Councilmembers David Grosso and Robert White introduce legislation to improve LGBTQ health data

For Immediate Release:
June 5, 2018
 
Contact:
Matthew Nocella, 202.724.8105 - mnocella@dccouncil.us

Councilmembers David Grosso and Robert White introduce legislation to improve LGBTQ health data

Washington, D.C. – Today Councilmembers David Grosso (I-At Large) and Robert White (D-At-Large) introduced a bill to improve the documentation by D.C. agencies of health outcomes and behavioral risk factors of the lesbian, gay, bisexual, transgender and questioning (LGBTQ) community, as the federal government prepares to limit its collection of this critical public health data.

“At a time when the federal government is retreating from its responsibility to protect everyone’s human rights, D.C. must do everything it can to ensure those rights,” said Councilmember David Grosso. “We have a responsibility to meet the unique health needs of our LGBTQ residents.  Requiring our agencies to collect this critical public health data will better inform our policymaking and improve the health outcomes of all District residents.”

“We celebrate Pride in June, but we must go beyond words and parades to affirm and support our LGBTQ friends and neighbors. We need to push back on these proposals by the Trump administration that would impact their health by pretending they don’t exist,” said Councilmember Robert White.

The LGBTQ Health Data Collection Amendment Act of 2018 would require the District Department of Health to collect demographic data on sexual orientation and gender identity through its annual Behavioral Risk Factor Surveillance Survey (BRFSS).

The BRFSS is a cross-sectional telephone survey conducted by state health departments in all 50 states and the District of Columbia with technical and methodological assistance provided by the Center for Disease Control.

It would also require the Office of the State Superintendent of Education to collect information on the sexual orientation, gender identity, and gender expression of respondents to the school-based Youth Risk Behavior Surveillance System (YRBSS). YRBSS monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults.

“Having a better understanding of how our students identify and the impact their sexual orientation or gender identity has on their behavior and risk factors will enable schools to better serve our students’ non-academic health needs,” Grosso, chairperson of the Committee on Education, said. “When those needs are met, we know they are better prepared to succeed academically.”

All levels of government rely on the data from these surveys when making policy choices to address public health issues. Recently, Trump administration officials with the Center for Disease Controls hinted that they would discontinue the collection of this data.

Additionally, the bill would require that the data collected be used in the annual report on the health of the District’s LGBTQ community, a collaborative effort of the Department of Health and the Office of LGBTQ Affairs.

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LGBTQ Health Data Collection Amendment Act of 2018

LGBTQ Health Data Collection Amendment Act of 2018

Introduced: June 5, 2018

Co-introducers: Chairman Phil Mendelson, Councilmembers Robert White, Vincent Gray, Anita Bonds, Brianne Nadeau, Charles Allen, Elissa Silverman, Kenyan McDuffie, Mary Cheh, Brandon Todd, Jack Evans, Trayon White. 

BILL TEXT | PRESS RELEASE

Summary: To amend the Department of Health Functions Clarification Act of 2001 to require the Department of Health to collect information on the sexual orientation, gender identity, and gender expression of respondents to the Behavioral Risk Factor Surveillance System; and to amend the State Education Office Establishment Act of 2000 to require the Office of the State Superintendent of Education to collect information on the sexual orientation, gender identity, and gender expression of respondents to the Youth Risk Behavior Surveillance System.

Councilmember Grosso's Introduction Statement:

Thank you Mr. Chairman. Today, Councilmember Robert White and I are introducing the Lesbian, Gay, Bisexual, Transgender and Questioning Health Data Amendment Act of 2018. We are joined by Councilmembers Vincent Gray, Anita Bonds, Brianne Nadeau, Charles Allen, Elissa Silverman, Kenyan McDuffie, Mary Cheh, and Brandon Todd as co-introducers.

This is a very simple bill—it requires the Department of Health and the Office of the State Superintendent of Education to gather demographic data on sexual orientation and gender identity as part of their public health surveys of adults and students, respectively, in D.C.
Some members will recall this issue came up with regards to DOH a few years ago, and I introduced similar legislation then.

The Department did commit to gather the data, but only every other year, and new developments at the federal level threaten the progress that has been made.

This is data that OSSE is, in contrast, already collecting, and I don’t anticipate it causing any problem for them.

Understanding how our students identify and how that relates to their behavior or risk factors enables us to better serve students’ non-academic health needs.

When those needs are met, we know they are better prepared to succeed academically.

At a time when the federal government is retreating from its responsibility to protect everyone’s human rights, we must ensure that D.C. is doing everything it can to ensure those rights.

Part of that is documenting the health disparities that affect our LGBTQ neighbors so that we can target interventions to end those disparities. 

LGBTQ Health Data Collection Amendment Act FINAL by Team_Grosso on Scribd

DOH, DBH responds to Grosso letter regarding safe injection sites to combat the opioid crisis

Councilmember David Grosso received a letter from Department of Health Director Dr. LaQuandra Nesbitt and Department of Behavioral Health Director Dr. Tanya Royster in response to his Sept. 19 letter urging exploration of supervised injection facilities (SIFs) as part of a comprehensive public health approach to combating the opioid crisis and saving lives in the District of Columbia.

