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Post-DOMA rule proposed for hospice care, nursing homes

Administration seeks to ensure same-sex marriages recognized regardless of state of residence

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Centers for Medicare & Medicaid Services, gay news, Washington Blade

The Centers for Medicare & Medicaid has proposed a new rule for hospice care and nursing homes. (Image public domain).

The Obama administration on Thursday announced a proposed rule that aims to ensure medical care for individuals in same-sex marriages — regardless of the state in which they live — following the Supreme Court decision against the Defense of Marriage Act.

The Centers for Medicare & Medicaid proposes the rule to change conditions for medical care providers and suppliers receiving support from Medicare and Medicaid, including hospitals and hospice care, as well as the requirements for long-term care facilities, or nursing homes.

The thrust of the proposed rule is to ensure same-sex marriages are recognized nationwide, even in states without marriage equality, for programs that in some aspects are administered by the states.

“This proposed rule addresses certain regulations governing Medicare and Medicaid participating providers and suppliers where current regulations look to state law in a matter that implicates (or may implicate) a marital relationship,” the rule states. “Our goal is to provide equal treatment to spouses, regardless of their sex, whenever the marriage was valid in the jurisdiction in which it was entered into, without regard to whether the marriage is also recognized in the state of residence or the jurisdiction in which the health care provider or supplier is located, and where the Medicare program explicitly or impliedly provides for specific treatment of spouses.”

The proposed rule, which can found here, is set for publication in the Federal Register on Friday. Once it’s published, comments must be received by 60 days to be assured consideration before the rule is made final.

Karen Loewy, senior attorney and seniors program strategist for the LGBT group Lambda Legal, said the proposed rules are “a very welcome development” and would “amend references to discriminatory state laws to provide equal treatment to spouses.”

“In practical terms, these changes will mean that a patient’s same-sex spouse will have the same right to access information, make decisions, and be part of admissions processes that a different-sex has in hospitals, hospice care, surgical care centers, long term care settings, labs, and community mental health centers that receive Medicare or Medicaid dollars, even when the laws of the state would not recognize their right to do so,” Loewy said. “These rules would provide important automatic protections for same-sex spouses, ensuring that a patient’s spouse gets to be by his or her side, be informed, and make those difficult decisions in vulnerable health care situations.”

In summary, the proposed rule seeks to established a same-sex spouse should be considered a person’s representative — regardless of state law — for the purposes for care from ambulatory surgical centers, hospice care, exercising a patient’s rights, informing patients of their rights, notification for laboratory services to screen blood and blood products for potentially infectious diseases like HIV and Hepatitis C, care in long-term facilities, pre-admission screening and resident review for long-term care, findings of these evaluations, care in Community Mental Health Centers and client rights at these facilities.

Mark Daley, a spokesperson for the National LGBTQ Task Force, said changes in proposed rule are “common-sense” and would help elders in the LGBT community ensure they receive equal care in medical facilities.

“These new policies help ensure that one of the most vulnerable populations in our country, LGBTQ elders, are able to access federal programs in the same way that non-LGBTQ people access programs,” Daley said. “This means ensuring that same-sex spouses will be treated exactly the same as different-sex spouses in programs like long-term care facilities, Hospice care, and hospitals. What this really means for LGBTQ folks is that same-sex spouses will be able to visit and make medical decisions on behalf of their spouse, just like different-sex couples. It means that LGBTQ elders will have legal rights in the health care context, regardless of whether your state continues to discriminate against you by refusing to recognize your marriage.”

After the Supreme Court decision against DOMA, the Centers for Medicare & Medicaid already issued guidance — once in September 2013 and again in May 2014 — to ensure same-sex marriages are recognized in determining eligibility for Medicaid and the Children’s Health Insurance Program. But the proposed rule says it’s needed because policies it addresses “are administered by different statutes and are administered by state Medicaid agencies and CMS.”

Sarah Warbelow, legal director for the Human Rights Campaign, said the proposed rule will help individuals in same-sex marriages in the medical care situations when they need assistance the most.

“When people are at their most vulnerable, from hospitals to hospice care to nursing homes, they need to know that their spouse will be fully informed, be able to help them make decisions, and be fully regarded as their spouse,” Warbelow said. “The rule proposed by the Centers for Medicare and Medicaid will help to ensure that the marriages of same-sex couples are treated equally regardless of where the couple lives.”

