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HHS broadens definitions for women & LGBTQ+ in healthcare protections

Proposed rule would ensure communities who have had barriers to accessing health care would be able to obtain it

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Photo Credit: County of Los Angeles

WASHINGTON – A new regulation proposed by the Biden administration seeks to ensure non-discrimination in health care settings for women who have had abortions and LGBTQ people at a time when monkeypox cases continue to increase and fears persist after the U.S. Supreme Court overturned Roe v. Wade.

The new regulation, announced Monday by the Department of Health & Human Services, would interpret Section 1557 of the Affordable Care Act to apply more broadly to the definition of sex after the court’s earlier 2016 decision in Bostock v. Clayton County, which determined anti-LGBTQ discrimination was an illegal form of sex discrimination. The rule would enhance the prohibition discrimination on the basis of sex in health care setting and federally funded health care programs consistent with the law.

The regulation also institutes non-discrimination protections for intersex traits; and pregnancy or related conditions, including pregnancy termination; and people with limited English proficiency.

Xavier Becerra, secretary of health and human services, announced the proposed rule on Monday during a conference call with reporters and said it would ensure communities who have had barriers to accessing health care would be able to obtain it.

“Everyone in America should be able to get the care that they need from any health provider in the country, especially if they’re that provider is receiving funding from HHS,” Becerra said. “We want to make sure that Americans are free from discrimination when they try to access the care that they need. Pretty simple proposition.”

Becerra, asked by the Washington Blade how he sees the proposed rule playing out as part of the Biden administration’s approach to the monkeypox among gay and bisexual men, said the rule makes clear discrimination in health care is unacceptable and enables LGBTQ people to file a complaint with the Office of Civil Rights at the Department of Health & Human Services,.

“The reality is that today, the issue of monkeypox, you should not face any discrimination when it comes to the issue of accessing the health care services you might need to address monkeypox,” Becerra said.

The new regulation doesn’t appear to be timed as a means to address monkeypox, but a follow-up to earlier commitment from the Biden administration to make the change.

The proposed rule is similar to a regulation in the final years of the Obama administration, which interpreted the language of Section 1557 to bar discrimination based on sex stereotypes and gender identity. The rule, however, was rescinded during the Trump administration under HHS Director of the Office of Civil Rights Roger Severino, who bucked the decision in Bostock and reversed the rule pursuant an earlier lower federal court ruling in Texas.

Melanie Fontes Rainer. now the director of the Office of Civil Rights under the Biden administration, said in the call restoring non-discrimination protections after they were rescinded makes health care more accessible for everyone.

“The 2020 version of this rule narrowed its scope to cover fewer health programs and activities, limiting vital non-discrimination protections for so many across the country,” Rainer said. “The proposed rule proposes revisions to Section 1557 implementing regulation by restoring and strengthening provisions that protect individuals from discrimination and health programs and activities”

The Biden administration rule, however, is different from the Obama-era rule in key aspects. For starters, the Biden-era rule explicitly prohibits discrimination on the basis of sexual orientation in addition to other sex-based categories that were articulated before, using the Supreme Court’s decision in Bostock as justification.

The newer regulation also contains language interprets Medicare Part B as federally funded assistance and includes an explicit exemption for health care providers who have objections to certain procedures, such as abortion and gender reassignment surgery. The exact breadth of the religious exemption wasn’t immediately clear.

Becerra said during the call the religious conscience provision was included as a result of stakeholder feedback and consistent with the Biden administration’s goal to protecting the rights of people in health care settings.

“That is also part of the work that we do, and we don’t believe that there’s any inconsistency and making sure that people are accessing care without discrimination,” Becerra said.

Becerra, asked during the call about the timeline for the rule, said he expects it will be made final before the end of this year and the formal 90-day comment period.