DOH/DBH's letter details Dr. Nesbitt's findings from a recent site-visit to a SIF in Vancouver. SIFs there have led to a decrease in opioid-related deaths and, to date, have not experienced an overdose related death on-premises. 

DOH and DBH noted that the success of such facilities has been made possible by coordination between local and federal authorities in Canada, which could present a barrier to implementation in the District of Columbia.

However, the Opioid Working Group is committed to reducing harm and deaths associated with the opioid crisis and will consider what would be required to implement SIFs in D.C. as it develops the Opioid Strategic Plan over the next few months.

You can read the response letter and the original letter sent by Councilmember Grosso below.

DOH/DBH Response to CM Grosso regarding supervised injection facilities by Team_Grosso on Scribd

CM Grosso Letter to DOH on Safe Injection Facilities by Team_Grosso on Scribd

Abortion Provider Non-Discrimination Amendment Act of 2017

Abortion Provider Non-Discrimination Amendment Act of 2017

Introduced: November 7, 2017

Co-introducers: Councilmembers Brianne K. Nadeau, Jack Evans, Charles Allen, Robert C. White, Jr., Anita Bonds

FACT SHEET | BILL TEXT | PRESS RELEASE

Summary: To amend the Human Rights Act of 1977 to prohibit discrimination against health care professionals by a health care provider, based on the professional’s participation in, willingness to participate in, or support for abortion or sterilization procedures, or public statements related to abortion or sterilization procedures.

Councilmember Grosso's Introduction Statement:

Despite the protection provided by Roe versus Wade, elected officials in state houses across the country and up on Capitol Hill are trying to make it effectively impossible to access abortion services.

This includes a climate of demonization of the medical professionals who provide these services.

A doctor, nurse, or other health practitioner should not have to fear for their job based on their support for the right to choose or their willingness to participate in abortion services.

In fact, discrimination based on an employee’s participation in abortion – or willingness to do so – has been illegal under federal law since 1976.

But there are gaps in the federal law, which has led a number of states to legislate additional protections.

The District of Columbia does not done so, but this legislation would fix that.

It is a rather simple bill, adding protections under our Human Rights Act for health professionals who speak publicly about abortion, or who have a second job providing abortion services.

At a time when speaking out about the importance of access to abortion is critical, we had an incident here in D.C. last year in which a hospital tried to silence a doctor who was an outspoken defender of reproductive rights.

This sort of retaliation, or the firing of healthcare professionals for treating a woman seeking an abortion as has happened elsewhere, is inappropriate and discriminatory.

With over 45,000 people employed in the healthcare industry in the District of Columbia, we need to protect these individuals from employment discrimination like this.

While only a few of those would be likely to need the protection of this bill, we pride ourselves as a jurisdiction that staunchly defends the right to an abortion, and we should ensure that no nurse or doctor fears that they will lose their jobs or careers because of participation in abortion services or advocacy.

Abortion Provider Non-Discrimination Amendment Act of 2017 by Team_Grosso on Scribd

Grosso proposes bills to deal with opioid crisis, improve public health as Council returns from summer recess

For Immediate Release:
September 19, 2017
 
Contact:
Matthew Nocella, 202.724.8105 - mnocella@dccouncil.us

Grosso proposes bills to deal with opioid crisis, improve public health as Council returns from summer recess

Washington, D.C. – Today Councilmember David Grosso (I-At Large) introduced two bills to address the opioid crisis in the District of Columbia.

“For decades we have attempted to use criminal penalties to solve drug addiction and its associated consequences,” Grosso said.  “This ‘War on Drugs’ has failed and in recent years, D.C. has adopted a public health and evidence-based approach to reduce harm and help people find appropriate treatment.  My proposals continue that approach.”

Last year, D.C. reported 216 opioid-related deaths—nearly triple the number reported in 2014. Grosso’s proposals would remove penalties for possession of certain drug paraphernalia and promote access to the medical marijuana program, both of which have been shown to reduce overdoses.

The Safe Access for Public Health Amendment Act of 2017, allows for access to new technology that enables drug users to test their own drugs to avoid overdosing and supports harm reduction efforts for injection drug use by improving access to clean syringes to reduce the transmission of HIV/AIDS and Hepatitis C.

The bill achieves this greater access by removing criminal penalties for possession for personal use of syringes and drug testing kits, and expanding the areas in which D.C.’s successful needle exchange program can operate.

“There is no scientific basis for criminalizing paraphernalia possession,” Grosso said. “It only increases the likelihood of harm to those who are struggling with addiction and continues the failed policies of the War on Drugs that has had a disproportionate impact on our African-American communities.”

Councilmember Vincent Gray joined Grosso in co-introducing this bill. Grosso joined Gray in co-introducing two other opioid focused bills: Opioid Abuse Treatment Act of 2017 and the Opioid Overdose Prevention Act of 2017.

