Tag Archives: Health and human services

Trump team rolling back data collection on older LGBT adults

Hardly two months into the Trump administration — and only one month after Congress confirmed notoriously anti-LGBT Tom Price as health secretary  — the U.S. Department of Health and Human Services has eliminated questions about LGBT people from two critical surveys.

The administration is already rolling back data collection on LGBT people who receive certain federal programs, making it impossible to assess whether key programs for seniors and people with disabilities are meeting the needs of LGBT Americans.

Putting LGBT older adults at risk

The National Survey of Older Americans Act Participants is an annual, national survey of people who receive select services funded under the Older Americans Act, or OAA, the primary vehicle for delivering social support and nutrition programs to older adults in our country.

These essential programs include home delivered meals, congregant meals, transportation, caregiver support, and senior centers. The survey obtains performance outcome information, identifies service gaps, and supports program improvements. Policymakers and advocates rely on data to ensure OAA programs are meeting their goals without leaving anyone out.

The National Survey started collecting data on LGBT program recipients in 2014, and continued to do so in both 2015 and 2016 (available on file with CAP).

HHS’ proposed 2017 protocol, publicly announced on March 13, omits the survey’s only question about sexual orientation and gender identity. Despite the fact that LGBT people have been erased from the survey, the notice announcing the proposed survey alleges that “no changes” were made to the survey.

LGBT older adults face acute levels of economic insecurity, social isolation, and discrimination — including difficulty accessing critical aging services and supports. Data on LGBT program recipients would help HHS ensure its programs are meeting the need of LGBT seniors.

By rolling back data collection on LGBT people, HHS is giving up the tools it needs to ensure its effectively and equitably reaching all elders, including LGBT elders.

Ending data collection on LGBT people with disabilities

The Trump administration is also targeting LGBT individuals with disabilities, removing questions on LGBT identities from the Annual Program Performance Report for Centers for Independent Living.

A proposed redesign of the performance report was issued in January 2017 and did include questions about sexual orientation and gender identity; however, a revised version, issued in March 2017, omits these questions.

The Annual Report helps HHS evaluate the effectiveness and equity of programs designed to serve people with disabilities and ensure they can live independently in their homes and communities.

Available research suggests that LGBT people, especially LGBT older adults, face significant barriers to accessibility services. For this reason, it is particularly concerning that HHS is abdicating its responsibility to ensure the programs it funds equitably serve LGBT people with disabilities.

Why data matters

Data on LGBT program recipients could reveal disparities in how these HHS programs—which provide a critical safety net for to seniors and people with disabilities—serve LGBT people, potentially indicating discrimination or other barriers to access in the programs.

By rolling back data collection, the Department of Health and Human Services is throwing away the tools to ensure the department reaches vulnerable LGBT people in programs ranging from home delivered meals and senior center group meals, to transportation, caregiver support, and health promotion services.

Federal data collection on LGBT people is already scarce, but rolling back collection on crucial safety net programs is particularly disturbing. LGBT people experience overt and systematic discrimination across all areas of life—from education to housing, healthcare, employment, and the public square.

As a result, LGBT people face acute levels of income insecurity, making it particularly important that federal safety net programs meet the needs of the LGBT community.

By removing this data, the Department of Health and Human Services and Secretary Price risk erasing the experiences LGBT seniors and people with disabilities and making it impossible for HHS to identify and end disparities and discrimination in taxpayer-funded programs.

Sejal Singh is the Campaigns and Communications Manager for the LGBT Research and Communications Project at American Progress. Laura E. Durso is the Vice President of the LGBT Research and Communications Project at American Progress. Aaron Tax is the director of federal government relations for Services & Advocacy for GLBT Elders.

Related resources

Extensive stock trading by Trump’s pick for Health and Human Services raises questions

Public Citizen says the Office of Congressional Ethics and the U.S. Securities and Exchange Commission should look more closely at the stock trading activity of U.S. Reps. Tom Price of Georgia and Chris Collins of New York for conflicts of interest and possible insider trading.

Price is President-elect Donald Trump’s pick for director of the Department of Health and Human Services.

