If the threats could be reasonably anticipated, covered entities and business associates have to implement measures to protect against the threats, or mitigate the consequences if the threats were to materialize. These barriers, including workplace and housing discrimination, can result in increasing SES disparities for LGBTQ persons and families. As it would be impractical for HIPAA to stipulate there has to be fewer than so many Mr. Xs in a population of Y before the two identifiers are considered to be PHI, all combinations of identifiers maintained in a designated record set are considered PHI under HIPAA even Mr. In addition, some single-sex or co-educational fraternities and sororities have become gender-inclusive. This is not surprising, as there are times when the same information can be both protected and non-protected depending on how it is maintained. PHI HIPAA is a 1996 federal law that is intended to improve the portability and continuity of health insurance coverage and to establish national health information privacy standards. endstream endobj startxref %PDF-1.6 % The following 18 HIPAA identifiers will qualify as PHI if included in any written or electronic document or spoken conversation: Privacy Protected Health Information (PHI) is health information, including demographic data, created or received by a covered entity (such as any UNC Health entity hospital, clinic, department or workforce member of UNC Health or UNC SOM) which relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision of health care by an individual and that identifies or can be used to identify the individual. Status Consequently, in order to reduce the number of complaints to HHS Office for Civil Rights, it is advisable for Covered Entities and Business Associates to ensure all members of the workforce have a thorough understanding of what is considered Protected Health Information under HIPAA not only to answer patients questions, but also to carry out their functions within the Covered Entity or Business Associate in compliance with HIPAA. 5. Consider SES in your education, practice, and research efforts. Sexual Orientation and Gender Identity People may experience this attraction in differing ways and degrees over their lifetime. The term marriage includes all lawful marriages. Brown from New York. Eighteen states have no laws prohibiting workplace discrimination against LGBTQpeople (Human Rights Campaign, 2015). Many LGBTQ youth may also be rejected by their family of origin or caregivers and forced to leave the home as minors. Retrieved from http://www.hrc.org/press/hrc-hails-historic-eeoc-ruling-on-employment-discrimination, Human Rights Campaign. (2009). From insurance enrollment to program-specific resource areas such as Recovery, Wellness, Family and Youth, find a compilation of LGBT-focused organizations and opportunities to connect. WebHowever, when a provider discloses information about a patient, the provider usually must try to reveal as little private information as possible. doi:10.1007/s10964-011-9681-3, Thomeer, M. B. In light of the Windsor and Obergefell decisions, this guidance makes clear that the terms marriage, spouse, and family member include, respectively, all lawful marriages, lawfully married spouses, and both the lawful spouses and the dependents of all lawful marriages, and clarifies certain rights of individuals under the Privacy Rule. www.healthprivacy.org, Lambda Legal | 120 Wall Street, 19th Floor, New York, NY 10005 | P - 212-809-8585. A person who can form enduring physical, romantic, and/or emotional attractions to those of the same gender or more than one gender. This standard defines designated record sets as a group of records maintained by or for a Covered Entity that is the medical records and billing records about individuals [] or the enrollment, payment, and claims information maintained by or for a health plan that is used in whole or in part by or for the Covered Entity to make decisions about individuals.. Studies indicate that between 11 percent and 45 percentof all homeless youth identify as LGBTQ(Durso & Gates, 2012; Gattis, 2009; Wells, 2009). Additionally, any information maintained in the same designated record set as the individually identifiable health information that could be used to identify the individual is also protected. It also generally requires covered entities to treat an individuals personal representative, who may be a spouse, as the individual, for purposes such as exercising the individuals rights under the Privacy Rule, including the right to access the individuals health information. HIPAA should not be used as an excuse to deny rights to LGBTQ patients. Webof LGBT persons remains legally permitted. Protected Health Information WebProtected Health Information (PHI) is an individuals health information that is created or received by a health care provider related to the provision of health care by a covered entity that identifies or could reasonably identify the individual. Although there could be thousands of Mr. Browns in New York, there is likely no more than a handful of Mr. Kwiatowskis in Crivitz, WI. WebThis umbrella term includes people who have