SF set to adopt LGBT seniors bill
by Matthew S. Bajko
The San Francisco Board of Supervisors is set to adopt on Tuesday first-in-the-nation legislation that protects the rights of LGBT seniors living in assisted care settings.
As the Bay Area Reporter first reported in January, the legislation sets out a number of pro-LGBT policies operators of long-term care facilities in the city would have to follow. They would be required to allow residents to room with the person of their choosing and could not restrict residents from being sexually intimate.
Under the measure, such facilities would also be barred from evicting residents based on their sexual orientation, gender identity, or HIV status. It also lays out protocols for caring for transgender and non-gender conforming residents and protects the visitation rights of same-sex spouses or partners of residents in such facilities.
"San Francisco has an opportunity to be a model for the rest of the country on how we address the aging needs of the LGBT community," gay District 9 Supervisor David Campos, a co-sponsor of the measure, told reporters at a press conference March 19 prior to a hearing about the proposal before the board's Government Audit and Oversight Committee.
Gay District 8 Supervisor Scott Wiener is the lead author of the ordinance creating a "Bill of Rights" for LGBT seniors. It is the first piece of legislation to be introduced based on the recommendations of a city created LGBT Aging Policy Task Force that completed its work last spring.
"These are the people who went to hell and back through the HIV epidemic to fight for our community. This is the least we can do," said Wiener, who is also planning to introduce a measure that would require city agencies to collect LGBT data on users of their services, which the aging task force also called for in its final report.
At last week's hearing on the Bill of Rights measure, Supervisors Norman Yee (District 7), London Breed (D5) and Julie Christensen (D3) voted unanimously to recommend that the full board adopt it. At its March 31 meeting the board is expected to pass the ordinance on first reading, and Wiener plans to hold a signing ceremony soon after with Mayor Ed Lee.
"Once again San Francisco can lead the way in ensuring our LGBT seniors are treated with the respect and dignity they deserve," Wiener said. "While state law mandates nondiscrimination in general, this sets clear guidelines on what that means."
It is unknown how many long-term care providers are currently operating in the city, as local officials do not compile a comprehensive list. Aging advocates say there could be anywhere from 500 to 1,000 such facilities ranging in size from having five or six beds to larger communal living settings with hundreds of units.
Nor are there any statistics on the number of LGBT people living in long-term care facilities. In general, it is estimated there are at least 20,000 LGBT seniors in San Francisco.
Some incidents reported
There does not appear to be widespread problems of LGBT harassment or discrimination at the city's long-term care facilities, with many holding LGBT sensitivity trainings for staff members. But incidents do occur.
Mullane Ahern, director of discrimination investigations and mediations at the San Francisco Human Rights Commission, reported during last week's hearing that of the 86 housing, employment, and public accommodation discrimination complaints the agency received in 2014, sexual orientation was the basis of the claim in 13 percent of the cases, with gender identity cited in 8 percent.
As for the 17 public accommodation claims in 2014, Ahern reported that nearly 20 percent were filed based on gender identity or sexual orientation discrimination. In a follow up interview with the Bay Area Reporter, Ahern said she did not know if any of the complaints involved long-term care facilities.
She explained that "the point of my testimony was these are the main areas of discrimination" she sees in her job, noting that many of the gender identity claims involve the names and pronouns used to address transgender people.
Once the ordinance is adopted, 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.
The law also mandates that within six months the Human Rights Commission and the local long-term care ombudsman office publish a handbook to help facilities comply with the ordinance.
Other cities expected to follow suit
LGBT agencies from across the country have contacted Wiener's office to express support for the measure, and advocates expect other cities will move to adopt similar legislation.
"From the national response we have received there is a sense this ordinance could be a pivotal moment, perhaps ushering in more attention and more discussion on these issues," said attorney Daniel Redman, a gay man who served on the LGBT aging panel and worked with Wiener's office to craft the Bill of Rights measure.
In February the American Geriatrics Society issued a policy statement calling for "fairer and more equitable treatment" of LGBT older adults. Drafted by the society's ethics committee, the position statement specifically called for the "creation of a culture of respect for LGBT older persons in supportive living situations" such as assisted living facilities and nursing homes.
It cited a 2011 study by the National Senior Citizens Law Center that found only 22 percent of LGBT older adults perceived they could be open about their sexual orientation or gender identity with staff at long-term care facilities.
"Adults in long-term care facilities may lose the privacy they have experienced in their own homes. Because of this, special attention is needed to ensure that LGBT identity is respected in residential facilities," states the geriatrics society policy paper.
Dr. Eric Widera, an associate professor of clinical medicine, division of geriatrics at UCSF, serves on the society's ethics committee but did not assist with the drafting of the policy statement. A straight ally whose work includes addressing the needs of San Francisco's older LGBT population, Widera said the city's ordinance is needed despite local and state laws that protect LGBT residents.
One particular area of concern Widera pointed to is in visiting hours for family members, "especially for individuals who self-identify family members rather than have biological family members." He noted that many LGBT seniors may be estranged from their biological families and have formed their own families of choice who may encounter problems when they go to visit them in a care setting.
"There is a lot of misunderstanding among health care providers, especially among long-term care settings, that makes LGBT residents not as open about their sexual orientation," said Widera. "I am sure it still goes on in the city. If you look outside the city, it is an even larger issue. They are discriminated against."
Michelle Alcedo, director of programs at Openhouse, testified during the supervisor hearing last week that the LGBT senior services agency seven years ago routinely received calls from "LGBTs rejected by long-term care facilities."
Yet today, Alcedo said the San Francisco-based nonprofit is more likely to field inquiries from "younger queers concerned about how they would be received as the caregivers for their straight parents."