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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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World Pride 2025

D.C. liquor board extends drinking hours for WorldPride

Gay bars, other liquor-serving establishments can stay open 24 hours

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Sasha Colby performs at Pitchers in 2023. Liquor-serving establishments in D.C. will be able to remain open for 24 hours during WorldPride. (Washington Blade photo by Michael Key)

D.C.’s Alcoholic Beverage and Cannabis Board, which regulates liquor sales for the city’s bars, restaurants, nightclubs, and other establishments licensed to serve alcoholic beverages, has approved extended hours for alcohol service and sales during the days when most WorldPride events will be held in the nation’s capital.

In a May 2 announcement, the Alcoholic Beverage and Cannabis Administration, which works with the board, said the extended liquor serving and sales hours for WorldPride will take place beginning Friday, May 30, through 4 a.m. Monday, June 9.

Although the official schedule for WorldPride events shows the events will take place May 17-June 8, most of the large events, including a two-day Pride street festival, parade, and concert, were expected to take place between May 30 and June 8.

According to the ABCA announcement and an ABCA spokesperson, liquor servicing establishments with the appropriate license can stay open for 24 hours and serve alcoholic beverages from 6 a.m. through the day and evening until 4 a.m., with no liquor sales allowed from 4 a.m. to 6 a.m. during the May 30-June 9 period.

The ABCA announcement says liquor serving establishments must apply for the extended hours option and pay a $100 registration fee by a deadline on May 27.

Sources familiar with the liquor board have said the board has for many years approved the extension of liquor serving and sales hours for important events and for certain holidays such as New Year’s Eve.

At the time it approved the extended hours for WorldPride the liquor board also approved extended hours during the time when games for a World Cup soccer tournament will be held in the city on June 18, June 22, and June 26.

It couldn’t immediately be determined how many of D.C.’s 22 LGBTQ bars plan to apply for the extended drinking hours. David Perruzza, owner of the Adams Morgan gay bar Pitchers and its adjoining lesbian bar A League of Her Own, said he will apply for the 4 a.m. extended hours option but he does not intend to keep the two bars open for the full 23 hours.

Under the city’s current alcoholic beverage regulations, licensed liquor serving establishments may serve alcoholic beverages until 2 a.m. on weekdays and 3 a.m. on weekends.

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The Vatican

Executive director of LGBTQ Catholic group to travel to Rome for conclave

Marianne Duddy-Burke met Pope Francis in 2023

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DignityUSA Executive Director Marianne Duddy-Burke, middle, greets Pope Francis in 2023. (Photo courtesy of Marianne Duddy-Burke)

The executive director of a group that represents LGBTQ Catholics will travel to Rome next week for the papal conclave that starts on May 7.

DignityUSA Executive Director Marianne Duddy-Burke on Thursday told the Washington Blade she will arrive in Rome on May 6. Duddy-Burke said she plans to spend time in St. Peter’s Square “and have conversations with people.”

“I will wear Dignity insignia, have rainbow flags,” she said.

Pope Francis died on April 21. His funeral took place five days later.

The Vatican’s tone on LGBTQ and intersex issues softened under the Argentine-born pope’s papacy, even though church teachings on homosexuality did not change.

Francis, among other things, described laws that criminalize consensual same-sex sexual relations as “unjust” and supported civil unions for gays and lesbians. Transgender people were among those who greeted Francis’s coffin at Rome’s St. Mary Major Basilica before his burial on April 26.

Duddy-Burke and two others from the Global Network of Rainbow Catholics met with Francis in October 2023 during a meeting that focused on the Catholic Church’s future. Duddy-Burke noted Francis “invited” her and her colleagues as his “special guests for the audience and then had a conversation with him afterwards.”

“For me the sort of visibility that he (Francis) brought to our community and to our concerns feels irreversible,” said Duddy-Burke. “He empowered so many people and so many new ministries.”

Cardinal Fridolin Ambongo Besungu — the archbishop of Kinshasa in Congo who has described homosexuality as an “abomination” — is among the cardinals who are reportedly in the running to succeed Francis.

“I really don’t know,” said Duddy-Burke when the Blade asked her who the next pope will be. “Of course, I am hoping and praying hard that it will be someone who will continue to lead the church on responsiveness of human need and greater inclusivity.”

“What happens in that room is such a mystery,” she added.

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World Pride 2025

Episcopal bishop to speak at WorldPride human rights conference

Trump demanded apology from Mariann Edgar Budde over post-Inauguration sermon

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The Right Rev. Mariann Edgar Budde. (Screen capture via PBS NewsHour/YouTube)

The Right Rev. Mariann Edgar Budde is among those who are scheduled to speak at the WorldPride 2025 Human Rights Conference that will take place from June 4-6.

Budde, who is the bishop of the Diocese of Washington, in January urged President Donald Trump “to have mercy” on LGBTQ people, immigrants, and others “who are scared right now” during a post-Inauguration service that he and Vice President JD Vance attended at the Washington National Cathedral. Trump criticized Budde’s comments and demanded an apology.

The Right Rev. Mariann Edgar Budde speaks at the Washington National Cathedral on Jan. 21, 2025. (PBS NewsHour clip)

A press release the Washington Blade received notes Icelandic Industries Minister Hanna Katrín Friðriksson, UK Black Pride founder Phyll Opoku-Gyimah, and Bob the Drag Queen are among those who are also expected to participate in the conference.

The conference will take place at the JW Marriott (1331 Pennsylvania Ave., N.W.) and registration is open here.

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