The Medical Marijuana Improvement Amendment Act of 2017 reduces two major barriers to the city’s medical marijuana program: the requirement for a doctor referral and long wait times to get a registration card.

Under the bill, patients would be granted provisional registration and same-day access to medical marijuana like any other medicine. Patients without a primary care physician, or with one who does not wish to recommend medical marijuana, would be able to self-certify.

“Medical marijuana has been shown to be a viable alternative to the prescription of opioid painkillers, which can set people down the path to addiction,” Grosso said. “While we have made significant improvements to our medical marijuana program here in D.C., there is more we can do to improve access for patients and reduce opioid reliance and overdose.”

A study in JAMA Internal Medicine found that medical marijuana programs reduce opioid overdose death rates by as much as 25 percent.  Americans for Safe Access also reported lower prescription rates of painkillers in states with medical marijuana programs.

Grosso believes D.C. can go even further to combat the opioid crisis.  In a letter sent to Department of Health Director Dr. LaQuandra Nesbitt today, the councilmember asked her to examine how D.C. might set up supervised injection sites where injection drug users could be monitored to prevent overdose and be connected to treatment.  He also believes DOH should find a way to allow Narcan, the opioid overdose prevention medication, to be obtained over-the-counter at any pharmacy in the District of Columbia.

“I hope that Dr. Nesbitt and her team will find a way forward,” Grosso said.

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Public School Health Services Amendment Act of 2017

Public School Health Services Amendment Act of 2017

Introduced: January 10, 2017

Co-introducers: Councilmembers Brianne Nadeau, Jack Evans, Charles Allen, Mary Cheh, Vincent Gray, Elissa Silverman, Trayon White, Anita Bonds

Summary: To amend the District of Columbia Public School Nurse Assignment Act of 1987 to increase the minimum hours per week of registered public school nurse services at elementary and secondary public and public charter schools to 40 hours per week.

Councilmember Grosso's Introduction Statement:

Thank you Chairman Mendelson.

This morning along with Councilmembers Nadeau, Evans, Allen, Cheh, Gray, Silverman, T. White, and Bonds, I am introducing the “Public School Health Services Amendment Act of 2017.”

This legislation amends the District of Columbia Public School Nurse Assignment Act of 1987 to increase the minimum hours per week of registered public school nurse services at public and public charter schools to 40 hours per week.

As most of you know, last year, the Deputy Mayor for Education sent a letter to LEA leaders announcing the Department of Health’s new model for the school health services program. Under the new program, registered nurses will continue to provide clinical care for all children with special health care needs who require daily medications or treatment. Additional health professionals and community navigators will work with families, schools, and students’ primary care providers to make sure students receive well-child exams and the preventive services they need to be healthy. 

However, the school nurse service levels were to be reset for all schools at a minimum of 20 hours each week. Schools may receive more nursing coverage depending on the medical needs of student population based on a risk-based health needs assessment.

While families and the public were supportive of adding more allied health professionals to schools to help with care coordination, including community navigators to connect families with local assets, parents were alarmed at the idea that there would not always be a qualified health professional on site to assess and triage sick and injured children or provide emergency care as needed. Simply calling 911 or working parents anytime a child presents with a potential health problem should not be our schools default.

Due to these concerns, the Council was successful in delaying in reduction in nurse services to school year 2017-2018. However, there still needs to be a public conversation about whether the District should be reducing school nursing hours or rather aligning itself with the American Academy of Pediatrics and the Centers for Disease Control and Prevention, which both recommend having at least one full-time nurse in every school.

During a public roundtable on school health services last year, witnesses testified for five and a half hours about their concerns regarding the new program, particularly fear of losing full-time school nurses services. Many asked the Council to introduce legislation to increase the statutory minimum school nursing service level to 40 hours per week. To those constituents I say, we heard you. For me, this is about giving our families a piece of mind. Ensuring that there is always a qualified health professional at our public schools is a safety net.

I welcome any and all co-sponsors.

Public School Health Services Amendment Act of 2017 (as introduced) by Team_Grosso on Scribd

Grosso starts new term with renewed focus on students

For Immediate Release: 
January 10, 2017
 
Contact:
Matthew Nocella, (202) 724-8105

Grosso starts new term with renewed focus on students

Washington, DC – At the first legislative meeting of Council Period 22, Councilmember David Grosso introduced legislation to increase the health and financial resources that will put youth in the District of Columbia in the best position to succeed.

“Education continues to be my top priority on the Council,” said Grosso, who returns as chairperson of the Committee on Education. “Ensuring our students’ well-being and providing financial equity to our students is vital to their educational achievement.”

First, Councilmember Grosso introduced the “Public School Health Services Amendment Act of 2017” to provide students access to a full-time registered nurse at their school.

Last year, the Department of Health attempted to implement a new model for school health services which would have resulted in school nurse service levels being reset to a minimum of 20 hours each week.

Many parents were alarmed at the idea that there would not always be a qualified health professional on site to assess and triage sick and injured children or to provide emergency care as needed. The Council subsequently delayed implementation of the program for the remainder of the 2016-2017 school year.

