Senior 'Bill of Rights' Unveiled

A new law set to be introduced in San Francisco aims to protect LGBT seniors living in long-term care facilities in the city.

Under the measure, operators of such facilities would be barred from evicting residents based on their sexual orientation, gender identity, or HIV status. They would be required to allow residents to room with the person of their choosing and could not restrict residents from being sexually intimate.

They would also be required to allow residents to use bathrooms that correspond with their preferred gender. The proposed law would mandate that employees and managers refer to residents by their preferred names and pronouns and allow them to dress in the clothing, accessories, and makeup of their choosing.

Pat McGinnis, the executive director of California Advocates for Nursing Home Reform, told the Bay Area Reporter that San Francisco would be the first city to enact such legislation.

"The San Francisco ordinance is a great step forward in creating safe environments for people, and that is what you need," said McGinnis, whose San Francisco-based agency was not involved in the drafting of the proposed law.

Gay District 8 Supervisor Scott Wiener plans to introduce the local ordinance creating a "Bill of Rights" for LGBT residents of long-term care facilities at the Board of Supervisors meeting Tuesday, February 3. Gay District 9 Supervisor David Campos is a co-sponsor of the law, which was one of the recommendations made last spring by the city's now disbanded LGBT seniors task force.

"I think, in talking to members of the task force, this made sense as a foundational piece of legislation to address the needs of LGBT seniors," said Wiener. "There are a lot of programs for seniors, so we need to make sure that those programs are being run in a nondiscriminatory manner."

While there is little data regarding LGBT seniors in long-term care facilities, aging advocates point to a study published in 2011 by the National Senior Citizens Law Center that looked into the issue and found myriad problems residents, their families, and friends had experienced.

Of the 800 respondents, 78 percent felt it would be unsafe for LGBT seniors to be out of the closet in a care facility, with 89 percent believing out seniors would face discrimination from staff.

It included several examples reported by people in San Francisco, such as one 83-year-old resident who reported staff at one unnamed facility refused to bathe his partner for 16 days because of being uncomfortable helping a gay man. A woman told of staff at one facility refusing to use the more masculine name her friend, a lesbian in her 80s, went by and instead used her given, more feminine name.

"We have heard examples of more broadly, not just in San Francisco, of LGBT seniors experiencing significant problems when they go into a facility in terms of going back into the closet and not being with their partner," said Wiener. "Certainly, it is not as big a problem in San Francisco as it is in other parts of the state."

The issue takes on added importance due to LGBT seniors being more likely to need facility-based care compared to heterosexual seniors because they have less people they can rely on to help them age at home, noted attorney Daniel Redman, a gay man who served on the San Francisco task force and focused on long-term care issues.

"For folks, especially, without family members to advocate for them, this bill is necessary to empower our allies in facilities. It sets the tone for what nondiscriminatory and proper care looks like," said Redman. "We are giving people the tools they need to advocate for themselves, their friends, partners and families of choice."

Due to the advancement of marriage rights for same-sex couples, the federal Centers for Medicare and Medicaid is looking to enact national guidelines protecting the rights of gay and lesbian couples when they move into long-term care facilities, said McGinnis.

"Interestingly enough, the federal government just came out with draft regulations we commented on regarding discrimination against same-sex spouses in nursing homes," she said. "They want to change the rights of residents of nursing homes at the federal level."

A statewide law requiring administrators of residential care facilities receive training in LGBT issues went into effect in California January 1. A similar law mandating that licensed health care professionals at senior care facilities in the state be trained in LGBT issues took effect at the start of 2009.

The proposed ordinance in San Francisco is believed to be the first in the nation to focus on all LGBT residents of long-term care facilities, particularly transgender seniors. It would empower gender-nonconforming residents to demand certain privacy protections, such as requesting visual barriers when they disrobe, and to refuse to be examined for educational purposes rather than therapeutic.

Facilities would be required to update their admission forms so that questions regarding a person's gender identity and preferred names and pronouns are included. They would also need to designate a staff member as an LGBT liaison responsible for annual trainings on cultural competency and other issues.

Once adopted, the law would mandate that within six months the San Francisco Human Rights Commission and the local long-term care ombudsman office publish a handbook to help facilities comply with the ordinance.

The Board of Supervisors likely will vote on the Bill of Rights law sometime in March or April.