nonbinary, gender-fluid, or gender nonconforming identities. Out on the street: A public health and policy agenda for lesbian, gay, bisexual, and transgender youth who are homeless. Sometimes shortened to ace, it is an umbrella term that can also include people who are demisexual, meaning they do experience some sexual attraction; graysexual, meaning those who may not fit the strictest definition of the word asexual; and aromantic, meaning they experience little to no romantic attraction and/or has little to no desire to form romantic relationships. The following 18 HIPAA identifiers will qualify as PHI if included in any written or electronic document or spoken conversation: Names. However, the next four items imply a lack of understanding about what is considered Protected Health Information under HIPAA: It is worth noting that, other than mandatory breach notifications, the most likely source of a complaint to HHS Office for Civil Rights is a patient. On the contrary, HIPAA specifically provides a mechanism for patients to indicate their wishes in these areas. LGBT and LGBT-friendly fraternities and sororities Comfortable dialogue about a patients identity and relationships can help to focus a providers inquiries, personalize professional advice and assistance, and generate an overall higher quality of care. hbbd```b``:"& DYH`G0,f A M6i d6Y=XtGH@}L@JD: @ y WebFor instance, LGBTQ+ youth who have access to spaces that affirm their sexual orientation and gender identity report lower rates of attempting suicide 4 and experiencing supportive environments. Following are LGBT-specific fraternities. People under the transgender umbrella may describe themselves using one or more of a wide variety of terms including transgender or nonbinary. Sometimes lesbian is the preferred term for women. This field is for validation purposes and should be left unchanged. LGBTQ community rejects false association with A Covered Entity may maintain multiple record sets about an individual (i.e., a patient or plan member), but individuals only have the right to access and request amendments to information maintained in designated record sets. WebHIPAA Identifiers. Any information that could be used to identify the subject of health information that is maintained or transmitted by a Covered Entity or a Business Associate acting on a Covered Entitys behalf is Protected Health Information when it is maintained or transmitted in the same designated record set as health information. Your generosity helps The Center provide vital programs and services to support our evolving LGBT community. The adjective describes a person who does not experience sexual attraction. LGBT and LGBT-friendly fraternities and sororities SEXUAL ORIENTATION, GENDER IDENTITY However, when non-health information is maintained outside the record set, the protections do not apply. BISEXUAL WebEvidence indicates individuals who identify as lesbian, gay, bisexual, and/or transgender (LGBTQ) are especially susceptible to socioeconomic disadvantages. Several factors that can help improve outcomes for LGBTQ+ young people include: Addressing LGBTQ+-related stigma, discrimination, and violence. LGBTQhomeless youth are 62 percent more likely to attempt suicide than their heterosexual counterparts, and they are at greater risk for sexual abuse, exploitation, sexual violence and drug abuse (National Alliance to End Homelessness, 2009). For professionals looking for internship opportunities with The Center to those looking to further their understanding of the LGBT community, find resources designed to enhance your professional experience. WebThe regulations provide protections for the privacy of certain individually identifiable health data, referred to as protected health information, and establish rules balancing patient rights with the need to protect public health. Wells, K. (2009). Aside from the confidentiality and disclosure of health information, the new federal rules describe a few related rights that patients may exercise: How can a patient complain if a provider has violated the privacy rules? To learn more, please read our Privacy Policy. As long as the information is collected from the patient, can be used to identify the patient, and is transmitted or maintained in some form by the healthcare provider or health plan, it is protected under the federal privacy rules. For example, many states broadly prohibit healthcare providers and laboratories from disclosing patients HIV test results except in certain circumstances. When do medical providers have to tell patients about their privacy rights? Protected Health Information Yes. Any disclosure of HIPAA data (that qualifies as Protected Health Information) that is not permitted by the Privacy Rule or that is not authorized by the individual to whom the data relates is a violation of HIPAA. Are there any other ways that private information about a patients health condition, sexual orientation or gender identity can be protected against disclosure by a healthcare provider? From time to time, the Health Insurance Portability and Accountability Act is incorrectly cited as an obstacle to hospital visitation rights and decision making authority