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Federal Government

Derogatory racial slur removed from federal geographic names use

The term has been used throughout history as an offensive ethnic and sexist term, particularly against Indigenous and Native women

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U.S. Secretary of the Interior Deb Haaland (Photo Credit: U.S. Department of the Interior)

WASHINGTON – The Department of the Interior today announced the Board on Geographic Names (BGN) has voted on the final replacement names for nearly 650 geographic features featuring the word squaw, bringing an end to hundreds of years of the offensive term being used in an official capacity.

The term has been used throughout history as an offensive ethnic and sexist term, particularly against Indigenous and Native women.

“I feel a deep obligation to use my platform to ensure that our public lands and waters are accessible and welcoming. That starts with removing racist and derogatory names that have graced federal locations for far too long,” said U.S. Secretary of the Interior Deb Haaland, who is the nation’s first Native American to serve as a presidential cabinet secretary.

“I am grateful to the members of the Derogatory Geographic Names Task Force and the Board on Geographic Names for their efforts to prioritize this important work. Together, we are showing why representation matters and charting a path for an inclusive America,” she added.

The effort to wipe the offensive term from both the federal and public lexicon has been an ongoing battle for generations, but has gained steam after Secretary Haaland established a task force to review and replace the term and ordered the federal body responsible for naming geographic places to no longer use it.

During the public comment period, the Task Force received more than 1,000 recommendations for name changes. Nearly 70 Tribal governments participated in nation-to-nation consultation, which yielded another several hundred recommendations. While the new names are immediately effective for federal use, the public may continue to propose name changes for any features — including those announced today — through the regular BGN process.

While the Secretary’s order for the Task Force considered only the squaw derogatory term in its scope. Haaland’s Order 3405 created a Federal Advisory Committee for the Interior Department to formally receive advice from the public regarding additional derogatory terms, derogatory terms on federal land units, and the process for derogatory name reconciliation. Next steps on the status of that Committee will be announced in the coming weeks.

The task force, comprised of representatives from the Department’s Bureau of Indian Affairs, Bureau of Land Management, Bureau of Safety and Environmental Enforcement, National Park Service, Office of Diversity, Inclusion and Civil Rights, Office of Surface Mining Reclamation and Enforcement, and the U.S. Geological Survey and the Department of Agriculture’s U.S. Forest Service, had to evaluate inconsistent spelling of Native languages and evaluate the diverse array of opinions of those making recommendations.

Ultimately, nearly 650 geographic sites, including the 80 in California, were renamed.

The California landmarks that will be renamed are below:

New NamePrevious NameFeature ClassCounty or EquivalentState
Habematolel ValleyBig Squaw ValleyValleyLake CountyCalifornia
East Fork Sulanharas CreekEast Fork Squaw CreekStreamShasta CountyCalifornia
North Fork Waydalmem CreekNorth Fork Squaw CreekStreamShasta CountyCalifornia
South Fork Waydalmem CreekSouth Fork Squaw CreekStreamShasta CountyCalifornia
Ehluyeh CanyonSquaw CanyonValleyPlumas CountyCalifornia
Spruce Grove CreekSquaw CreekStreamHumboldt CountyCalifornia
K’ ohuy CahSquaw CreekStreamMendocino CountyCalifornia
Log ValleyLittle Squaw ValleyBasinLake CountyCalifornia
Bald CreekSquaw CreekStreamShasta CountyCalifornia
Washeshu CreekSquaw CreekStreamPlacer CountyCalifornia
Waydalmem CreekSquaw CreekStreamShasta CountyCalifornia
Telegraph CreekSquaw CreekStreamHumboldt CountyCalifornia
Lolsel CreekSquaw CreekStreamColusa CountyCalifornia
Grasshopper CreekSquaw CreekStreamHumboldt CountyCalifornia
Tip Top Ridge CreekSquaw CreekStreamHumboldt CountyCalifornia
Mayacmas CreekSquaw CreekStreamSonoma CountyCalifornia
Papakum Pakan FlatSquaw FlatFlatPlacer CountyCalifornia
Yét Atwam FlatSquaw FlatFlatShasta CountyCalifornia
Grasshopper Creek RidgeSquaw Creek RidgeRidgeHumboldt CountyCalifornia
Sawabü FlatSquaw FlatFlatInyo CountyCalifornia
Gates OpeningSquaw OpeningFlatMendocino CountyCalifornia
Logan FlatSquaw FlatFlatGlenn CountyCalifornia
Table HollowSquaw HollowValleyTehama CountyCalifornia
Milk PeakSquaw PeakSummitModoc CountyCalifornia
Mudoim PeakSquaw PeakSummitPlumas CountyCalifornia
Pieta Rock SlideSquaw Rock SlideSlopeMendocino CountyCalifornia
Yét Atwam CreekSquaw Valley CreekStreamShasta County, Siskiyou CountyCalifornia
Olympic ValleySquaw ValleyValleyPlacer CountyCalifornia
Oso Kum SpringSquaw Valley SpringSpringPlumas CountyCalifornia
Habematolel CreekSquaw Valley CreekStreamLake CountyCalifornia
Delunga PeakSquaw Valley PeakSummitPlumas CountyCalifornia
Om Chatim SpringsSquaw Valley Peak SpringsSpringPlumas CountyCalifornia
West Fork Sulanharas CreekWest Fork Squaw CreekStreamShasta CountyCalifornia
Mat Kwa’rar NemaawSquaw CanyonValleySan Diego CountyCalifornia
Bull Spring MountainSquaw MountainSummitSan Bernardino CountyCalifornia
Tenaja MountainSquaw MountainSummitRiverside CountyCalifornia
Xanyō XamshréSquaw LakeLakeImperial CountyCalifornia
Mat Puy Nah AchhuukaaypSquaw PeakSummitSan Diego CountyCalifornia
Ho’toy PeakSquaw PeakSummitMonterey CountyCalifornia
Needle SpringSquaw SpringSpringInyo CountyCalifornia
Mohave PeakSquaw TitSummitSan Bernardino CountyCalifornia
Arch PeakSquaw PeakSummitSan Bernardino CountyCalifornia
S’ o”” Kuku CreekSquaw CreekStreamVentura CountyCalifornia
Yokuts BasinSquaw ValleyBasinFresno CountyCalifornia
East Fork North Fork Sulanharas CreekEast Fork North Fork Squaw CreekStreamShasta CountyCalifornia
Paac Kü̱vü̱hü̱’kSquaw TankReservoirRiverside CountyCalifornia
Tubbe Paa LakeOld Squaw LakeLakeFresno CountyCalifornia
Sulanharas CreekSquaw CreekStreamShasta CountyCalifornia
North Fork Sulanharas CreekNorth Fork Squaw CreekStreamShasta CountyCalifornia
Uti FlatSquaw FlatFlatPlacer CountyCalifornia
Sulanharas Creek ArmSquaw Creek ArmBayShasta CountyCalifornia
Whichwo CreekSquaw CreekStreamTrinity CountyCalifornia
Mani’pa GulchSquaw GulchValleyPlacer CountyCalifornia
Oak HollowSquaw HollowValleyCalaveras County, Tuolumne CountyCalifornia
Kapa HollowSquaw HollowValleyEl Dorado CountyCalifornia
Deer Lick FlatSquaw FlatFlatTrinity CountyCalifornia
Stoveleg GulchSquaw GulchValleyTrinity CountyCalifornia
Hunchup CreekSquaw Hollow CreekStreamEl Dorado CountyCalifornia
Nüümü Hu HupiSquaw LakeLakeFresno CountyCalifornia
Deer Hollow CreekSquaw Hollow CreekStreamTehama CountyCalifornia
San Joaquin ButteSquaw LeapCliffFresno CountyCalifornia
Mo Bisipi CreekSquaw Queen CreekStreamPlumas CountyCalifornia
Washeshu PeakSquaw PeakSummitPlacer CountyCalifornia
Damalusung LakeSquaw LakeLakeSierra CountyCalifornia
Tamarack PeakSquaw PeakSummitSiskiyou CountyCalifornia
Corral ValleySquaw ValleyValleyLassen CountyCalifornia
Kahus FlatSquaw FlatFlatVentura CountyCalifornia
Saputiwah SpringSquaw SpringSpringVentura CountyCalifornia
Scratch CreekSquaw CreekStreamTulare CountyCalifornia
Hukaht CanyonSquaw CanyonValleyLos Angeles CountyCalifornia
Inman RockSquaw RockSummitMendocino CountyCalifornia
Beyem Seyo ValleySquaw ValleyValleyPlumas CountyCalifornia
Leaning Pine HillSquaw HillSummitMariposa CountyCalifornia
Mat Kwa’KurrSquaw TitSummitSan Diego CountyCalifornia
Frog Woman RockSquaw RockSummitMendocino CountyCalifornia
Panther PrairieSquaw PrairieAreaHumboldt CountyCalifornia
Pkwo’-o-lo’ ‘ue-merkwSquaw TitSummitHumboldt CountyCalifornia
MúmawetSquaw HillSummitRiverside CountyCalifornia
Hayfork SpringSquaw Camp SpringSpringTrinity CountyCalifornia
Ehluyeh Canyon SpringsSquaw Canyon SpringsSpringPlumas CountyCalifornia

