Recently had a call with @MassDPH and @MassAGO staff re: rationing and #LGBTQ communities prior to release of the Crisis Standards of Care Planning Guidance for the #COVID19 Pandemic

https://protect-us.mimecast.com/s/Stf7Czp59jCEPD3mU4WhZP?domain=mass.gov

Here is what I'm concerned about

While @MassGov is focused on addressing patient needs on a case-by-case basis, we know that is not possible in crisis situations. Decisions will be made fast and with what (incomplete) information is available at the moment.

How does this affect #LGBTQ people in particular?

While #COVID19 does not discriminate, we know systems do, particularly the health care system.

1) 16% of LGBTQ report being discriminated against when going to a doctor or health clinic

https://www.npr.org/documents/2017/nov/npr-discrimination-lgbtq-final.pdf

2) 22% of #transgender individuals avoided doctors or health care out of concern they would be discriminated against

https://www.npr.org/documents/2017/nov/npr-discrimination-lgbtq-final.pdf

3) 31% of #transgender folks say they have no regular doctor or form of health care.

https://www.npr.org/documents/2017/nov/npr-discrimination-lgbtq-final.pdf

This means #LGBTQ folks are:
1) less connected to health care (can't call a PCP to discuss symptoms)
2) less likely to have a health care advocate,
3) more terrified of how they could be treated in a crisis

While the @MassDPH @MassAGO guidelines provide for an appeal process if someone is denied resources (i.e., ventilator), who will be the advocate? While married couples are granted rights, what happens when next of kin are family that have rejected their #LGBTQ family members?

The Crisis Standards do note that "family or emergency contact" will be involved in patient decisions (pg 14).

BUT who will supercede the other in making decisions? Family of blood or family of choice?

https://protect-us.mimecast.com/s/Stf7Czp59jCEPD3mU4WhZP?domain=mass.gov

These issues need to be discussed and adjudicated ASAP to ensure a more equitable application of the @MassDPH and @MassAGO Crisis Standards of Care Planning Guidance for the #COVID19 Pandemic