How the Health Care Equality Index is improving LGBTQ+ care

Key points to remember

  • The Healthcare Equality Index (HEI) is an annual report by the Human Rights Campaign Foundation aimed at promoting inclusive care for the LGBTQ+ community.
  • The index ranks how well health systems provide care for LGBTQ+ patients.
  • The 2022 report included the largest number of participating health systems to date.
  • Participating properties demonstrate their commitment to change and better serve their local LGBTQ+ community.

Health systems are improving to provide care for LGBTQ+ patients. This year, a record 906 facilities participated in the Human Rights Campaign Foundation’s Health Care Equality Index (HEI), and 82% were considered top performers or leaders in patient-centered care. LGBTQ+ patients.

the annual report of HEIs, released in April, is designed to address the discrimination and lack of competence that many LGBTQ+ patients face from healthcare providers. The first survey to examine barriers to health care for this population, conducted by Lambda Legal in 2010, found that 73% of transgender respondents and nearly 29% of bisexual, gay and lesbian respondents thought their identity would lead them to be treated differently in health care.

For these patients, care from specialists who understand gender identity is a necessity.

“If you have a place where you feel safe to access your health care, then you are going to be able to access [more] services,” Sergio Luna, a patient navigator at Vista Community Clinic in Southern California, told Verywell. “It could be anything, like getting your pap smear as a trans man, which might not be easy to get into any family planning and get.”

What is HEI?

The HEI is a tool created by the Human Rights Campaign in 2007 to assess LGBTQ+ healthcare policies and practices.

This year, nearly 500 healthcare facilities achieved a score of 100, the highest possible score, earning the designation of “Leader in Equality in LGBTQ+ Healthcare”. These facilities have been noted for their excellent treatment and support for LGBTQ+ patients in their community.

The institutions listed in the index have shown their willingness to comply with the criteria noted, thus demonstrating their commitment to care for all their patients.

“In a way, it’s almost like getting a recommendation from a friend; you can kind of have that validity,” Luna said, explaining why facilities want to be on the index. “It’s like Yelp for health.”

What does the HEI assess?

The HEI classifies facilities into five rating categories. These include LGBTQ+ patient services and support, employee benefits and policies, patient and community engagement, non-discrimination and staff training, and responsible citizenship.

  1. Patient Services and Support: The criteria in this section include things like having a documented plan to reduce LGBTQ+ health inequities, providing LGBTQ+-specific medical care, promoting that care as equitably as mainstream care, and providing resources from allied organizations.
  2. Social and political benefits: LGBTQ+ employees should receive equal treatment when comes to their benefits. This means that insurance and bereavement policies must cover spouses and same-sex domestic partners. Workplaces that have a diversity and inclusion office to champion equal treatment also help organizations rank well on the HEI.
  3. Patient and Community Engagement: Facilities can show that they understand the needs of their LGBTQ+ patients in different ways. These include things like staff demographics and concerns that align with LGBTQ+ patients, focus groups, representation on advisory boards, and health-related LGBTQ+ research.
  4. Non-discrimination and staff training: HEI senior leaders have strong non-discrimination policies in place, as well as plans on how to tackle discrimination when it occurs. Leaders provide staff with proper training, so they know what practices will best help the LGBTQ+ community.
  5. Responsible Citizenship: Responsible citizenship refers to the absence of major or minor offences.

What an LGBTQ+ healthcare equality leader looks like

Verywell spoke with two representatives of national facilities that scored 100 out of 100 on the HEI. They explained the changes they have made at all levels and the impact of these changes on their community.

Intermountain Healthcare Hospitals in Utah

Utah’s Intermountain Healthcare had 13 hospitals that scored 100 out of 100 on the HEI.

“The Health Care Equality Index isn’t kidding when they say they want you to do something to qualify,” Jan Stucki, MPH, equity and inclusion consultant at Intermountain Healthcare, told Verywell. “They are very rigorous.”

Still, Stucki thinks Intermountain Healthcare earned points for doing something relatively simple.

“One of the things that I think is really essential that we have been able to do this year is to put a list online [of] healthcare providers for LGBTQ+ people,” Stucki said. “We have also created an option in our registration system for sexual orientation and gender identity.”

During the pandemic, Intermountain also had to make changes to its website to clarify that COVID policies included equal visitation rights for LGBTQ+ patients, which could easily become obscure among the many restrictions.

In the future, Intermountain Healthcare plans to introduce “Equity Advocates” for employees or patients with an LGBTQ+ equity issue.

“Even after achieving this leadership status, we are very aware that we still have a long way to go,” Stucki said. “This is a group of individuals with significant disparity. They should be able to get affirmative care in their own neighborhood. We should be able to provide care that people are comfortable getting.

Stony Brook Medicine in Stony Brook, New York

Stony Brook Medicine is another facility that scored 100 out of 100 on the HEI.

“We’ve made changes, like working with IT to update medical records so they’re more inclusive and affirming,” Allison Eliscu, MD, co-chair of Stony Brook Medicine’s LGBTQ+ committee, told Verywell. “I had [an instance] where we were able to update [a patient’s] name in their medical records, so even though their legal name was still on their insurance, the name they chose was at the top of their file. The patient hadn’t been to the doctor for a while, then started going because of this interaction.

Stony Brook also ranks well for staff training. Eliscu attributes the training to “all levels of staff: doctors, nurses, nutritionists, front desk staff, interns, medical students, residents, and fellows,” which “truly provides cultural competency training.”

Visual changes throughout the hospital are also significant.

“We worked with maintenance people to have signage for bathrooms, for example, to make sure we had gender-neutral toilets throughout the hospital and health sciences center,” said said Eliscu.

What this means for you

If you are looking for a health care provider specifically trained to meet your needs as an LGBTQ+ person, you can view the health systems in your state that have participated in the HEI here.

Leave a Reply

Your email address will not be published.