“Extensive stock trading activity in industries that Price and Collins oversee as congressmen, and unusually good timing and financial benefits of those stock trades, raise red flags about the potential use of insider information,” said Craig Holman, government affairs lobbyist for Public Citizen’s Congress Watch division. “The public information available falls short of hard evidence of insider trading, but the patterns of trading activity certainly warrant further investigation to determine if it occurred.”

Since 2009, according to congressional financial disclosure reports, Price has conducted over 630 trades on the stock market, many of which involve the pharmaceutical and health care sectors that he oversees as chair of the U.S. House of Representatives Budget Committee and as a member of the House Ways and Means Subcommittee on Health.

Price’s colleague Collins also is a prolific trader of health care investments on the stock market, according to news and disclosure reports.

Collins, a member of the House Energy and Commerce Subcommittee on Health, is a board member and the largest shareholder of a major biotech company, Australia’s Innate Immunotherapeutics Limited — a company in which both Price and Collins made major stock purchases within days of each other, according to financial disclosure reports.

“Collins purchased 4 million shares in August in the company whose board he sits on , and Price followed up with his own major stock purchase in the company two days later,” said Lisa Gilbert, director of Public Citizen’s Congress Watch division. “The stock value doubled in the three months following their investments. That’s quite good luck. This is worthy of investigation to determine whether any wrongful conduct occurred.”

Since passage of the STOCK Act in 2012, members of Congress have been subject to the same laws against insider trading that apply to everyone else. Additionally, congressional ethics rules warn members to avoid substantial conflicts of interest that may cast aspersions on the integrity of their office. Rules also mandate that members may not use their office for personal gain.

Public Citizen’s letter asks that the OCE and SEC investigate the stock trading activity of Price and Collins for potential violations of insider trading laws and conflict of interest rules and regulations.

On the Web

Read Public Citizen’s letter.

Recommendations for nation’s dietary patterns due

Dietary advice can be confusing. Is it OK to eat meat and eggs? Is fat in or out? What about grains? How much salt?

An advisory committee’s recommendations for the nation’s dietary patterns are due soon, and some advice may be changing. The committee is expected to downplay the importance of lowering cholesterol intake and may put less emphasis on eating lean meats. The panel could also tweak its recommendations on exactly how much salt is too much and put limits on sugar consumption for the first time.

Still, despite some revisions, the main advice never changes: eat more fruits and vegetables and whole grains, and eat less saturated fats, salt and sugar.

The Agriculture and Health and Human Services Departments will use the advisory committee’s report to write the final version of the 2015 dietary guidelines, due by the end of this year.

A look at the upcoming dietary guidelines, and what they mean for consumers:

WHY THEY’RE IMPORTANT

The dietary guidelines are issued every five years. The federal government uses them to set standards for school lunches and other federal feeding programs, and they serve as the basis for information on the nutrition facts panel on the backs of food packages.

They’re also used to create the government’s “My Plate” icon, which replaced the food pyramid and recommends a variety of fruits and vegetables, whole grains, lean proteins and low-fat dairy.

Doctors and nutritionists use the guidelines when giving advice, and food companies use them to make claims about their food.

EVOLVING WITH SCIENCE

The guidelines evolve as science evolves. Take cholesterol.

In December, the advisory panel said in its preliminary recommendations that cholesterol is no longer “considered a nutrient of concern for overconsumption.” That would be a change from previous guidelines, which said Americans eat too much cholesterol. This follows increasing medical research showing how much cholesterol is in your bloodstream is more complicated than once thought, and depends more on the kinds of fats that you eat. Medical groups have moved away from specific targets for cholesterol in the diet in recent years.

It’s unclear if the recommendation will make it into the final guidelines. Dr. Robert Eckel, a professor of medicine at the University of Colorado in Denver who is a past president of the American Heart Association, says there’s not enough evidence to make good recommendations on cholesterol right now, but “no evidence doesn’t mean the evidence is no.”

People can enjoy high-cholesterol egg yolks in moderation, he advises, but “a three- to four-egg omelet isn’t something I’d ever recommend to a patient at risk for cardiovascular disease,” he says.

