Joint Commission expressed concern with HHS rule eliminating protections for transgender individuals
The 2016 rules interpreted Section 1557’s sex discrimination prohibition to require covered entities (e.g., hospitals, insurers) to treat individuals consistent with their gender identity. Under the rule, covered entities could not deny access to health services or facilities based on gender identity, exclude coverage for gender transition services, or otherwise restrict or limit services based on an enrollee’s transgender status. The new amendments completely drop these protections from CMS implementing regulations. The new rules only bar discrimination based on biologic gender of male or female and do not recognize discrimination based upon gender identity. The Joint Commission expressed concern that deleting the specific reference to gender identity may worsen inequalities of care for the transgender community, including those who are lesbian, gay, or bisexual. Studies show that these patients often experience lower quality of care because of stigma, lack of awareness, and barriers to care.
Since the new rule was issued, an unrelated U.S. Supreme Court decision on June 15, 2020, stated that the term “sex” in the Civil Rights Act of 1964 prohibits discrimination based upon sexual orientation and gender identification.
In March 2020, The Joint Commission placed a hold on the initial public reporting of two ORYX Perinatal Care (PC) measures on Quality Check®:
- PC-02 Cesarean Birth
- PC-06 Unexpected Complications in Term Newborns
Due to extended data submission timelines and optional reporting for fourth quarter 2019 data because of the coronavirus pandemic, the planned July 2020 display on Quality Check® was placed on hold. The Joint Commission has since received the fourth quarter 2019 data and determined most health care organizations with ORYX requirements for perinatal care measures did submit data for the fourth quarter, allowing for public reporting of 2019 data. The Joint Commission is planning for public reporting of the two perinatal care measures on Quality Check® in early 2021.
For more background on this, see the announcement that was published in the April 1 issue of Joint Commission Online.
Questions may be directed to the ORYX Help Email.
A consultant for Joint Commission Resources, Robert Carlock III, MS, MBA, CHE, is also director of environment of care at AltaPoint Health. He recently shared what he sees as the positives to come out of the COVID-19 pandemic and how those will help health care prepare for the future.
“We’re hearing so much about the death rate and positive testing rates rising,” he said. “I wish we could put more of the good stories happening out there. We’re no stranger to emergency preparedness. We have severe weather in our north regions and hurricanes in our south regions so we’re constantly exercising our emergency operations plans. We had everyone willing to jump in and do whatever it took to meet our patient’s and employee’s needs. Looking at our community partners, we’re seeing the true benefit of the relationships we developed with them. We have not seen one single instance of a competition for resources or an everyman for themselves mentality since this has begun. We’ve seen people come together with the attitude of what can we do to help each other. I’ve been impressed with what I’ve seen internally and with our community partners.
“We are learning so many lessons from this. Just in environment of care, what I’ve seen from my colleagues is that we’re a very resilient group. We come up with contingencies, we come up with plans, we talk to each other, we go to conferences, we read studies and we do what we can to prepare for things like this. If this was a hurricane, I could say turn to our emergency operations plan, and you’ll see what to do on page 72. But there is nothing that tells us exactly what you do every single day during a pandemic of this magnitude. So, we’re writing the playbook as we go along. We’re doing it with resilience and with our community partners.
“A lot of things seem to be settling down, and there seems to be a light at the end of the tunnel. But in reality, we’ve got to keep in mind there is potential for a second round. I’m seeing a lot of my colleagues, who are very smart, making preparations for that second round. I know that sounds a bit contradictory, as we haven’t gotten through the first part of this crisis yet. But the fact that they are smart enough to make those plans shows that they have taken into consideration what they’ve learned from The Joint Commission about how to make emergency plans and not get comfortable. They are looking at all six functions of emergency management and making sure they’re prepared not just for this event, but every new event that comes down the road.”
Read more “Real Voices. Real Stories.”
- Dateline @ TJC — Nurses Confronting COVID-19 Misinformation: Nurses everywhere should be of one mind regarding their critical role in shaping public perceptions on wearing masks, social distancing and other public health practices critical to stabilizing the outbreak. Now is not the time to let our personal discomfort hinder our responsibility to be part of the solution, writes Jean-Luc Venzia, BSN, MPH, RN, surveyor, Behavioral Health and Human Services Program.
- Improvement Insights — Advocacy and Mentorship for Quality Improvement: I am feeling at a loss for words in the face of the serious epidemics plaguing our country (and the world) at this moment. Since the COVID-19 pandemic began, a disproportionate number of those deaths and injustices have hit the nation’s elderly, poor and racial minority populations, writes Gordon D. Schiff, MD, associate director, Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women's Hospital; associate professor of medicine Harvard Medical School; and quality and safety director Harvard Medical School Center for Primary Care, Boston.