HHS Letter Urges Hospitals to Institute Same-Sex Rights in Advance of Formal Rule

HHS Secretary Kathleen Sebelius yesterday sent a letter to leaders of major hospital associations in advance of a proposed rule in the Federal Register based on Obama's April 15 memorandum directing hospitals to grant same-sex partners visitation rights and medical power of attorney. 

The letter urges hospitals to not wait for the formalities of the rulemaking process to conclude before instituting changes at their own facilities.

The text of the letter follows:

Dear Colleagues:

On April 15, 2010, the President issued a Presidential memorandum to the U.S. Department of Health and Human Services (HHS) calling for the initiation of rulemaking that would ensure that hospitals that participate in Medicare or Medicaid respect the rights of patients to designate visitors, regardless of whether the visitors are legally related to the patients. The President’s directive clearly instructed HHS to propose that a participating hospital not deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability. It also directed that the rulemaking take into account the need for a participating hospital to restrict visitation in medically appropriate circumstances.

I have tasked the Centers for Medicare & Medicaid Services (CMS) to satisfy the President’s directive through new requirements that will be included in the Medicare Hospital and Critical Access Hospital Conditions of Participation, 42 C.F.R. Parts 482 and 485 subpart F, respectively. CMS intends to publish a proposed rule shortly and a final rule by late fall of this year.

Your organizations play a crucial role in advancing quality care and patient safety in hospitals across the nation. I recognize that many of your members have been at the forefront of advancing patient-centered hospital visitation policies in their respective institutions or have worked with their state legislatures to develop state laws that promote such policies. I welcome your input into this rulemaking process once the notice of proposed rulemaking (NPRM) is published.

Furthermore, in the interim, until such time as a final rule can be published, I would appreciate your voluntary support for the intent of the Presidential memorandum by encouraging your members to review policies they may currently have in place and adopt and enforce patient-centered visitation policies, as contemplated by the President, to the extent that they have not done so already. Your actions could spare many patients the pain of being separated from a loved one during an admission to a hospital – often one of the most anxious times in their lives.

I know the President and I can count on you now to ensure that this patient right – and all others – are recognized and honored.

A copy of the Presidential memorandum is enclosed. Thank you for your dedication to the cause of greater patient involvement in health care decisions.


Kathleen Sebelius


  1. Craig says

    Take the initiative. When I adopted my son recently, I sent e-mails to each of the area hospitals asking this precise question. Almost all of them responded very positively that my wishes for advance directives would be honored and that I would always be allowed visitation rights on same-sex partners, etc. To my surprise one of the first to respond positively was a Catholic-based hospital system. One, Northwest, never bothered to answer. Guess which hospital I will NEVER be allowed to be taken to. Know this stuff in advance, and stay out of the bigoted ones so this isn’t an issue.

  2. says

    An advance directive (living will, medical power of attorney, etc) is very important. Specific address of visitation rights can be particularly necessary, regardless of the relationship between the patient and any appointed agent. Where an advance directive fails to specify agent visitation authority and his/her authority regarding the control over other individuals seeking visitation access, considerable confusion and conflict can result. On advance directive that specifically provides for agent visitation rights and authority is the Lifecare Advance Directive (www.LifecareDirectives.com). It also comprehensively addresses a multitude of other important advance planning issues. Many studies indicate that the more detailed and complete an advance directive, the more likely an individual’s wishes will be followed.
    Regardless of the forms chosen, everyone should make sure that their wishes are well documented and clearly spelled out. Doing so can prevent much unnecessary suffering and can greatly reduce the burdens that individuals and families experience at these very difficult times, as well.
    – JT McKay, PhD.

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