The
Human Rights Campaign Foundation, the nation's largest lesbian, gay,
bisexual and transgender (LGBT) civil rights organization, and the Gay
and Lesbian Medical Association, the nation's largest association of
LGBT healthcare professionals, today released the third annual
Healthcare Equality Index (HEI), a national report that sets benchmarks
and highlights best practices in healthcare facility policies for LGBT
Americans. The release coincides with the annual observance of
National Hospital Week. To view the report, visit:
www.hrc.org/HEI.
"While
many facilities are leading the way in fairness for LGBT patients and
their families, on the whole, the healthcare industry is failing to
adequately address the needs of our community," said Human Rights
Campaign Foundation President Joe Solmonese. "But tools like the HEI
can turn this trend around. By helping to remove barriers and create
truly welcoming healthcare environments, we can build a stronger,
healthier community."
A key
finding in the 2009 report is the dramatic disparity between the number
of patient non-discrimination policies inclusive of sexual orientation
and those inclusive of gender identity. Less than seven percent of
participating facilities protect patients from discrimination based on
gender identity, while nearly three-quarters of participants provide
these protections based on sexual orientation. This finding is
symptomatic of the healthcare discrimination faced by transgender
Americans every day, from the explicit denial of healthcare services to
insensitive remarks by medical staff.
"Tragically,
the importance of protecting transgender patients and their families
from healthcare discrimination is made clear to us time and time again
when we hear stories of discrimination," said transgender health
advocate and HEI Advisory Council Member Dr. Rebecca Allison, a
cardiologist practicing in Arizona. "As healthcare providers, we have
the responsibility to ensure that all of our patients are given the
culturally competent care they need and the respect they deserve. The
policies and practices highlighted by the HEI provide a starting point
for ensuring transgender competence."
Ten of
the 166 participants answered "yes" to each of the survey's main
criterion which applied to them, thereby establishing a set of model
policies that will serve the entire healthcare industry. The
participation of all facilities is appreciated and seen as indicative
of a commitment to furthering healthcare equality for LGBT patients and
employees.
"We
believe the growing level of participation we're seeing by hospitals
and healthcare facilities across the country reflects a genuine
interest in the healthcare industry to better understand and address
the specific needs of LGBT patients." said Jason Schneider, MD,
President of the Gay and Lesbian Medical Association. "We're
encouraged by this level of participation, and believe that the HEI is
moving the healthcare industry toward policies, standards, and training
that will ensure equal treatment for the LGBT community."
"We at
Brigham and Women's Hospital in Boston are thrilled to have
participated in the HEI survey in 2009, and we vigorously embrace the
commitment to inclusion and diversity in healthcare that it embodies,"
said Dr. Michael Gustafson, BWH's senior vice president for Clinical
Excellence. "And while we are proud of our perfect HEI score, we are
equally gratified that the process of self-assessment has stimulated
significant new quality improvement activity to further bolster our
care policies and practices for both LGBT patients and our LGBT staff."
Other key findings of the HEI include:
- Visitation Policies. The HEI survey has identified model visitation policies that are explicitly inclusive of the LGBT community. These model policies will set the standard for credit on these questions in the future.
- Advance Healthcare Directives. All
HEI-participating facilities have compliance policies requiring the
honoring of legally-valid advance healthcare directives. Unfortunately,
LGBT individuals come forward with tragic stories of hospitals failing
to recognize these directives, reflecting a disconnect between the
existence of written policies and the actual implementation of these
policies on the part of all personnel. Future HEI surveys will focus on
staff training related to advance healthcare directives as a means to
eliminating this disconnect. - Cultural Competency Training. Seventy-two
percent of participating facilities provide cultural competency
training addressing sexual orientation and healthcare issues relevant
to lesbian, gay and bisexual community. Seventy-one percent of
participating facilities provide cultural competency training
addressing gender identity and healthcare issues relevant to
transgender community. - Employment Non-Discrimination Policies. Ninety-eight
percent of the participating facilities bar employment discrimination
based on sexual orientation, while only 63 percent of those policies
include "gender identity or expression" or "gender identity."
The
report is based on responses to an online survey, conducted October
through December 2008, addressing patient non-discrimination and
visitation policies; cultural competency training; recognition of legal
documents between same-sex partners; and the protection of LGBT
employees through fair employment policies. The responses in the HEI
2009 report represent the policies of 166 facilities from across the
country, including 93 hospitals and 73 clinics.
"We
thank the participating facilities for their willingness to review
their policies affecting the LGBT community, and laud them for the
remarkable work they've already done," said Solmonese.
In
addition to the report, the HRC Foundation is releasing a new resource
for healthcare lawyers and administrators entitled, "Breaking Down
Barriers: An Administrator's Guide to State Law & Best Policy
Practice for LGBT Healthcare Access." Included in the document is an
explanation of the issues most relevant to the equal treatment of the
LGBT community, including hospital visitation access and medical
decision-making rights. The document provides model policies and best
practice recommendations, as well as a review of the hospital policies
submitted by HEI participants and research into relevant state
healthcare law. The document is available for download:https://www.hrc.org/issues/12668.htm.