For a complete list of geographic sites across the country that will be renamed, click here. A map of the sites can be found here.

 

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Federal Government

Dr. Fauci announces his departure after 54 years in government

Fauci has been a prominent voice over the past three decades as a preeminent infectious-disease expert in his role as Director of NIAID

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Black AIDS Institute founder Phill Wilson with Dr. Anthony Fauci as Fauci received a Hero's Award in 2014 (Photo by Karen Ocamb)

WASHINGTON – After a half century of government service including heading the National Institute of Allergy and Infectious Diseases NIAID, since 1984, Dr. Anthony Fauci announced Monday that he is stepping down in December.

In his statement, Dr Fauci said:

Over the past 38 years as NIAID Director, I have had the enormous privilege of serving under and advising seven Presidents of the United States, beginning with President Ronald Reagan, on newly emerging and re-emerging infectious disease threats including HIV/AIDS, West Nile virus, the anthrax attacks, pandemic influenza, various bird influenza threats, Ebola and Zika, among others, and, of course, most recently the COVID-19 pandemic. I am particularly proud to have served as the Chief Medical Advisor to President Joe Biden since the very first day of his administration.

While I am moving on from my current positions, I am not retiring. After more than 50 years of government service, I plan to pursue the next phase of my career while I still have so much energy and passion for my field. I want to use what I have learned as NIAID Director to continue to advance science and public health and to inspire and mentor the next generation of scientific leaders as they help prepare the world to face future infectious disease threats.”

Fauci has been a prominent voice in public discourse over the past three decades as a preeminent infectious-disease expert in his role as Director of NIAID, most recently as the coronavirus pandemic gripped the nation and the world. Fauci also has endured withering political attacks as the face of the coronavirus pandemic response under first former President Donald Trump and President Joe Biden who he has served as Biden’s Chief Medical Advisor.

