Healthcare Equality Index 2010 by Human Rights Campaign

healthcare EQUALITY INDEX 2O1O Creating a National Standard for Equal Treatment of Lesbian, Gay, Bisexual and Transgender Patients and Their Families

â&#x20AC;&#x153;There are few moments in our lives that call for greater compassion and companionship than when a loved one is admitted to the hospital...â&#x20AC;? President Barack Obama in an April 2010 presidential memorandum, directing the Secretary of the U.S. Department of Health and Human Services to protect the visitation and medical decision-making rights of LGBT people.

healthcare EQUALITY INDEX 2O1O Creating a National Standard for Equal Treatment of Lesbian, Gay, Bisexual and Transgender Patients and Their Families

contents 5

Letter from HRC Foundation President Joe Solmonese

Overview of Findings

HEI 2010 Top Performers

Methodology & Rating Criteria

10 12

Methodology Rating Criteria Changes from 2009

Findings: HEI 2010 Rating Criteria

Patient Non-Discrimination Policies Visitation Policies Cultural Competency Training Employment Non-Discrimination Policies

Findings: Additional Best Practices & Policies

Advance Healthcare Directive Compliance Training Transgender Health Benefits Partner Health Benefits LGBT Employee Groups Data Collection Policies

Appendices

Appendix A: HEI-Rated Facilities and Breakdown of Responses Appendix B: HEI-Rated Facilities by State Appendix C: HEI-Rated Facilities by Network Appendix D: Testimonials from HEI 2010 Top Performers Appendix E: LGBT Patient Protections within 200 of the Largest U.S. Hospitals

16 18

28 28 30

39 45 51

Acknowledgments

About the HRC Foundation Family Project

Healthcare Equality Index Advisory Council

a dedication ÂŠ2010 by the Human Rights Campaign Foundation. The Human Rights Campaign Foundation owns all right, title and interest in and to this publication and all derivative works thereof. Permission for reproduction and redistribution is granted if the publication is (1) reproduced in its entirety and (2) distributed free of charge. The Human Rights Campaign name and the Equality logo are trademarks of the Human Rights Campaign. The Human Rights Campaign Foundation and design incorporating the Equality logo are trademarks of the Human Rights Campaign Foundation. ISBN 13: 978-1-934765-16-6 ISBN 10: 1-934765-16-3

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â&#x20AC;&#x153;The Joint Commissionâ&#x20AC;&#x2122;s vision is that all people always experience the safest, highest-quality, best-value healthcare across all settings. Recently, The Joint Commission convened an expert panel to advance effective communication, cultural competence, and patient- and family-centered care in hospitals. The panel produced new and revised standards, which include language that expresses the commitment of hospitals to prohibit discrimination based on age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression. These standards are an important step toward meeting our mission to continuously improve healthcare for all. The Healthcare Equality Index fills an important role in this effort. We congratulate the HEI project and the participating healthcare organizations for engaging in this work.â&#x20AC;? The Joint Commission