There’s also some new science on salt. The 2010 dietary guidelines recommend that people eat less than 2,300 milligrams a day. That is reduced to 1,500 milligrams for some people at risk of heart disease.

A 2013 report by the Institute of Medicine said that while lowering salt intake is important for heart health, there is no good evidence that eating less than 2,300 milligrams a day of sodium offers benefits. The advisory panel’s discussions hint that they may not include the lower recommendation for certain groups.

POLITICAL BATTLES

While they are based on dietary science, the guidelines aren’t immune to politics. This year, the battles have already started over meat.

Current guidelines advise that people eat lean meats as a healthy way to get protein, but the advisory panel has debated whether lean meats should be included. In addition, the draft recommendations say a healthy dietary pattern includes fewer “red and processed meats” than are currently consumed. The meat industry called the draft recommendations absurd.

The committee has also discussed the idea of including sustainability as a dietary goal. The advisory panel said in its draft recommendations that there is “compatibility and overlap” between what is good for health and what is good for the environment.

A diet higher in plant-based foods and lower in animal-based foods is “more health promoting and is associated with lesser environmental impact than is the current average U.S. diet,” the draft recommendations said.

Environmentalists have been pushing those recommendations, while Congress is pushing back. Language attached to a massive year-end spending bill enacted in December noted the advisory committee’s interest in the environment and directed Agriculture Secretary Tom Vilsack “to only include nutrition and dietary information, not extraneous factors” in final guidelines.

WHAT WON’T CHANGE

The “My Plate” isn’t expected to change much – the guidelines issued at the end of the year will most certainly recommend putting fruits, vegetables, whole grains and lean proteins on your plate, accompanied by low-fat dairy.

In its draft recommendations, the panel said the problem it is trying to solve is high rates of “preventable chronic disease” and obesity.

The panel said the gap is an American diet too high in sodium, saturated fat, refined grains, added sugars and calories, and too low in vegetables, fruit and whole grains.

Baldwin leads lawmakers in urging end to ban on gay blood donors

U.S. Sen. Tammy Baldwin and other Democrats in the Senate and House are urging an end to the federal lifetime ban on gay and bisexual men donating blood.

Baldwin, along with U.S. Sens. Elizabeth Warren, D-Mass., and Tom Harkin, D-Iowa, and U.S. Reps. Mike Quigley, D-Ill., and Barbara Lee, D-Calif., led a letter with 75 of their congressional colleagues calling on Health and Human Services Secretary Sylvia Burwell to replace the ban on blood donations from men who have sex with men with a policy based on individual risk factors.

The legislators expressed concerns with the recent recommendations made by the HHS Advisory Committee on Blood & Tissue Safety & Availability.

Under current regulations, men who have sex with men are banned from donating blood for life. Yet the AABB, the American Red Cross, America’s Blood Centers and the American Medical Association agree that the ban is no longer scientifically justified.

Last month, the ACBTSA voted to replace the lifetime deferral policy with a one-year deferral policy, contingent on the implementation of a blood safety surveillance system, while dismissing a risk-based policy.

The legislators, in their letter, raised concerns about this proposal, writing, “A one-year deferral policy, like a lifetime ban, is a categorical exclusion based solely on the sex of an individual’s sexual partner – not his actual risk of carrying a transfusion-transmittable infection.”

The legislators continued, “The ACBTSA’s proposed policy change would, in practice, leave that lifetime ban in place for the vast majority of MSM, even those who are healthy and low-risk. Both policies are discriminatory, and both approaches are unacceptable. Low-risk individuals who wish to donate blood and help to save lives should not be categorically excluded because of outdated stereotypes.”

The legislators also urged HHS to consider the work of implementing an infection monitoring system separately from the MSM deferral policy.

