into a state-owned website their name, date of birth and email or phone associated with their vaccine records and they will be asked to create a four-digit PIN. The record will include a QR code that users can save to their mobile phones.

With nearly 20 million people fully vaccinated in California and proof of vaccination already required in some circumstances such as travel, state health officials felt there would be demand for the tool, though it remains optional, Pan noted.

“The odds are someone is going to misplace their paper CDC card and a digital COVID-19 vaccine record provides a convenient backup,” she told reporters.

 Amy Tong, director of the state’s department of technology told reporters that businesses that use a QR scanner would see the same information as residents — their name, birthdates and vaccination details, she said. She added that businesses would not be able to store that data for future use.

The system is accessible through myvaccinerecord.cdph.ca.gov. Governor Gavin Newsom has said the digital version wouldn’t be a “passport” or a requirement.

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AIDS and HIV

Oregon House passes over-the-counter HIV prevention drugs bill

HIV-related stigma, homophobia and transphobia, and lack of access create equity gaps in HIV prevention, testing, and treatment

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Oregon State Capitol Building in Salem (Photo Credit: State of Oregon)

SALEM, OR. – The Oregon House of Representatives re-passed House Bill 2958B, a measure that would allow Oregon’s pharmacists to prescribe, dispense, and administer both pre-exposure, (PrEP) and post-exposure prophylaxis, (PEP) the two drugs designed to prevent HIV infection.

The bill also sets the legal authority to conduct HIV tests in the state. The measure had passed in April on a 44-11 vote, was sent to the Senate, and then the measure was sent back after a compromise and conference bill was voted out of the Senate returning it to the House.

The Oregon House on Monday re-passed House Bill 2958 B, which allows pharmacists to prescribe, dispense, and administer both pre-exposure and post-exposure prophylaxis. Known as PrEP and PEP, the two drugs prevent HIV infection. The bill also clarifies that pharmacists have the legal authority to conduct HIV tests. The bill, which previously passed out of the House in April, passed today 44-11.

In an interview with Oregon Public Broadcasting, Rep. Rob Nosse, (D-SE Portland) who is openly gay and a lead sponsor of the bill noted; “Throughout this bill’s journey through the legislative process, we heard repeatedly that pharmacists have the training necessary to administer these life-saving drugs.”

“By making PrEP and PEP more widely available, we can get these medicines into communities that have been disproportionately impacted by HIV,” he added.

Approximately 1.2 million people in the U.S. have HIV. About 13 percent of them don’t know it and need testing. HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay, bisexual, and other men who have sex with men.

CDC estimates of annual HIV infections in the United States show hopeful signs of progress in recent years. CDC estimates show new HIV infections declined 8% from 37,800 in 2015 to 34,800 in 2019, after a period of general stability.

While new HIV diagnoses have declined significantly from their peak, the CDC and other Public Health officials across the U.S. have expressed concern of HIV resurgence due to several factors, including trends in injection and other drug use.

“When this disease first came into national focus, it was often referred to as ‘gay related immune deficiency,’ or GRID. Today, HIV is recognized as a disease that can be contracted by anyone, and those who are diagnosed as HIV positive can be given resources and medical support to live a long and healthy life,” said Nosse. “This bill is potentially a lifesaving solution that will prevent deaths from HIV by making PrEP more accessible to all who need it.”

Lawmakers in support of the bill say HIV-related stigma, homophobia and transphobia, and lack of access create equity gaps in HIV prevention, testing, and treatment, OPB reported.

“This is about reducing barriers to access for life-saving medications,” said Rep. Dacia Grayber, D-Tigard, who also co-sponsored the bill. “PrEP and PEP are both vital parts of the toolkit for ending the HIV epidemic. By empowering pharmacists to test for HIV and prescribe these medications, we make it easier for Oregonians to get the health care services they need.”

“Preventative treatments for HIV have saved countless lives, but not all communities have equal access to these drugs, and we can see the disparities in outcomes for low-income and BIPOC communities,” said co-sponsor Rep. Karin Power, D-Milwaukie. “HB 2958 will help to distribute these life-saving drugs more broadly, so that we can begin to close these gaps in our health care system and ensure that more people are protected.”

HB 2958 B now heads to Governor Kate Brown for her signature.

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