In the fall of 1995, freshly out of grad. school, I got a case management job at an Adult Foster Care program, funded by Medicaid, within an elder services agency in the Greater Boston area. An evangelical Christian nurse coworker was allowed to not work with people we served who had HIV, almost all of them being gay men. After so many years since then, it still appalls me that administration and her immediate supervisor allowed her to be so blatantly discriminatory. I’m not at all an expert in legal matters, but I imagine both state and federal law may have been violated, since Medicaid is a federal program administered by each state. And the agency was a quasi public/state organization, under the auspices of the Department of Elder Affairs.

Upon further reflection and reading, I remembered that the Employment Nondiscrimination Act and, later, the broader Equality Act, languished in the U.S. Congress for years. I just read (which reminded me about the ruling when I’d initially heard about it) that not until 2020 did the U.S. Supreme Court rule that Title VII of the Civil Rights Act of 1964 protects employees from discrimination based on their sexual orientation and gender identity.

Then, there is another major area of civil rights, which is more pertinent to this situation with my long ago coworker: the right for customers/clients of a business, or in this case, an agency, to not be denied services based on their sexual orientation or gender identity, let alone their health status. From what I can tell, there continue to be no blanket federal protections in America for these large groups. Some states provide these protections while others don’t. However, in regards to people with HIV receiving health care services, a diligent researcher I know informed me that the ADA (Americans with Disabilities Act) from 1990 requires any federal-based program, or one receiving federal funding, to provide treatment to people with HIV. Hence, from what I can gather, my coworker was enabled by her supervisors to skirt around this law, in order to avoid confrontation and conflict, by assigning only non-HIV cases to her. The clients with HIV didn’t know the difference, since they were always assigned the other nurse who had no issue with them. Still, what a “skirt around” nonetheless, in which a worker’s discrimination was allowed, quietly validated, wrongly and sadly.