The legislators wrote, “The ACBTSA’s recommendation to hinge any change in the MSM blood donation policy to the establishment of a blood safety surveillance system is an arbitrary condition that will inevitably result in further unnecessary delays. To be clear, a comprehensive surveillance system for our blood supply is a critically important initiative to protect the blood supply from Hepatitis, HIV, and emerging diseases, and is long overdue…Years of HHS inaction on this issue is problematic, but so is the fact that ACBTSA has now suddenly chosen to make such a system a precondition of revising the donation policies specific to MSM.”

The letter requests additional information from HHS regarding the timeline for reversing the lifetime deferral policy, actions being taken to work towards a risk-based deferral policy, and plans for implementing the long-overdue blood safety surveillance system.  

Walker calls for Ebola travel ban, despite opposition of health experts

Republican Gov. Scott Walker is calling on the federal government to institute a commercial travel ban for West African countries affected by Ebola, despite insistence from public health experts such a move would prove counterproductive. The call for a ban, however, is popular among uninformed voters.

Oshkosh Republican U.S. Sen. Ron Johnson also has called for restricting travel and quarantines for people who have recently been in affected nations or exposed to Ebola patients.

Wisconsin Republicans have frequently stood in opposition to the medical community on health issues with political implicatiions. The Wisconsin GOP, for instance, enacted a law forcing pregnant women to undergo invasive ultrasounds through vaginal probes when seeking abortion services. Theh procedures are unnecessary, invasive and disturbing to women, according to the medical community; they win anti-choice votes at the expense of women’s well-being, critics charge.

A ban on travel from West Africa might seem like a simple and smart response to the frightening Ebola outbreak there. It’s become a central demand of Republicans on Capitol Hill and some Democrats, and is popular with the public. But health experts are nearly unanimous in saying it’s a bad idea that could backfire.

The experts’ key objection is that a travel ban could prevent needed medical supplies, food and health care workers from reaching Liberia, Sierra Leone and Guinea, the nations where the epidemic is at its worst. Without that aid, the deadly virus might spread to wider areas of Africa, infecting larger and larger numbers of people. That would make the disease much more of a threat to the U.S. and the rest of the world, experts say.

In addition, preventing people from the affected countries from traveling to the U.S. could be difficult to enforce and might generate counterproductive results, such as people lying about their travel history or attempting to evade screening. Thus the ban would encourage possibly infected travelers to sneak into the nation undetected.

The U.S. has not instituted a travel ban in response to a disease outbreak in recent history. The experts insist now is not the time to start, especially given that the disease is still extremely contained in the U.S. and the only people who have caught it here are two health care workers who cared for a sick patient who later died.

“If we know anything in global health, it’s that you can’t wrap a whole region in cellophane and expect to keep out a rapidly moving infectious disease. It doesn’t work that way,” said Lawrence Gostin, a professor and global health expert at Georgetown University Law Center. “Ultimately people will flee one way or another, and the more infection there is and the more people there are, the more they flee and the more unsafe we are.”

Officials with the Centers for Disease Control and Prevention and the National Institutes of Health voiced similar objections at a congressional hearing this past week. So did President Barack Obama after meeting with administration officials coordinating the response.

Obama said he didn’t have a “philosophical objection” to a travel ban but that he was told by experts that it would be less effective than the steps the administration has instituted, including temperature screening and monitoring at the five airports accounting for 94 percent of the arrivals from the three impacted nations. There are 100 to 150 arrivals daily to the U.S. from that region.

“Trying to seal off an entire region of the world — if that were even possible — could actually make the situation worse,” Obama said today in his weekly radio and Internet address.

Still, with little more than two weeks from midterm elections and control of the Senate at stake, the administration is facing mounting pressure on Capitol Hill to impose travel restrictions. Numerous Republicans have demanded a ban, as have a handful of Democrats, including at least two endangered incumbent senators, Kay Hagan of North Carolina and Mark Pryor of Arkansas.

In this case, experts warn, political jockeying could prove deadly.

House Speaker John Boehner, R-Ohio, also favors a travel ban, and his spokesman, Kevin Smith, said the speaker hasn’t ruled out bringing the House back into session to address the Ebola issue. Obama “has the authority to put a travel ban into effect right now,” Smith said.