The legislation introduced today would permanently increase the minimum hours per week of registered public school nurse services to 40 hours per week.

“For me, this is about giving our families piece of mind,” Grosso said. “Ensuring that there is always a qualified health professional at our public schools is a safety net.”

He also introduced the “Early Learning Equity in Funding Amendment Act of 2017” to infuse more equity into early learning funding.

Thousands of three- and four-year olds receive Pre-K3 and Pre-K4 educational services from community-based early childhood development centers and homes. Although these organizations, like D.C.’s local education agencies, teach a quality comprehensive curriculum to ensure kindergarten readiness and meet the District’s early learning and development standards, the District has not provided them with the same financial resources that we provide to DCPS and public charter schools.

The bill qualifies these organizations for additional funding by adding pre-kindergarten students receiving education services at community-based organizations in the definition of “at-risk”. It also establishes a pilot program to provide a facility allowance to high-quality child development centers and child development homes that meet certain criteria.

“Access to high-quality and affordable early care and learning is a growing concern for families in the District of Columbia, especially as the number of residents with young children continues to rise,” Grosso said. “More equitable funding invested in our youth at these early stages of development sets them up for later educational success.”

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DOH updates Grosso on opioid overdoses, LGBTQ policies, and other health issues

In August, Councilmember Grosso sent a lengthy letter outlining a number of concerns to Department of Health Director Nesbitt. The letter covered the agency’s response to the increase in opioid overdoses, changes to home visiting programs, updates on LGBTQ health policies, health impact assessments, and the agency’s medical marijuana program.

On September 13, Grosso received a response from Nesbitt, which you can view below along with Grosso’s original letter. This past week brought further progress on some issues, as the Council’s Committee on Health and Human Services passed the Substance Abuse and Opioid Overdoes Prevention Amendment Act of 2016 and the mayor announced the doubling of the amount of cannabis medical marijuana program participants may request in a month. Grosso, a member of the Committee on Health and Human Services, will continue to monitor these topics and push DOH to improve its policies and programs, and make them known to the public.

DOH Response Letter to Councilmember Grosso, Sept. 8, 2016 by Team_Grosso on Scribd

Councilmember Grosso's original inquiry letter:

Councilmember Grosso's Letter to DOH, Aug. 22, 2016 by Team_Grosso on Scribd

Grosso and Department of Health exchange letters on LGBTQ health

In May, Councilmember Grosso wrote to Director of the Department of Health Dr. Nesbitt regarding implementation of his bill LGBTQ Cultural Competency Continuing Education Amendment Act of 2015, which became law on April 6, 2016, as well as other LGBTQ health issues including data collection under the BRFSS and a local survey. On June 10, the Director responded. You can read both letters below:

Councilmember Grosso's letter:

Grosso Letter to DOH Director Nesbitt on LGBTQ Health Issues

Director Nesbitt's response:

DOH Director Nesbitt Response to Grosso on LGBTQ Health Issues

Grosso exchange with Department of Health Care Finance on Medicaid for returning citizens

Earlier this year, Councilmember Grosso's staff began researching policy issues for D.C. residents who are Medicaid recipients and become incarcerated. According to the National Council of State Legislatures, D.C. and many other states terminate an individual's Medicaid when that person is sentenced to prison--but under Medicaid rules, the government could also suspend the individual's Medicaid until their release. Grosso wrote to Director Wayne Turnage of the Department of Health Care Finance (which handles D.C.'s Medicaid policies) about this issue, and got a very informative letter in response. This included the revelation that DHCF had recently amended this policy to the best practice of suspending, not terminating, Medicaid. Good news for public health and public safety. You can read the letters below:

Grosso letter to DHCF on Medicaid Suspension for Prisoners

DHCF Response to Grosso Medicaid Implementation for Incarcerated and Returning Citizens

Grosso Calls on Obama Administration to Cease Raids Targeting Central American Immigrant Communities

For Immediate Release
January 29, 2016

Contact: Keenan Austin
(202) 724-8105

Grosso Calls on Obama Administration to Cease Raids Targeting Central American Immigrant Communities

Washington, D.C.—Today, D.C. Councilmember David Grosso (I-At Large) released the following statement on the recent Immigration and Customs Enforcement (ICE) raids and deportations targeting Central American immigrant communities:

“Today I am calling on President Barack Obama and Department of Homeland Security Secretary Jeh Johnson to cease the policy of targeting Central American immigrant communities for detention and deportation. As a young man I traveled to Honduras and El Salvador to accompany refugees seeking to return to their homes and I saw firsthand the violence affecting these communities. I know that that the legacy of that war and instability continues today.

As the Chairman on the Committee of Education, I am particularly concerned about the impact of these raids and deportations on our students and their families, filling them with fear and causing emotional distress. Trauma, whether stemming from families being raided by ICE, gun violence plaguing our streets, or economic inequality that keeps children in poverty, stand as a significant barrier to the success of the students in our schools; I have made addressing such adversity a top priority for the Committee. Families, unaccompanied minors, and workers fleeing violence and persecution in Central America need our support and care, not fear of detention and removal.