for LGBTQ families. QUEER National recommended best practices for serving LGBT homeless youth. %%EOF HIPAA protects the privacy of individually identifiable health information via the provisions of the Privacy Rule. We are constantly inspired by the passion, creativity and pride of the LGBT community. Studies on LGBTQ youth reveal the following: Although the U.S. Supreme Court ruled in 2015 that states must issue marriage licenses to same-sex couples and recognize same-sex unions that have been legally performed in other states, legal barriers continue to exist. > Special Topics The U.S. legal system does not prohibit discrimination on the basis of sexual orientation and gender identity in several states, including workplace discrimination. The FAQ, while applicable in a variety of circumstances, was developed in large part to address confusion following the 2016 Orlando nightclub shooting about whether and when hospitals may share protected health information with patients loved ones. U.S. Department of Health & Human Services The adjective describes people whose enduring physical, romantic, and/or emotional attractions are to people of the same sex. From relationships to parenthood, we can guide and connect you throughout your journey. PowerPoint presented at the American Psychological Association Fall Board Committee Meeting, Washington, DC. This depends on the federal law. Research has shown that an increase in the minimum wage would reduce the poverty rate by 25 percent for same-sex/gender female couples and 30 percent for same-sex/gender male couples. Protected Health Information Most health care providers in the U.S., including private physicians offices and hospitals, must provide each patient with a description of the patients privacy rights during the patients first doctors visit after the rules became effective in mid-April 2003. WebEvidence indicates individuals who identify as lesbian, gay, bisexual, and/or transgender (LGBTQ) are especially susceptible to socioeconomic disadvantages. Low-income LGBTQindividuals and same-sex/gender couples have been found more likely to receive cash assistance and food stamps benefits compared to heterosexual individuals or couples. Collecting Sexual Orientation and Gender Identity Information Under HIPAA regulations, hospitals may use or disclose a patients protected health information to a family member, other relative, close personal friend or any other person the patient identifies. Nineteen percent of transgender individuals in one study reported having been refused a home or apartment and 11 percent reported being evicted because of their gender identity or expression (Grant, Mottet, & Tanis, 2011). Thus, SES is inherently related to the rights, quality of life, and general well-being of LGBTQ persons. HITECH News The term family member includes lawful spouses and dependents of all lawful marriages. US EEOC You can unsubscribe at any time. Please report privacy incidents promptly using the online reporting tool (link below) or the Hotline phone number at, Auditing Access to Electronic Medical Record, Employee Access to Protected Health Information, Fundraising, Marketing, Informational Newsletter Guidelines, Surprise Billing and Good Faith Estimate Notices, Avisos de facturas mdicas sorpresas y avisos de presupuestos de buena fe, All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, Vehicle identifiers and serial numbers, including license plate numbers, Biometric identifiers, including finger and voice prints, Full face photographic images and any comparable images, and, Any other unique identifying number, characteristic, or code. Discrimination against LGBT persons in the workplace is a significant factor in socioeconomic differences for LGBT persons (McGarrity, 2014). The Human Rights Campaign uses cookies to improve your site experience. By clicking "GO" below, you will be directed to a website operated by the Human Rights Campaign Foundation, an independent 501(c)(3) entity. However, it is important to be aware that HIPAA provides a federal floor of privacy protections. If identifiers are removed, the health information is referred to as de-identified PHI. HIPAA and LGBTQ Healthcare Equality Because a single data breach can affect many thousands of individuals, it is not surprising to see impermissible uses and disclosures at the top of the list. If information relating to a patients Emotional Support Animal is maintained in a record set, it assumes the same protections as the patients health information. WebThe law forbids sexual orientation and gender identity discrimination when it comes to any aspect of employment, including hiring, firing, pay, job assignments, promotions, layoff, training, fringe benefits, and any other term or condition of employment. This term describes someone who is questioning their sexual orientation or gender identity. Defining LGBTQIA+ - The Lesbian, Gay, Bisexual & Transgender There are numerous examples of what is not considered PHI under HIPAA. What rights do the new privacy rules grant to patients? Testimony on S.811, The Employment Non-Discrimination Act of 2011. into their membership. Morrisville, NC 27560. New federal regulations that went into effect in April 2003 help to clarify the rights of LGBT persons and the responsibilities of health care providers regarding the confidentiality of medical information. For example, [emailprotected], Stillwater MN, and auto registration AYP 197 are not included in PHI when they are not maintained with health information. Becoming homeless is also related to future depressive and anxiety symptoms, disorderly conduct and substance use disorders, which highlights the long-term impact of unstable housing on LGBTQhomeless youth (Rosario, Scrimshaw, & Hunter, 2012). Badgett, M. V. L. (2012). All rights reserved. 