Lawmakers have proposed banning all visitors from Liberia, Sierra Leone and Guinea, or at least temporarily denying visas to nationals of those countries. They’ve suggested quarantining U.S. citizens arriving here from those nations for at least 21 days, Ebola’s incubation period, and limiting travel to West Africa to essential personnel and workers ferrying supplies.

Related steps that have been proposed by Pryor and others include strengthening existing quarantine centers, getting health officials to assist with screenings at airports and ensuring that information collected at airports on travelers from hot zones is shared with state officials..

Screening measures now in place allow arrivals from West Africa to be tracked; if those people go underground, attempt to enter via the Southern Border or by other means, it becomes that much harder to keep tabs on them.

Another difficulty arises because there are no direct flights to the U.S. from the impacted nations, raising the question of where to draw the line. Should flights from Paris, Amsterdam, London or Munich be banned if it turns out there is a passenger from Monrovia, Liberia, on them? Or should the other passengers just be screened? What if Ebola breaks out on European soil — should the travel ban be extended?

Among the travel ban skeptics is former President George W. Bush’s top health official, who coordinated the government’s response to bird flu in 2005 and 2006. At the time, it was feared that the H5N1 flu strain, capable of jumping from birds to humans, could become the catalyst for a global pandemic.

A travel ban “is intuitively attractive, and seems so simple,” said Mike Leavitt, who led the Health and Human Services Department from 2005-2009. “We studied it intensely in preparation for H5N1. I became persuaded that there are lots of problems with it.”

Report: Affordable Care Act rule saves consumers $9 billion on health insurance premiums

Consumers saved $9 billion on their health insurance premiums since 2011 because of the Affordable Care Act, according to Health and Human Services Secretary Sylvia M. Burwell.

The 80/20 rule, also known as the Medical Loss Ratio rule, requires insurers to spend at least 80 percent of premium dollars on patient care and quality improvement activities.

If insurers spend an excessive amount on profits and red tape, they owe a refund back to consumers.



“We are pleased that the Affordable Care Act continues to provide Americans better value for their premium dollars,” said Burwell in a news release. “We are continuing our work on building a sustainable long-term system, and provisions such as the 80/20 rule are providing Americans with immediate savings and helping to bring transparency and accountability to the insurance market over the long-term.”



An HHS report released on July 24 shows that last year consumers nationwide saved $3.8 billion up front on their premiums as insurance companies operated more efficiently.

Additionally, consumers nationwide will save $330 million in refunds, with 6.8 million consumers due to receive an average refund benefit of $80 per family.

This and other Affordable Care Act standards contributed to consumers saving about $4.1 billion on premiums in 2013, for a total of $9 billion in savings since the MLR program’s inception, according to HHS.

The report shows that since the rule took effect, more insurers are meeting the 80/20 standard by spending more of the premium dollars they collect on patient care.



If an insurer did not spend enough premium dollars on patient care and quality improvement, they must pay refunds to consumers in one of the following ways:

· a refund check in the mail.

· a lump-sum reimbursement to the same account that was used to pay the premium.

· a reduction in their future premiums.

Feds announce $1.9 billion in grants for HIV/AIDS care

More than $1.9 billion in grants have been awarded to cities, states and local community-based organizations for fiscal year 2013, the U.S. Department of Health and Human Services announced on Oct. 30.

The funding, according to a news release, will help to provide people living with HIV/AIDS continued access to health care services and medications. The awards were funded through the Ryan White HIV/AIDS Program.

“The Ryan White HIV/AIDS Program plays an important role in the fight against HIV/AIDS,” stated Secretary Kathleen Sebelius. “These grants will help make a real difference in the lives of Americans coping with HIV/AIDS, especially those in underserved urban and rural communities.”

The Health Resources and Services Administration, an agency within HHS, oversees the Ryan White HIV/AIDS Program, which provides funding for health services for people who lack sufficient health care coverage or financial resources to pay for treatment.

“The Ryan White HIV/AIDS Program helps more than half a million individuals each year obtain clinical care, treatment and support services,” said HRSA administrator Mary K. Wakefield. “The key to its success is the cities, states and community groups who know their populations and decide how best to allocate the funding they receive.”

