Throughout June, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) celebrates Pride Month. During this observance CMS OMH highlights the unique health care challenges and barriers faced by members of the Lesbian, Gay, Bisexual, Transgender, Queer and Questioning, Intersex, Asexual, and Two Spirit (LGBTQI+) community.

While members of the LGBTQI+ community share the burden of stigma surrounding their sexual orientation or gender identity and expression, their individual experiences related to health care outcomes vary by race, ethnicity, income, and other characteristics. For example, gay, bisexual, and other men who have sex with men are disproportionately affected by HIV. Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Transgender women have the highest rate of HIV in the US, with the highest prevalence among Black (44%) and Hispanic (26%) transgender women. Social determinants and drivers of health, including stigma and discrimination among other factors, can also influence health conditions.

In addition to these disparities in health outcomes, LGBTQI+ individuals continue to face barriers to accessing care, including an increased likelihood to be uninsured, delay care, not have a usual source of care, and be more concerned about medical bills than non-LGBTQI+ individuals. State and national surveys often lack questions on gender identity and sexual orientation, creating a lack of information and gap in addressing disparities.

Many LGBTQI+ individuals are reluctant to disclose their sexual orientation to health care providers because they fear rude and discriminatory reactions, or due to concern that their personal information could become public. Many patients have found in recent years that telehealth appointments have become a safe and convenient way to access health care, especially for those who live in rural areas or other locations without access to inclusive facilities, providers, and treatments.

During Pride Month, CMS OMH is highlighting how you can help address these barriers and disparities impacting the LGBTQI+ community. Below is a list of resources you can share during Pride Month and beyond to help individuals receive better health care coverage.

Resources

• Take the newly updated Medicare Learning Network training “Improving Health Care Quality for LGBTQ People” to learn how you can make a difference in the health care of LGBTQI+ individuals.

• View the LGBT Partners page to learn more about CMS’s partnerships with national and local organizations helping the LGBTQI+ community receive quality health insurance and health care information.

• Download the Office of the Assistant Secretary for Planning and Education’s Health Insurance Coverage and Access to Care for LGBTQ+ Individuals: Recent Trends and Key Challenges issue brief, which discusses demographic characteristics of the LGBTQI+ community, recent trends in insurance coverage for this population, and various challenges and barriers to care faced by the broader community.

• Review Telehealth.gov’s Telehealth for LGBTQ+ Patients resource for providers to learn how telehealth can support LGBTQI+ patients.

• Visit the Substance Abuse and Mental Health Service Administration’s Center of Excellence on LGBTQ+ Behavioral Health Equity, which provides behavioral health professionals with information on supporting LGBTQI+ populations.

• Download and share the HIV/AIDS Disparities in Medicare Fee-For-Service Beneficiaries data snapshot for an overview of HIV/AIDS prevalence among Medicare fee-for-service enrollees as well as various resources.

• Share the Coverage to Care (C2C) Enrollment Toolkit and Adult Preventive Services Flyer to help patients learn how to make the most of their health coverage. Use the C2C Roadmap to Behavioral Health to help LGBTQI+ individuals understand how to use their coverage to improve their physical and mental health.

• Check out the interactive Lesbian, Gay, Bisexual, and Transgender Health Workgroup website to track the progress of objectives related to LGBTQI+ health.

• Learn more about Healthy People 2030’s goal to increase the number of national surveys that collect data on lesbian, gay, and bisexual populations.

Explore the U.S. Department of Health and Human Services Office for Civil Rights Protecting the Rights of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) People webpage, which can help LGBTQIA2S+ individuals understand their rights and gather information about gender affirming care.

Office for Civil Rights issues report to reduce barriers and increase access to persons with limited English proficiency

Last week, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) released a report summarizing the progress the Department has made on improving the provision of meaningful access to language assistance services to persons with limited English proficiency (LEP). The report also identifies steps to continue and strengthen this work across HHS moving forward.

Effective communication is critical in health care and human services, where miscommunication may lead to misdiagnosis, improper or delayed medical treatment, and barriers to necessary services and programs.

“The need for meaningful access to language services continues to grow across America and HHS is taking important action to ensure individuals with limited English proficiency can fully access federal resources and programs,” said Secretary Xavier Becerra. “As a child, I often needed to translate insurance and medical documents for my parents. That is still necessary for many families in this country today, which is why we are working so hard to ensure everyone has access to health care and advance health equity for all people.”

Last week’s report was issued in response to President Biden’s Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, which seeks to increase access to government services to address barriers in federal programs and services. This is the first such report HHS has issued since 2016. The report is also in line with Executive Order 14012, Restoring Faith in Our Legal Immigration Systems and Strengthening Integration and Inclusion Efforts for New Americans, which directed the Federal Government to develop welcoming strategies to promote integration and inclusion and embrace the full participation of the newest Americans, many of whom come with LEP, in our democracy. In addition, earlier this year, OCR relaunched the Department’s Language Access Steering Committee.

“HHS is taking important steps to ensure that people have full and equal access to programs and services across the Department, so that no one is left behind because of the language they speak, or other communications barriers based on ability,” said OCR Director Melanie Fontes Rainer. “OCR is committed to guaranteeing that health and human services are inclusive, equitable, accessible, and in compliance with civil rights laws for limited English proficient persons and their families.”

This first annual report summarizes the Department’s progress to date and charts a course to increase meaningful language access across the Department. Recent accomplishments include:

• OpDivs and StaffDivs have greatly increased the amount of in-language online content;
• In response to a complaint alleging 19 states failed to provide meaningful access to their COVID testing, inoculation, and treatment programs, OCR is collaborating with the DHS and FEMA to provide technical assistance: and
• HHS added taglines in multiple languages at the bottom of HHS.gov homepage.