Just last summer I stood with immigrant communities and Congresswoman Norton to oppose fear-mongering and draconian legislation proposed in Congress to overturn local policies in D.C. and other jurisdictions which seek to protect human rights of immigrants. Migration is a fundamental human right recognized by the United Nations. Our federal government should focus its efforts on fixing our broken immigration system, not on breaking up families and sowing panic. President Obama should cease these ill-conceived actions immediately. In D.C. we stand for the human rights of everyone, including of our immigrant neighbors regardless of legal status.”

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01292016 Letter to Dr. Tanya Royster, Director of Behavioral Health

Committee Approves Grosso’s Bill to Improve Health of LGBTQ Residents

For Immediate Release: 
December 9, 2015
Contact: Darby Hickey
(202) 724-8105

Committee Approves Grosso’s Bill to Improve Health of LGBTQ Residents

Washington, D.C.--Today, Councilmember David Grosso (I-At Large) joined his colleagues on the D.C. Council Committee on Health and Human Services in a unanimous vote to approve the LGBTQ Cultural Competency Continuing Education Amendment Act of 2015. Introduced by Grosso and Councilmember Yvette Alexander in April, the legislation requires medical professionals, renewing their licenses in D.C., to take two credits of cultural competency training focused on patients who identify as lesbian, gay, bisexual, transgender, gender nonconforming, queer, or questioning their sexual orientation or gender identity.

“During the hearing on this bill, we heard truly heart breaking stories from LGBTQ residents about mistreatment they experienced at the hands of medical providers,” said Grosso. “In particular, our transgender friends and neighbors face disrespect and misunderstanding in medical settings, and this bill will continue our work to correct this serious problem.”

As many as one in five transgender people in D.C. have been denied medical care due to their gender, according to research released by the D.C. Trans Coalition last month in the "Access Denied" report. Locally and nationally, higher instances of chronic conditions among LGBTQ individuals have been documented, including higher rates of STDs and HIV, suicide attempts, mental illness, and some cancers.

“Quality medical care is often a life or death issue, and it is always a human right,” said Grosso. “I am grateful to Committee on Health and Human Services Chairperson Alexander for moving this legislation forward, for the health and well-being of our residents.” 

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Mayor expects to back ‘cultural competency’ bill

By Lou Chibarro, November 3, 2015, Washington Blade

D.C. Mayor Muriel Bowser on Monday said she expects to support the current version of a bill pending before the City Council that would require continuing education programs for licensed healthcare professionals that include LGBT-related “cultural competency” training.

Bowser’s comment follows testimony on Oct. 29 by her director of the city’s Department of Health, Dr. LaQuandra Nesbitt, calling for major changes to the bill – the LGBTQ Cultural Competency Continuing Education Amendment Act of 2015. LGBT advocates oppose her suggested changes.

Nesbitt told the Council’s Committee on Health and Human Services during a public hearing on the bill that she and Bowser support the general intent of the measure but believe it should be expanded to include cultural competency training “for all populations and sub-groups to whom healthcare professionals provide services.”

LGBT healthcare advocates joined more than a dozen representatives of healthcare organizations, including doctors and clinical social workers, in testifying at the hearing in favor of the version of the bill introduced in April by Council members David Grosso (I-At-Large) and Yvette Alexander (D-Ward 7). Alexander chairs the Health and Human Services Committee.

“I expect that we’ll support the Council bill,” Bowser told the Washington Blade following a news conference on Monday. “We will probably go with how they wrote it and if there are ways to enhance it down the line that’s what we would do,” she said.

The mayor’s comment will likely generate a collective sigh of relief from LGBT activists who expressed concern that Nesbitt had been pushing for a broader bill that could decrease its effectiveness in addressing the need for cultural training on medical issues impacting LGBT people.

Grosso told the Washington Blade he has no objection to cultural competency training pertaining to other population groups. But he said adding other groups to the bill would dilute its ability to address what he and others have said is lack of understanding and cultural sensitivity by many doctors and other health care providers toward LGBT patients.

The current version of the bill would amend an existing health care licensing law to require health care professionals, including doctors and mental health practitioners, to receive two credits of instruction on LGBT subjects as part of their continuing education programs.

“Despite the District’s strong policies against discrimination, our community, which is more than 10 percent of the District’s population, remains at risk,” said Rick Rosendall, president of the Gay and Lesbian Activists Alliance, in his testimony before the committee.

“[R]egarding the scope of this bill: Why is it limited to LGBTQ?” Rosendall asked. “For one thing, only so much can be covered meaningfully in two credits worth of training time. More crucially, our community faces the particular challenge of invisibility,” he continued. “If we are subsumed under a generic, all-encompassing category, we are effectively excluded.”

Alison Gill, senior legislative counsel for the Human Rights Campaign, told the committee that a 2009 nationwide survey found that more than half of LGBT respondents reported being refused needed care or being treated in a “discriminatory, disrespectful manner” by health care providers.