A total of $594 million was awarded to 53 cities to provide core medical and support services for individuals living with HIV/AIDS under Part A of the Ryan White HIV/AIDS Program. These grants are awarded to eligible metropolitan areas with the highest number of people living with HIV/AIDS and to areas experiencing increases in HIV/AIDS cases and emerging care needs.

About $1.16 billion was awarded for FY 2013 to 59 states and territories under Part B of the Ryan White HIV/AIDS Program. Part B grants include grants that can be used for home and community-based services, AIDS Drug Assistance Program assistance and other direct services.

Wisconsin received $8,662,447.

For FY 2013, about $178 million was awarded across the country to 357 local community-based organizations to provide core medical and support services to individuals living with HIV/AIDS under Part C of the Ryan White HIV/AIDS Program. Currently 351 Part C grantees are providing ongoing services. Part C grant recipients provide comprehensive primary health care in outpatient settings to people living with HIV disease.

In Wisconsin, awards included:

• $469,713, Milwaukee Health Services.

• $531,980, University of Wisconsin System.

• $485,624 AIDS Resource Center of Wisconsin.

• $392,884 16th Street Community Health Center.

Ban on gay blood donors endures despite pressure to repeal

The gay rights movement has achieved many victories in recent years – on marriage, military service and other fronts. Yet one vestige of an earlier, more wary era remains firmly in place: the 30-year-old nationwide ban on blood donations by gay and bisexual men.

Dating from the first years of the AIDS epidemic, the ban is a source of frustration to many gay activists, and also to many leading players in the nation’s health and blood-supply community who have joined in calling for change.

In June, the American Medical Association voted to oppose the policy. AMA board member William Kobler called it “discriminatory and not based on sound science.” Last month, more than 80 members of Congress wrote to the Department of Health and Human Services, criticizing the lifetime ban as an outdated measure that perpetuates inaccurate stereotypes about gay men.

On some college campuses, students have urged boycotts of blood drives until the ban is repealed. Over the summer, activists organized a “National Gay Blood Drive” – asking gay men to visit blood centers, take tests to show their blood was safe, and then try to donate in defiance of the ban.

In the face of such pressure, the Food and Drug Administration – the HHS agency that regulates America’s blood supply – has been unwavering. The lifetime ban will be eased, the FDA says, “only if supported by scientific data showing that a change in policy would not present a significant and preventable risk to blood recipients.”

Under the auspices of HHS, a few studies are in progress that might lay the groundwork for a review of the policy. Department spokeswoman Diane Gianelli said the studies reflect a commitment to “continuously improving the safety and availability of the nation’s blood supply.”

However, some activists are impatient at the prospect of a research process that’s likely to extend over several years with an uncertain outcome. They argue that the U.S. could move now to emulate Spain and Italy, where blanket bans on gay blood donations have been replaced by policies that ban donations by anyone – gay or straight – who’s recently had unsafe sex, while allowing donations from gays and bisexuals whose blood is tested as safe and whose sexual behavior is deemed to pose no risk.

“We do not think HHS is moving fast enough,” said Jason Cianciotto of Gay Men’s Health Crisis, a New York-based nonprofit engaged in AIDS prevention and care.

Cianciotto said the ban “perpetuates the stigma that gay and bisexual men are dangerous to public health,” and thus undercuts efforts to combat HIV.

The FDA says its policy is not intended as a judgment on donors’ sexual orientation, and instead is based on the documented risk of blood infections, such as HIV, associated with male-to-male sex.

According to the FDA, men who have had sex with other men represent about 2 percent of the U.S. population, yet accounted for at least 61 percent of all new HIV infections in the U.S. in 2010.

The FDA implemented the ban in 1983, when health officials were first recognizing the risk of contracting AIDS via blood transfusions. Under the policy, blood donations are barred from any man who has had sex with another man at any time since 1977 – the start of the AIDS epidemic in the U.S.

Critics say the policy has been rendered obsolete by advances in testing which can which can detect HIV – the virus that causes AIDS – within days of infection.