The White House Monday released a statement from President Biden regarding Fauci’s announcement:

During my time as Vice President, I worked closely with Dr. Anthony Fauci on the United States’ response to Zika and Ebola. I came to know him as a dedicated public servant, and a steady hand with wisdom and insight honed over decades at the forefront of some of our most dangerous and challenging public health crises. When it came time to build a team to lead our COVID-19 response – in fact, in one of my first calls as President-elect – I immediately asked Dr. Fauci to extend his service as my Chief Medical Advisor to deal with the COVID-19 crisis our nation faced.  In that role, I’ve been able to call him at any hour of the day for his advice as we’ve tackled this once-in-a-generation pandemic.  His commitment to the work is unwavering, and he does it with an unparalleled spirit, energy, and scientific integrity

Dr. Fauci has served under seven Republican and Democratic Presidents during his career, beginning with Ronald Reagan.  He was awarded the Presidential Medal of Freedom in 2008 under President George W. Bush.  For almost four decades, he has served as Director of the National Institute of Allergy and Infectious Diseases, helping our country navigate health crises ranging from HIV/AIDS to COVID-19.  Because of Dr. Fauci’s many contributions to public health, lives here in the United States and around the world have been saved.  As he leaves his position in the U.S. Government, I know the American people and the entire world will continue to benefit from Dr. Fauci’s expertise in whatever he does next. Whether you’ve met him personally or not, he has touched all Americans’ lives with his work. I extend my deepest thanks for his public service. The United States of America is stronger, more resilient, and healthier because of him.”

Fauci emphasized that while he is stepping down he is not retiring. The 81 year-old scientist and physician who joined the National Institutes of Health, in 1968 as a 27-year-old doctor who had just finished medical residency, is continuing his work:

While I am moving on from my current positions, I am not retiring. After more than 50 years of government service, I plan to pursue the next phase of my career while I still have so much energy and passion for my field. I want to use what I have learned as NIAID Director to continue to advance science and public health and to inspire and mentor the next generation of scientific leaders as they help prepare the world to face future infectious disease threats.”

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CMS, HHS pledge ‘prevent anti-Trans policies taking effect’ in Florida

“Attempts to restrict, challenge, or falsely characterize this potentially lifesaving care as abuse is dangerous”

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Screenshot/YouTube Chiquita Brooks-LaSure, Administrator, U.S. Centers for Medicare & Medicaid Services

WASHINGTON – After Florida’s Agency for Health Care Administration (AHCA) signaled its plans to stop Medicaid reimbursements for transgender related healthcare last week, U.S. federal health officials expressed concerns with the move in an exclusive statement to The Los Angeles Blade. 

The U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Service’s (HHS) Office of Civil Rights (OCR) pledged they would “continue to do everything within our authority to protect Medicaid beneficiaries’ access to care and prevent discriminatory policies from taking effect.”

Pursuant to AHCA’s announcement of the new rules, coverage exemptions would be carved out of the state’s Medicaid plans for health treatments like puberty blockers, hormone therapies, or surgical procedures for gender dysphoria. 

Florida will join other conservative states that have moved in recent years to prohibit or restrict access to transgender healthcare, particularly for young people. In May, the Texas Supreme Court ruled the state could weaponize its Child Protective Services to investigate parents for child abuse for giving their transgender children medically approved health treatments. 

In March, the HHS’s OCR issued a Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy, writing: “Attempts to restrict, challenge, or falsely characterize this potentially lifesaving care as abuse is dangerous. Such attempts block parents from making critical health care decisions for their children, create a chilling effect on health care providers who are necessary to provide care for these youth, and ultimately negatively impact the health and well-being of transgender and gender nonconforming youth.

In May, OCR announced Title IX’s rules prohibiting discrimination on the basis of sex includes sexual orientation and gender identity, with HHS Secretary Xavier Becerra writing, ““Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences. It is the position of the Department of Health and Human Services that everyone – including LGBTQ people – should be able to access health care, free from discrimination or interference, period.”

Shortly after the news in Florida broke on Thursday, the LGBTQ+ legal advocacy organization Lambda Legal told The Blade, “We are exploring all possible avenues for challenging this discriminatory rulemaking.” 

The American Academy of Pediatrics (AAP) and its Florida Chapter (FCAAP) also shared a statement with The Blade condemning the state’s “interference with the physician-patient relationship and its prohibition of this vital care.”

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