“Culturally competent care is especially important for LGBT people, as they continue to face substantial disparities in health, resulting from the stress of pervasive stigma; substance abuse and other health-endangering coping strategies; a reluctance to seek medical care due to fear of and actual healthcare discrimination; and the disproportionate impact of sexually transmitted disease,” Gill told the committee.

With the exception of Nesbitt, all of the nearly 20 witnesses testifying at the Council hearing expressed strong support for the bill as introduced by Alexander and Grosso. However, the executive vice president of the Medical Society of the District of Columbia, K. Edward Shanbacker, submitted a letter to the committee opposing the bill.

“The Medical Society believes strongly that the medical profession alone has the responsibility for setting standards and determining curricula in continuing medical education,” Shanbacker said in his letter. “In the District, the mechanism for that is the Board of Medicine, which has in the past opposed content-specific requirements surrounding continuing medical education,” he said.

Grosso said he has an answer to those, including the Medical Society, who say only doctors’ organizations and medical licensing boards should develop continuing education training on cultural competency matters.

“My answer to them is well you haven’t put this one in place and it would be important for us to put it on the books now,” he said, referring to LGBT cultural competence training.

He pointed to testimony by witnesses at last week’s Council hearing who told of LGBT patients who have been treated in a disrespectful manor and sometimes refused treatment by doctors unfamiliar with the special health needs of LGBT people, especially transgender people.

Dr. Raymond Martins, senior director of clinical education and training at D.C.’s Whitman-Walker Health, told the committee many of the mostly LGBT patients he has seen at Whitman-Walker have reported unpleasant experiences with other physicians and healthcare providers.

“Sadly, in this metropolitan area as well as throughout the country, physicians and other health providers do not receive adequate LGBT clinical and cultural competency training during medical school and their post graduate years,” he said. “This unfortunately leads to discrimination and poor health outcome for LGBT people,” Martins testified.

Grosso said he is hopeful that the bill will be finalized and brought up for a vote by the full Council before the end of the year. Eight other members of the 13-member Council signed on as co-sponsors of the bill.

Grosso Introduces Universal Paid Leave Legislation

For Immediate Release

October 6, 2015

Contact: Darby Hickey

(202) 724-8105

Grosso Introduces Universal Paid Leave Legislation

Washington, D.C.--Today, Councilmember David Grosso (I-At Large) introduced the Universal Paid Leave Act of 2015, along with Councilmembers Silverman, Allen, Nadeau, May, McDuffie, and Cheh. This legislation, which would give 16 weeks paid leave to all workers in D.C., follows Grosso’s success last year to give D.C. government employees 8 weeks of paid family medical leave.

 “As a country we lag behind the rest of the world on family leave—we need pro-family policies that encourage care taking and nurturing,” said Grosso. “The Universal Paid Leave Act will support our D.C. workers and families, while giving our local businesses a competitive advantage in attracting and retaining highly qualified employees.”

The bill, which Grosso co-wrote with Councilmember Silverman, would allow any employee in D.C., or any D.C. resident employed outside of the city, to access a government-run fund that would pay for up to 16 weeks of leave for a qualifying event. Qualifying events include a baby born or adopted, or major medical operations for the worker or a family member. The bill’s definition of family and major events are inclusive of the diversity of D.C.’s workers and families, including low-income workers, single-parent households, caregiving for non-child family members, lesbian, gay, bisexual and transgender individuals, and more.

“In D.C. we have been a leader on paid sick days, on raising the minimum wage, and providing paid family leave for government employees,” said Councilmember Silverman. “With this legislation, we once again position D.C. as a national leader on policies that bolster our families, workers, and employers.”

“I am very supportive of this legislation", said Michael Visser of Flying Fish Coffee and Tea. "As a small business, the proposed program would allow me to support paid family leave that I otherwise could not afford,  not only for my own employees, but employees throughout the city."

Research shows that paid leave for either parent after the birth or adoption of a child has a significant positive outcome for the child’s future academic success. After California and New Jersey enacted paid leave programs, employers stated that the new law had a positive effect on employee retention, productivity, and profitability. Read more about the Universal Paid Leave Act of 2015 below.

To read a copy of the bill, click here.

BILL SPECIFICS:

The Universal Paid Leave Act creates a system for District of Columbia workers to receive up to 16 weeks of paid leave for a major life event such as birth or adoption of a child or caring for a sick or injured family member or for self-care.  District of Columbia employers would pay into a city managed fund on a per-employee basis estimated to be less than 1% of the payroll.

Who takes: Any person working in the district for 50% or more of the preceding year for any covered employer.  Self-employed individuals can pay in and be covered; private residents will pay in for themselves and be covered.  DC Government Employees would continue to get their salary during paid leaves, rather than being part of this system, but the number of weeks of leave would be raised from 8 to 16 and add their own serious health conditions as a reason for taking leave.  D.C. residents who work for the federal government or an employer outside of D.C. will pay into the fund individually, as will self-employed D.C. residents.

How much does the employee get?  Up to 16 weeks for a qualifying event.  Wage replacement is Benefits would equal 100% of average weekly wages up to $1,000 a week and then 50% of average earnings above that amount, up to a maximum benefit of $3,000 a week.