Some critics say the lifetime ban could be replaced with a policy barring blood donations on the basis of gay sex within the past 12 months, or the past five years – as Canada recently decided to do. Others say there should be no set time periods, and that the screenings – as in Spain and Italy – should focus on high-risk behaviors of both gay and straight people, while making it easier for gays in monogamous, safe-sex relationships to qualify as donors.

“It’s very personal to a lot of people who would like to donate and yet are barred while knowing themselves not to be at risk,” said Brian Moulton, legal director of the Human Rights Campaign, a national gay-rights group.

“People perceive of giving blood as a civic duty,” Moulton added. “The current policy puts gay and bisexual men who are going to be honest in an awkward position during a blood drive. People ask, `Why aren’t you giving blood?'”

The FDA acknowledges that the ban leads to rejection of many healthy donors.

However, it says the policy “minimizes even the small risk of getting infectious diseases such as HIV or hepatitis through a blood transfusion.” And it says the blood supply in the U.S. has been stable.

Susan Stramer, executive scientific officer with the American Red Cross, agrees that the magnitude of the blood supply isn’t a decisive factor in the debate.

“We have a surplus of blood,” she said. “The question is about what’s equitable.”

The push for changing the policy gained momentum in 2006, when the Red Cross, the American Association of Blood Banks, and America’s Blood Centers reported to an FDA-sponsored workshop that the ban “is medically and scientifically unwarranted.”

Over the next few years, the California State Assembly and the city councils in New York and Washington, D.C., urged repeal of the ban.

Faced with such appeals, HHS sought input in 2010 from its Advisory Committee for Blood Safety and Availability. The committee concluded that the donor-screening policy is “suboptimal” – permitting some potentially high risk donations while preventing some low risk donations – but recommended that the ban on donations by gay and bisexual men be retained pending further research.

In March 2012, HHS asked for comments on a possible pilot study to assess alternatives that would permit some gay and bisexual men to donate blood while maintaining the current high level of blood safety. That study has yet to begin.

Regardless of the pilot study’s fate, Stramer said it’s possible federal officials could gather enough data from other ongoing research to make an incremental change, such as emulating Canada by barring donors who’ve had male-on-male sex during the previous five years.

“We’ve mounted as much pressure as can be mounted,” Stramer said. “Now it’s a question of time… The best we can hope for is a gradual change in policy.”

Stramer doubts there will be any groundbreaking findings from current studies. Their goals include evaluating the questionnaire presented to potential blood donors to ascertain their risk level, assessing the risk that quarantined blood donations might accidentally be released into the blood supply before being cleared via testing, and examining the phenomenon of some gay and bisexual men thwarting the ban by not acknowledging their sexual activity.

HHS, in a statement provided to members of Congress, said it hoped the studies would yield data sufficient to support a reassessment of the lifetime ban.

“The Department is committed to a full evidence-based evaluation,” HHS said. “If the data indicate that a change is possible while protecting the blood supply, we will consider a change to the policy.”

Moulton, the Human Rights Campaign official, says he is frustrated that the ban persists and yet acknowledges that scientific data gleaned through deliberative studies could help strengthen the case for change.

“I hope people understand there is a public health aspect to this that isn’t there in other aspects of the (gay-rights) movement,” he said. “We understand HHS is doing what they have to do.”

Dr. Louis Katz of America’s Blood Centers, a national network of community-based blood programs, favors replacing the lifetime ban with a ban on donations from men who’ve had male-on-male sex in the past 12 months. Though he shares the frustrations of more militant advocates, he advises them not to view the FDA as antagonists.

“The FDA is not homophobic – they are risk-averse,” said Katz, the network’s executive vice president. “We are going to get rational on this only by being patient and dogged.”

Katz says activists campaigning for change would be wise to solicit input from groups representing hemophiliacs and other users of blood banks whose overriding goal is to keep the blood supply safe.

The past president of one of those groups, the World Federation of Hemophilia, says he’d be open to changes in current policy if they are based on authoritative research.

