Resident Non-Discrimination Overview
LGBTQ people experience many forms of discrimination in long-term care because of their sexual orientation (lesbian, gay, and bisexual people), their gender identity or expression (transgender people), and/or their HIV status. An explicitly LGBTQ-inclusive resident non-discrimination policy can do much to reduce the discrimination that LGBTQ residents experience and fear in long-term care settings.
Explicitly inclusive language not only allows LGBTQ residents and their friends and family members to feel safe and welcomed in a community – it can be the deciding factor for an LGBTQ person when determining where to live.
In addition, the LEI encourages communities to include protection from discrimination based on HIV Status. In 2016, the Centers for Disease Control and Prevention reported that nearly half of those newly diagnosed with HIV were 50 years of age and older. Failure to protect those living with HIV from discrimination can result in significant health consequences for residents living with HIV.
A NOTE ABOUT STATE LAW
Some states are beginning to include specific protections for LGBTQ older adults in long-term care. California enacted the Lesbian, Gay, Bisexual and Transgender Long-Term Care Facility Residents’ Bill of Rights in 2017 which makes it unlawful for “any long-term care facility to take specified actions or wholly or partially on the basis of a person’s actual or perceived sexual orientation, gender identity, gender expression, or human immonodeficiency virus (HIV) status…”
Other states do not protect LGBTQ people from discrimination in long-term care or in employment, housing and public accomodations. In some cases, inclusion of one or more of the terms “sexual orientation,” “gender identity or expression,” and “HIV status” are not included in state non-discrimination laws. Adding “sexual orientation,” “gender identity or expression,” and “HIV Status” to a non-discrimination policy signals a clear and welcome commitment to equity and inclusion and offers legal protections to residents within the community.
Adding the words “sexual orientation,” and “gender-identity or expression” to your community's resident non-discrimination policy not only provides explicit protections for LGBTQ residents but communicates your commitment to inclusivity. SAGE advises older adults to look at a community's non-discrimination policy when choosing a place to live. Having sexual orientation and gender identity written in your policy ensures protections for LGBTQ residents even when there are no statewide protections. See below for an example of a community's LGBTQ-inclusive resident non-discrimination policy.
Discrimination because of HIV is illegal. However individuals with HIV may fear that they will still experience discrimination when seeking long-term care. We strongly encourage a community to include HIV in their non-discrimination policy. This communicates your acknowledgement and assurance that residents will be free from discrimination based on their HIV status.
Ensuring that your non-discrimination policy includes protections related to moving in, moving out and transferring to other communities is essential based on research showing LGBTQ older adults experience particular discrimination in these areas. The Out & Aging Report conducted by SAGE revealed that 1 in 8 LGB older adults and 1 in 4 transgender older adults report being discriminated against when searching for housing. The following is an example of the inclusion of the above language in a resident non-discrimination policy.
Creating and broadly communicating a resident non-discrimination policy is a crucial step in ensuring safe, inclusive spaces for LGBTQ residents. It sends an important message to residents and employees alike: LGBTQ people must receive equal treatment.
There are a variety of ways in which communities can share their non-discrimination policies, including:
- Posted on the community’s website
- Shared during move-in procedures with all new residents
- Shared with new and existing residents at other time(s)
- Provided in print materials available in community spaces
- Posted on signs/placards
- Verbally shared at the launch of new programs and activities
A screen grab from Abramson's Center website.
Sharing your non-discrimination policy with staff and volunteers is an important step toward ensuring that the people providing services in your community are aware of the expectations regarding non-discrimination. Further, it provides a foundation for providing education and training to staff and volunteers.
The following list includes a variety of ways in which communities can share their non-discrimination policies with staff and volunteers:
- Provided in materials for all new employees and volunteers during orientation
- Reviewed in-person or online during employee and volunteer training
- Posted on the community intranet site
- Posted on signs/placards in employee work area(s)
- Revisited as part of the standard protocol when planning new programs and activities
The Centers for Medicare and Medicaid Services require licensed communitites to work to resolve resident grievances of all kinds, including those based on discrimination. All individuals living in nursing homes have the right to be free from discrimination and harrassment. In 2016, CMS strengthened and expanded its regulations to require nursing homes to inform residents that they have a right to file a complaint orally, in writing, or anonymously and with specific regulations regarding implementation and follow-up to any filed grievances. These regulations provide a model for not only skilled nursing communities, but also assisted living and independent living communities. The following documents provide additional information and guidance about these requirements:
Skilled nursing communities are required to communicate their grievance process to residents by the Centers for Medicare and Medicaid Services. Assisted living and independent living communities are encouraged to follow the same high standards required by skilled nursing communities, including providing all residents with information about how to file a grievance which includes: how to contact the grievance official, a time frame for complaint review, a written decision, and information about other entities with which grievances can be filed, such as state or federal authorities and their contact information.