Who pays: Covered employer means any individual, partnership, general contractor, subcontractor, association, corporation, business trust, or any person or group of persons acting directly or indirectly in the interest of an employer in relation to an employee, but shall not include the United States or the District of Columbia.

How much does the employer pay? A scaled percentage of their employee’s wage for that pay roll period (less than 1% of the annualized salary before taxes).

What is a qualifying event?     

• Qualifying event means one of the following:
  1. The birth of a child of the employee;
  2. The legal placement of a child with the employee (such as through adoption, guardianship, or foster care);
  3. The placement with the employee of a child for whom the employee permanently assumes and discharges parental responsibilities; or
  4. Care for a family member or personal serious health condition
• Family member means
  1. A person to whom the employee is related by blood, legal custody, domestic partnership, or marriage;
  2. A foster child;
  3.  A child who lives with the employee and for whom the employee permanently assumes and discharges parental responsibility; or
  4. A person with whom the employee shares or has shared, within the last year, a mutual residence and with whom the employee maintains a committed relationship. 
• Personal Care for a "Serious health condition" – this definition is expansive and inclusive so that our LGBTQ population can access leave for procedures that require hospitalization or managed care. The Bill contains inclusive definition of serious health conditions, caregiving, needs for military families, and other reasons for long-term paid leave.

Is the person’s job protected?  D.C. Family Medical Leave Act (FMLA) currently protects many employees from termination or other forms of retaliation for taking a leave (which would typically be unpaid, but could include vacation or sick days as a part). Currently, the D.C. FMLA applies to, Businesses with 20 or more employees in the District; and Employees who have worked for the same employer more than a year and worked 1,000 or more hours in the year leading up to their leave request.  The legislation would make only modest changes to job protections under the DC FMLA. It would decrease the hours and month requirement for eligibility for job protection, leave the small business exemption in place, and amends the definitions of “family” and “serious health condition” to match those in other laws.

FREQUENTLY ASKED QUESTIONS (link)

BACKGROUND:

Infographic: How Access to Paid Leave Helps Fathers

Infographic: To Promote Women’s Leadership, We Need Public Policy 

The Business Case for Paid Leave and Paid Sick Days 

Business School Faculty Letter to Congress

The Economic Benefits of Family and Medical Leave Insurance 

The Science Behind Why Paid Parental Leave is Good for Everyone 

Small Business Majority Research on Paid Family Leave 

The Cost of Doing Nothing, U.S. Department of Labor Secretary Perez

Frequently Asked Questions: Universal Paid Leave Act of 2015

1. Why does D.C. need the Universal Paid Leave Act of 2015?

The Universal Paid Leave Act would allow workers to care for themselves and their loved ones when major life events arise. Paid family medical leave helps families and  workers to be healthier and happier. For businesses, the legislation allows them to retain talented and dedicated employees, while avoiding the high costs and lengthy processes associated with staff turnover and on-boarding. A robust paid family and medical leave program will give D.C. employers a competitive advantage in attracting and retaining highly qualified workers.

2. What would this legislation mean for employees?

The bill would cover up to 16 weeks of paid leave annually for a qualifying event (family bonding or personal/family medical issues).  100% of an employee’s wages will be replaced for the first $1,000 of her or his average weekly salary and then 50% thereafter up to $3,000 a week.

Example:  Your annual salary is $50,000.  You are a new father and want to take time off to be with your adopted child.  You elect to take off 8 weeks and qualify to take leave after applying and having your eligibility verified. Your average weekly salary is $961, so you will receive that full amount for the entire 8 weeks.

3.  Who is covered by the proposed legislation?

All District of Columbia employees are eligible for paid family medical leave if they are residents of the city or spend more than 50% of their time working for an employer in the city. Employees are eligible to receive payments from the family medical leave fund at the start of employment. However, employees are only eligible for job protection after six months or 500 hours of work in a 12-month period. 

4. What are the responsibilities of an employer?

An employer pays a percentage (estimated 1% or less) from payroll for each employee into the government managed family medical leave fund. The fund administrators will be required to verify and process claims and will then pay the employees directly. The fund administrators would also handle any related investigations or appeals.

5. How will the proposed legislation be funded?

The Universal Paid Leave Act creates a city-managed fund financed by an employer-based cost-sharing model. Similar to Unemployment Insurance, all D.C. employers (except the federal and local government) will pay up to 1% of payroll into the fund. This fund would be administered by the D.C. government—keeping the burden off of employers—and the fund size will have  a maximum limit.

6. What is the difference between paid sick days and paid family medical leave?

Paid family medical leave is different than paid sick days. It would be used only for birth or adoption of a child, or for a major medical event. The estimated average cost per employee paid by the employer will be $385 annually and that amount will cover the employee for up to 16 weeks of paid leave—far less than paying directly out of pocket which will give businesses the opportunity to offer competitive benefits packages.

7. Is the employer required to hold the employee’s job during leave?

Yes, the D.C. Family Medical Leave Act standards provide 16 weeks of job protection that is unpaid. The Universal Paid Leave Act of 2015 proposes to extend job protection to employees who have worked for 6 months or 500 hours in a 12 month period. 