“What we support very much is a review of the policy,” said Mark Skinner, the federation’s president from 2004 to 2012. “We want to move toward a system that reduces discrimination but does not increase risk.”

On the Web

FDA’s blood-donation policy: HTTP://1.USA.GOV/ABDTLK

Joint statement from blood-supply groups: HTTP://BIT.LY/19KPLNB

Joint letter from members of Congress to HHS: HTTP://1.USA.GOV/1CWZ1CI

Health and Human Services extends Medicare benefits to married gay couples

The U.S. Department of Health and Human Services today (Aug. 29) issued a memo clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives.

This is the first guidance issued by HHS in response to the U.S. Supreme Court ruling that section 3 of the Defense of Marriage Act unconstitutional.

“HHS is working swiftly to implement the Supreme Court’s decision and maximize federal recognition of same-sex spouses in HHS programs,” HHS Secretary Kathleen Sebelius said in a statement.  “Today’s announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court’s decision and to ensure that gay and lesbian married couples are treated equally under the law.”

At the Centers for Medicare and Medicaid Services, administrator Marilyn Tavenner added, “Today, Medicare is ensuring that all beneficiaries will have equal access to coverage in a nursing home where their spouse lives, regardless of their sexual orientation. Prior to this, a beneficiary in a same-sex marriage enrolled in a Medicare Advantage plan did not have equal access to such coverage and, as a result, could have faced time away from his or her spouse or higher costs because of the way that marriage was defined for this purpose.”

Under current law, Medicare beneficiaries enrolled in a Medicare Advantage plan are entitled to care in, among certain other skilled nursing facilities, the SNF where their spouse resides – assuming that they have met the conditions for SNF coverage and the SNF has agreed to the payment amounts and other terms that apply to a plan network SNF. Seniors with Medicare Advantage previously may have faced the choice of receiving coverage in a nursing home away from their same-sex spouse, or dis-enrolling from the Medicare Advantage plan, which would have meant paying more out-of-pocket for care in the same nursing home as their same-sex spouse.

The announcement today clarifies that this guarantee of coverage applies equally to all married couples.

The guidance specifically clarifies that this guarantee of coverage applies equally to couples who are in a legally recognized same-sex marriage, regardless of where they live.

$1.2 M federal grant to fight substance abuse and HIV among African-American women in Milwaukee

The U.S. Department of Health and Human Services has awarded a three-year, $1.2 million grant to the AIDS Resource Center of Wisconsin and Community Advocates to expand alcohol and substance abuse services, along with HIV and Hepatitis C prevention efforts, targeting African-American women in Milwaukee.

Although African Americans represent 27 percent of Milwaukee County’s population, they accounted for half of the county’s new HIV infections reported last year. Their risk for contracting the virus is 25 times greater than that of white women.  

According to studies, substance abuse plays a major role in fueling new HIV infections, and African-American women are at increased risk for substance abuse. In Milwaukee County, more than 7,500 African American women need substance abuse treatment, according to a press statement issued by ARCW.

The three-year, federally funded collaboration between ARCW and Community Advocates is projected to reach 9,900 women and to conduct 600 HIV and 800 HCV tests while providing alcohol/substance abuse treatment and counseling for 492 women. Services offered under the grant award will begin during spring 2014. 

“Through this strategic partnership with Community Advocates, we will be able to help African-American women in Milwaukee access the medical and mental health services they need to overcome addiction and stay safe from HIV,” said ARCW president and CEO Mike Gifford.

“We know behind the data and statistics are real women and families impacted by this issue, said Joe Volk, CEO of Community Advocates. “The need for this type of collaboration is apparent in the community, and we are committed and glad to be working with partners like ARCW who are equally committed to addressing this issue.”

According to the National Survey on Drug Use and Health, Milwaukee ranks seventh in the nation for urban areas in past-month binge drinking and first in the percentage of people with past-year alcohol abuse or dependence. Alcohol abuse by women of childbearing ages is 68 percent in Milwaukee compared with 50 percent nationally.

Health care costs for drug-related hospitalizations in Wisconsin totaled $287 million in 2010, an increase of 126 percent from the $127 million in 2002.