185 0 obj <>stream Under the Privacy Rule, if a state provides legally married spouses with health care decision making authority on behalf of one another, a covered entity is required to recognize the lawful spouse of an individual as the individuals personal representative without regard to the sex of the spouses. In other words, there are many situations where a patients disclosures to a doctor may not remain confidential. LGBT and LGBT-friendly fraternities and sororities The regulations provide protections for the privacy of certain individually identifiable health data, referred to as protected health information, and establish rules balancing patient rights with the need to protect public health. Importantly, this also includes any data relating to a family member, friend, or employer that could identify the individual. The following 18 HIPAA identifiers will qualify as PHI if included in any written or electronic document or spoken conversation: Names. The definition of a family member is relevant to the application of 164.510 (b) regarding permitted uses and disclosures of PHI related to another persons involvement in an individuals care, and for making notifications about the individuals location, general condition, or death. Retrieved from http://www.endhomelessness.org/library/entry/national-recommended-best-practices-for-serving-lgbt-homeless-youth, Rosario, M., Schrimshaw, E. W., & Hunter, J. > HIPAA Home All covered entities and business associates are required to conduct frequent risk analyses in order to identify threats to the integrity of PHI. Authorized personnel and certain organizations can have access to information under HIPAA if it involves a permissible use or disclosure as defined by the Privacy Rule. The new privacy rules regulate disclosure of a wide range of information about patients. HIPAA In addition to groups established for LBGT members, in the 21st century, many Greek letter organizations have become LGBT-friendly by adopting diversity and inclusivity statements. HHS Office for Civil Rights updates an Enforcement Highlights webpage on which it lists the compliance issues most often alleged in complaints in order of frequency. The definition of family member in the Privacy Rule at 45 CFR 160.103 includes the terms spouse and marriage. Youth Patients should keep these documents in their files for future reference, particularly if they have questions about the release of sensitive information by their healthcare providers. It pains me to have to clarify that no, the LGBTQ community does not embrace pedophilia, and LGBTP is not an acronym used or supported by the LGBTQ community. For more information about the regulations, we encourage you to visit any of these web sites: www.hhs.gov/ocr/ WebWithout this information, lesbian, gay, bisexual, and transgender (LGBT) patients and their specific health care needs cannot be identified, the health disparities they experience cannot be addressed, and important health care services may not be delivered. Psychosocial problems associated with homelessness in sexual minority youths. This guidance also updates and expands on related guidance issued in September 2014. About LGBTI people and human rights | OHCHR However other federal laws exist that also protect health information in certain circumstances. All health information relating to an individuals past, present, or future physical or mental health or condition, the provision of health care to the individual; or the past, present, or future payment for the provision of health care to the individual when the health information is maintained in a record set with any PHI identifier. It is important to note that these definitions only apply to health care providers, health plans, and health care clearing houses that qualify as HIPAA Covered Entities, and only to Business Associates while they are performing a service for or on behalf of a Covered Entity. Some transgender people are prescribed hormones by their doctors to bring their bodies into alignment with their gender identity. (2012). Youth Those who identify and express their gender outside of the gender binary. Therefore, the answer to questions such as is gender a HIPAA identifier, is gender considered PHI, and is LGBTQ status considered PHI is that is can be depending on who is maintaining or transmitting the information and whether it is maintained or transmitted with health information. Collecting Sexual Orientation and Gender Identity Information hb`````Z $e@@,&gY1e*b>|9! Copyright 2014-2023 HIPAA Journal. www.hipaadvisory.com