8. What if all the staff at a small business take leave at the same time?

We do not underestimate the effects that long-term leave has on businesses, but this is unlikely to be a problem—nationally only 13% of workers take family medical leave annually. The bill aims to enable workers to take the time they need to care for themselves or family members when the situation arises and then return to work at full capacity. The ability to retain talented and dedicated employees, and avoid the high costs and lengthy processes associated with staff turnover, makes paid family medical leave good business, no matter a business’ size.

8. What if I reverse commute or my employer is not mandated to pay into this fund?

If your employer is not required to pay into the fund, then you, as a resident, will pay into the system on your own behalf thereby enabling you to receive benefits when you become a parent or personal or family medical situations arise.  If you are a self-employed individual then you are automatically enrolled in the system to pay into the fund and receive the benefit.

9. What other jurisdictions have paid leave?

New Jersey (2008), California (2002), and Rhode Island (2013) have income tax-based family leave and temporary disability insurance policies that cannot be implemented in D.C. because of federal Home Rule restrictions on taxing income. We have, however, learned from the strengths and challenges with these programs and have incorporated their best practices into the D.C. legislation.  Globally, the United States lags behind other countries that all offer some form of paid leave for their citizens.  

Supporting Sustainable Communities through Health Impact Assessments

By Katrina Forrest

Poor health is not only physically and emotionally taxing for individuals, but there are important economic implications—these include increased costs to the healthcare system associated with the diagnosis and treatment of chronic conditions and lost time and productivity in the workforce.  While access to quality healthcare is without question a necessity, prevention is key.

Research indicates that there are a myriad of factors outside of the traditional health scope that shape health-related behaviors.  If we are to promote health and prevent disease, we must carefully consider and analyze all of the factors that impact health outcomes.  Economic sectors such as housing, transportation and agriculture can have profound impacts on the health and well-being of individuals and communities and yet these impacts are often not sufficiently evaluated.

As the District of Columbia continues to grow, with new development projects emerging every day, it is imperative that we assess how these projects positively or negatively affect the health of our residents.  By utilizing health impact assessments, we are able to better understand and identify the potentially significant unknown, unrecognized or unexpected health effects of policies, plans and projects across diverse economic sectors.

Health impact assessments rely on quantitative, qualitative and participatory techniques, to determine health impacts, the distribution of those impacts within communities and identify mitigation strategies to address adverse effects.  For example, in Washington State, legislation was enacted in 2007 to require a health impact assessment to examine the impact of a bridge replacement project on air quality, carbon emissions and other public health issues.

Recognizing the value of this tool, Councilmember Grosso introduced the Health Impact Assessment Program Establishment Act of 2015 .  This legislation establishes a health impact assessment program within the Department of Health to ensure that we are properly evaluating the potential health effects of construction and development projects on our residents and the communities they call home.

Implementing this comprehensive approach here in D.C. would help to promote sustainable development, improve and reduce health inequities, encourage cross-sectoral collaboration, and inspire a greater appreciation for public health in the policymaking process.   Grosso is committed to improving the health and wellness of every D.C. resident and this legislation is a critical step to accomplish that goal.

*This post is part of an ongoing series of posts by Councilmember Grosso’s staff to support professional development. All posts are approved and endorsed by Councilmember Grosso.

Grosso's Anti-Shackling Law Will Soon Come into Effect

In December of 2014, at the end of the D.C. Council's 20th legislative session, the Council passed Councilmember Grosso's bill to eliminate the use of shackles or restraints on pregnant inmates and detainees during and leading up to labor. Although the final version of the law did not go as far as Grosso had hoped it would in prohibiting the shackling or restraining of pregnant in almost any situation, nonetheless this is an important human rights victory. The legislation, the Limitations on the Use of restraints Amendment Act of 2014, is expected to become official law on July 25, 2015, at the conclusion of the mandated Congressional review period.

The final law states that no woman or girl in the custody of the Department of Corrections (DOC) or the Department of Youth Rehabilitative Services (DYRS) shall be restrained during the third trimester of pregnancy, during labor, or during post-partum recovery, except in extraordinary circumstances. Any such uses of restraints in extraordinary circumstances are to be documented and justified. For women and girls in the first or second trimester of pregnancy, the law stipulates that when restraints are necessary, the least restrictive restraint possible shall be used, except in extraordinary circumstances--which also must be documented. It is the responsibility of DOC and DYRS to inform the women and girls in their custody of these rules.

In advance of the legislation coming into effect as law, Grosso sent letters to the Directors of the DOC and DYRS. The responses from DOC Director Thomas Faust and DYRS Director Clinton Lacey are below. Although the Metropolitan Police Department (MPD) was not included in the final version of the legislation, the Councilmember will seek to work with MPD to ensure that pregnant women and girls in the Department's custody are treated with the utmost respect for their health needs and human rights.

DYRS Director Lacey Response to Grosso on Anti-Shackling Law

DOC Director Faust Response to Grosso on Anti-Shackling Law