A Look at Long-Term Care and LGBTQIA Protections - Plus A Survey To Improve Advocacy for Aging LGBTQIA

There are an estimated 3 million LGBT older adults in the US; by 2030, that number will double. Some of those individuals will become residents of assisted living communities, while still others will require a stay in a skilled nursing facility.  Over the last 10 years, California legislatures have enacted three statutes fostering LGBTQIA cultural competency for workers in long-term care settings, and aiming to prevent discrimination based on sexual orientation and gender identity. Two bills (SB 1729, 2008 and AB 663, 2013) require professionals in California long-term care facilities (skilled nursing facilities, intermediate care and residential care facilities for the elderly [RCFEs]) to receive cultural competency training for the underserved aging lesbian, gay, bisexual and transgender community. Those laws heightened awareness of LGBTQIA issues, but did nothing to stem insidious or blatant discrimination inside long-term care settings.

50 years of human rights advances for LGBTQIA individuals can come to a full stop once an older gay man or aging lesbian moves into an assisted living community or long-term care health setting. Many times, these individuals are forced to return to the closet to avoid harassment, discrimination, isolation or worse.

With PRIDE Season upon us, it's time to highlight the 2017 law: The LGBT Senior Bill of Rights, attempts to put an end to LGBTQIA discrimination or mistreatment.  SB 219/Chapter 483, Statutes of 2017 has been called a bellwether for the nation's long-term care industries, for its broad applicability, and razor-sharp specificity.  Specifically, the bill prevents a long-term care facility or its staff, on the basis of a person's actual or perceived sexual orientation, gender identity, gender expression, or HIV status to: 

  • Deny admission to a long-term care facility, transfer or refuse to transfer a resident within a facility or to another facility, or to discharge or evict a resident from a facility;
  • Deny a request by residents to share a room;
  • Where rooms are assigned by gender, assigning,  reassigning, or refusing to assign a room to a transgender resident other than in accordance with the transgender resident's gender identity, unless at the transgender resident's request;
  • Prohibit a resident from using, or harassing a resident who seeks to use, or does use, a restroom available to other persons of the same gender identity;
  • Willfully and repeatedly fail to use a resident's preferred name or pronouns after being informed of the preferred name or pronouns;
  • Deny a resident the right to wear or be dressed in clothing, accessories, or cosmetics that are permitted for any other resident;
  • Restrict medical or nonmedical care that is appropriate to a resident's organs and bodily needs or provide medical or nonmedical care in a manner than unduly demeans the resident's dignity, or causes avoidable discomfort; and requires that the facility
  • Prominently post a required notice of the facility's nondiscrimination practices along with its current nondiscrimination policy in all places and on all materials where that policy is posted.

We are hopeful that both the California Department of Public Health, in its oversight of licensed long-term medical facilities (skilled nursing and intermediate care facilities) and California's Department of Social Services, Community Care Licensing, the oversight agency for RCFEs, vigorously enforce the provisions of SB 219.  CARR will be watching and you should be too.  If you find a facility is not complying with this law, your options are to file a complaint with a) the California Department of Social Services at 1-800-LET-US-NO, or b) find and contact your local Ombudsman office

If you identify as LGBTQIA, we are interested in your perspective on assisted living.  Please take our brief, 2 minute survey here.  Your input will help shape CARR's advocacy for the LGBTQIA community.


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