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Netherlands

Rob Jetten becomes first gay Dutch prime minister

38-year-old head of government sworn in on Monday

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Rob Jetten (Photo via @RobJetten/X)

Rob Jetten on Monday became the Netherland’s first openly gay prime minister.

Jetten’s centrist D66 party won the country’s elections last October, narrowly defeating Geert Wilders’ far-right Party for Freedom.

King Willem-Alexander on Monday swore in Jetten, who is also the country’s youngest-ever prime minister. The Associated Press notes Jetten’s coalition government includes the center-right Christian Democrats and the center-right People’s Party for Freedom and Democracy.

“Proud to be able to do this together,” said Jetten in an X post before Willem-Alexander swore him in.

COC Nederland, a Dutch LGBTQ advocacy group, in a statement said Jetten “becoming prime minister shows that your sexual orientation doesn’t have to matter.”

“You can become a construction worker, a doctor, a lawyer, and even prime minister,” said COC Nederland.

The advocacy group noted Jetten has said his government will implement its “Rainbow Agreement” that include calls for strengthening nondiscrimination laws “to better protect transgender and intersex people,” appointing more “discrimination investigators … to address violence against LGBTQ+ people and other minorities,” and introducing measures “to promote acceptance in schools.”

“COC will hold the Cabinet to that promise,” said COC Nederland.

Jetten’s fiancé is Nicolás Keenen, an Argentine field hockey player who competed in the 2024 Summer Olympics in Paris.

Jetten is one of two openly gay heads of government: Andorran Prime Minister Xavier Espot Zamora came out in 2023. Gay Latvian President Edgars Rinkēvičs, who is the country’s head of state, took office in 2023.

Leo Varadkar, who was Ireland’s prime minister from 2017-2020 and from 2022-2024, and Xavier Bettel, who was Luxembourg’s prime minister from 2013-2023, are gay. Ana Brnabić, who was Serbia’s prime minister from 2017-2024, is a lesbian.

Former Icelandic Prime Minister Jóhanna Sigurðardóttir in 2009 became the world’s first openly lesbian head of government. Former Belgian Prime Minister Elio Di Rupo, former San Marino Captain Regent Paolo Rondelli, and former French Prime Minister Gabriel Attal are also openly gay.

Colombian presidential candidate Claudia López, who is the former mayor of Bogotá, the Colombian capital, would become her country’s first female and first lesbian president if she wins the country’s presidential election that is taking place later this year.

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District of Columbia

D.C. police arrest man for burglary at gay bar Spark Social House  

Suspect ID’d from images captured by Spark Social House security cameras

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Spark Social House (Washington Blade photo by Michael Key)

D.C. police on Feb. 18 arrested a 63-year-old man “of no fixed address” for allegedly stealing cash from the registers at the gay bar Spark Social House after unlawfully entering the bar at 2009 14th St., N.W., around 12:04 a.m. after it had closed for business, according to a police incident report.

“Later that day officers canvassing for the suspect located him nearby,” a separate police statement says. “63-year-old Tony Jones of no fixed address was arrested and charged with Burglary II,” the statement says.

The police incident report states that the bar’s owner, Nick Tsusaki, told police investigators that the bar’s security cameras captured the image of a man who has frequently visited the bar and was believed to be homeless.

“Once inside, the defendant was observed via the establishment’s security cameras opening the cash register, removing U.S. currency, and placing the currency into the left front pocket of his jacket,” the report says.

Tsusaki told the Washington Blade that he and Spark’s employees have allowed Jones to enter the bar many times since it opened last year to use the bathroom in a gesture of compassion knowing he was homeless. Tsusaki said he is not aware of Jones ever having purchased anything during his visits.

According to Tsusaki, Spark closed for business at around 10:30 p.m. on the night of the incident at which time an employee did not properly lock the front entrance door. He said no employees or customers were present when the security cameras show Jones entering Spark through the front door around 12:04 a.m. 

Tsusaki said the security camera images show Jones had been inside Spark for about three hours on the night of the burglary and show him taking cash out of two cash registers. He took a total of $300, Tsusaki said.

When Tsusaki and Spark employees arrived at the bar later in the day and discovered the cash was missing from the registers they immediately called police, Tsusaki told the Blade. Knowing that Jones often hung out along the 2000 block of 14th Street where Spark is located, Tsusaki said he went outside to look for him and saw him across the street and pointed Jones out to police, who then placed him under arrest.