It discusses the need for reducing barriers and increasing language access in the four key areas identified in the Equity Plan:

• Internet access;
• Telephone access;
• Access to programs and activities; and
• Federal funds to provide needed language services.

The report also maps specific benchmarks and progress to date, including OCR’s collection and analysis of 25 HHS agency and component-level Language Access Plans, and a review of work by the HHS Language Access Steering Committee to assess needed improvements and to share best practices. The report discusses how work will continue in 2023 and beyond, including:

• The creation of a new HHS Language Access Coordinator position;
• The setting up of a centralized language access center hub for HHS;
• Updating and revising HHS’s 2013 Language Access Plan; and
• Taking steps to address problems identified in OCR investigations of LEP complaints filed against HHS

Read the Report:

• In English: https://www.hhs.gov/sites/default/files/language-access-report-2023.pdf – PDF
• En Español: https://www.hhs.gov/sites/default/files/language-access-report-2023-spanish.pdf – PDF
• 用中文: https://www.hhs.gov/sites/default/files/language-access-report-2023-simplified-chinese.pdf – PDF* and https://www.hhs.gov/sites/default/files/language-access-report-2023-traditional-chinese.pdf – PDF*

Read the Press Release:

• En Español: https://www.hhs.gov/es/about/news/2023/05/24/hhs-releases-report-increase-language-access-persons-with-limited-english-proficiency.html
• 用中文: https://www.hhs.gov/sc/about/news/2023/05/24/hhs-releases-report-increase-language-access-persons-with-limited-english-proficiency.html and https://www.hhs.gov/tc/about/news/2023/05/24/hhs-releases-report-increase-language-access-persons-with-limited-english-proficiency.html

HHS is committed to ensuring that all people can access health care and human services free from discrimination. If you believe that you or another person have been discriminated against based on national origin or another protected category, you can file a complaint with OCR at: https://www.hhs.gov/ocr/complaints/index.html.

*People using assistive technology may not be able to fully access information in this file. For assistance, contact the HHS Office for Civil Rights at (800) 368-1019, TDD toll-free: (800) 537-7697, or by emailing OCRMail@hhs.gov.

Sens. Baldwin (D-WI), Bennet (D-CO), and Ernst (R-IA), introduced S. 1736, the Farmers First Act of 2023, to address the mental health crisis in rural communities and expand access to mental health support for farmers and ranchers. This legislation reauthorizes the Farm and Ranch Stress Assistance Network (FRSAN) and provides additional funding to help agricultural workers access behavioral health specialists and services. NRHA is proud to endorse this legislation and supports expanding the network of rural providers to deliver critical services to farming and ranching populations.

There are 293 rural hospitals at immediate risk of closure due to inflation, staffing shortages and other financial stress, according to the Center for Healthcare Quality & Payment Reform.

Hospitals at immediate risk of closure have lost money on patient services for multiple years, excluding 2020 during the pandemic, and aren’t likely to receive sufficient funds to cover the losses with public assistance ending, according to the report. These hospitals also have low reserves and more debt than assets.

Click here to see the state-by-state list.

The U.S. Census Bureau released the 2020 Census Demographic and Characteristics File (DHC). These products provide the next round of data available from the 2020 Census, adding more detail to the population counts and basic demographic and housing statistics previously released.

This release includes population counts (total, by race and Hispanic ethnicity, age, and sex) as well as housing counts. These data are available through the U.S. Census Bureau’s data dissemination platform data.census.gov.

PA Census 2020 Data Portal

Today, in conjunction with the release of the 2020 DHC data, the PA State Data Center launched the Census 2020 Data Portal. The portal serves as a tool to host data localized to Pennsylvania and also provides guidance, overviews, and interactive reports/visualizations to help users make sense of the Census 2020 data.

View the portal at: https://census2020-pasdc.opendata.arcgis.com/

While you’re there, check out our latest dashboard and report which make DHC data for the state, counties, and municipalities easy to view!

This resource is a living catalog of data releases and supporting documentation and analysis from the U.S. Census Bureau and the PA State Data Center. Existing data, resources, and reports/visualizations, such as those for the Redistricting (P.L. 1994) data, have been added to the portal, and more will come soon!

Coverage to Care has updated its partner resources! Now available on the C2C website, these materials are designed to help partners across the country share more information about C2C with their communities on how to make the most of their health coverage.

Coverage to Care is one of CMS OMH’s signature initiatives to help consumers understand their health coverage and connect them to the primary care and preventive services that are right for them. C2C offers resources to assist community partners in their outreach. Please be sure to use the newly updated C2C Partner Toolkit and presentation resources linked below!

Resources

• C2C Partner Toolkit provides prepared information and graphics for partners to use in their own emails, listservs, or social posts, as well as ideas on how to get started with health literacy in your community. Spanish coming soon!
• Updated C2C Community Presentation slide deck, a visual aid featuring the 8 Steps of the Roadmap to Better Care with prepared script and slides.
• C2C Presenter’s Guide (PDF) provides an overview of the C2C Community Presentation slide deck and tips for a better discussion.
• Accompanying Resources handout (PDF) with additional links to help with consumers’ health care journey.

Be sure to check out these and other resources on the C2C partner resources webpage.

To learn more about C2C, please visit go.cms.gov/c2c.

To continue receiving updates from about new C2C resources and programs, please sign up for our C2C listserv.