A police arrest affidavit filed in court states that at the time they arrested him police found the stolen cash inside the pocket of the jacket Jones was wearing. It says after taking him into police custody officers found a powdered substance in a Ziploc bag also in Jones’s possession that tested positive for cocaine, resulting in him being charged with cocaine possession in addition to the burglary charge.

D.C. Superior Court records show a judge ordered Jones held in preventive detention at a Feb. 19 presentment hearing. The judge then scheduled a preliminary hearing for the case on Feb. 20, the outcome of which couldn’t immediately be obtained. 

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District of Columbia

Judge rescinds order against activist in Capital Pride lawsuit

Darren Pasha accused of stalking organization staff, board members, volunteers

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Darren Pasha (Washington Blade photo by Michael Key)

A D.C. Superior Court judge on Feb.18 agreed to rescind his earlier ruling declaring local gay activist Darren Pasha in default for failing to attend a virtual court hearing regarding an anti-stalking lawsuit brought against him by the Capital Pride Alliance, the group that organizes D.C.’s annual Pride events.

The Capital Pride lawsuit, initially filed on Oct. 27, 2025, accuses Pasha of engaging in a year-long “course of conduct” of “harassment, intimidation, threats, manipulation, and coercive behavior” targeting Capital Pride staff, board members, and volunteers.

In his own court filings without retaining an attorney, Pasha has strongly denied the stalking related allegations against him, saying “no credible or admissible evidence has been provided” to show he engaged in any wrongdoing. 

Judge Robert D. Okum nevertheless on Feb. 6 approved a temporary stay-away order requiring Pasha to stay at least 100 feet away from Capital Pride’s staff, volunteers, and board members until the time of a follow-up court hearing scheduled for April 17. He reduced the stay-away distance from 200 yards as requested by Capital Pride.

In his two-page order issued on Feb. 18, Okun stated that Pasha explained that he was involved in a scooter accident in which he was injured and his phone was damaged, preventing him from joining the Feb. 6 court hearing.

“Therefore, the court finds there is a good cause for vacating the default,” Okun states in his order.

At the time he initially approved the default order at the Feb. 6 hearing that Pasha didn’t attend, Okun scheduled an April 17 ex parte proof hearing in which Capital Pride could have requested a ruling in its favor seeking a permanent anti-stalking order against Pasha.

In his Feb. 18 ruling rescinding the default order Okun changed the April 17 ex parte proof hearing to an initial scheduling conference hearing in which a decision on the outcome of the case is not likely to happen.

In addition, he agreed to consider Pasha’s call for a jury trial and gave Capital Pride 14 days to contest that request. The Capital Pride lawsuit initially called for a non-jury trial by judge.

One request by Pasha that Okum denied was a call for him to order Capital Pride to stop its staff or volunteers from posting information about the lawsuit on social media. Pasha has said the D.C.-based online blog called DC Homos, which Pasha claims is operated by someone associated with Capital Pride, has been posting articles portraying him in a negative light and subjecting him to highly negative publicity.

“The defendant has not set forth a sufficient basis for the court to restrict the plaintiff’s social media postings, and the court therefore will deny the defendant’s request in his social media praecipe,” Okun states in his order. 

A praecipe is a formal written document requesting action by a court.

Pasha called the order a positive development in his favor. He said he plans to file another motion with more information about what he calls the unfair and defamatory reports about him related to the lawsuit by DC Homos, with a call for the judge to reverse his decision not to order Capital Pride to stop social media postings about the lawsuit.    

Pasha points to a video interview on the LGBTQ Team Rayceen broadcast, a link to which he sent to the Washington Blade, in which DC Homos operator Jose Romero acknowledged his association with Capital Pride Alliance.

Capital Pride Executive Director Ryan Bos didn’t immediately respond to a message from the Blade asking whether Romero was a volunteer or employee with Capital Pride. 

Pasha also said he believes the latest order has the effect of rescinding the temporary stay away order against him approved by Okun in his earlier ruling, even though Okun makes no mention of the stay away order in his latest ruling. Capital Pride attorney Nick Harrison told the Blade the stay away order “remains in full force and effect.”

Harrison said Capital Pride has no further comment on the lawsuit.

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