letter from hrc foundation president joe solmonese

This has been a landmark year in the fight to make healthcare equality a reality in America. While considerable work remains to be done, it is clear that a sea change in the healthcare landscape for lesbian, gay, bisexual and transgender Americans is now under way. Within just the past few months, the agency responsible for the accreditation and certification of healthcare facilities nationwide, The Joint Commission, announced new, fully inclusive patient non-discrimination standards as part of its accreditation process. This means that healthcare facilities nationwide — from Mississippi to Montana and Alabama to Alaska — will soon be accredited based on their respect for all patients. While there is no doubt that this is a critical step forward, there’s no reason why healthcare facilities shouldn’t do the right thing and voluntarily adopt these standards now. This important development came shortly before another breakthrough: President Barack Obama’s directive that patients have the right to designate their visitors in hospital settings and have their choices respected about who will make key healthcare decisions for them. The president was moved to action by the tragic story of Janice Langbehn, who was denied access to her partner, Lisa Pond, in her final hours of life. It is entirely fitting that the Healthcare Equality Index 2010 is dedicated to Lisa’s memory and Janice’s advocacy. Even with those important developments, we will still have much work to do. As the Healthcare Equality Index 2010 illustrates, our nation’s hospital system is simply not meeting the needs of LGBT patients and their families. In this report, you will find two compelling snapshots of the healthcare industry: zz The HEI 2010 rates 178 facilities on four measures of equality: patient nondiscrimination, visitation, cultural competency training and employment nondiscrimination. Only a handful of facilities achieved credit for each of these measures. However, there were some important bright spots. We are pleased to recognize Kaiser Permanente Network as the HEI’s first top-performing network of hospitals. zz This report also includes the review of a representative sample of 200 of the largest healthcare facilities nationwide, which found that 93 percent fail to protect all LGBT patients from discrimination by not including “gender identity” in their patient non-discrimination policies. More than 40 percent do not include “sexual orientation” in these policies. These barriers to equal access have serious consequences for LGBT patients and their families, who often delay treatment to avoid the challenging, embarrassing or openly hostile situations that may arise in a healthcare setting. The patchwork of regulations and policies that may cover, deny or ignore these issues creates a climate of uncertainty for LGBT people. Our unified message is clear: LGBT patients deserve access to highquality healthcare — free from discrimination — in every healthcare facility in America. Lastly, we are indebted to the hospital administrators and healthcare professionals who dedicate themselves every day to making healthcare equality a reality in America. We also thank LGBT patients and their families who continue to share their stories, reminding us all of the urgent need to end discrimination wherever and however it may occur.

Sincerely,

Joe Solmonese, President Human Rights Campaign Foundation

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overview of findings The Healthcare Equality Index is an annual survey of healthcare policies and practices related to lesbian, gay, bisexual and transgender patients and their families. This report details the results of the 2010 survey, outlining the responses from 178 healthcare facilities from 21 states and the District of Columbia. Thirteen healthcare networks submitted surveys covering a total of 141 network facilities. The balance of the data comes from 37 surveys representing individual, non-network facilities. While the HEI focuses primarily on U.S. hospitals, participation is open to the full range of healthcare facilities. The 2010 report includes data from 116 hospitals and 62 clinics. Thirty-four of the 178 facilities are rated for the first time this year. The complete list of HEI-rated facilities and their responses to the HEI 2010 survey is available as Appendix A on page 33. Survey results show HEI-rated facilities are updating their policies and practices to ensure LGBT patients and their families are welcomed, respected and given culturally competent care. Several have updated their policies to protect LGBT patients from discrimination based on “sexual orientation” and/ or “gender identity.” They include HEI 2010 Top Performers: Baystate Medical Center, Dana-Farber Cancer Institute and The University of Texas MD Anderson Cancer Center. Notably, Kaiser Permanente Network (representing 31 hospitals) also amended its policy — making this network the first to achieve Top Performer status in the HEI. A complete list of HEI 2010 Top Performers is on page 9. Legacy Health System (representing 21 facilities) amended its patient nondiscrimination policy to include “sexual orientation.” However, the policy does not yet include “gender identity.” The same is true for Duke University Hospital.

Improvements have also been made in the area of employment protections. Both Beth Israel Deaconess Medical Center (Mass.) and Stanford University Hospital & Clinics updated their patient and employment non-discrimination policies to include “gender identity.” Advocate Illinois Masonic Medical Center, Oregon Health & Science University and University of California San Diego Medical Center also took the steps necessary to update their employment nondiscrimination policies to include “gender identity” this year. These facilities now protect the entire LGBT community from employment discrimination. In addition to these improvements, leading HEI-rated facilities updated their visitation policies to ensure equal access for same-sex couples and same-sex parents (more on page 16). This is just a snapshot of the progress made since 2009. While this is encouraging, research conducted on 200 of the largest hospitals in the U.S. — independent of the HEI survey — found that only 58 percent of these hospitals protect patients from discrimination based on sexual orientation and a mere 7 percent protect patients from discrimination based on gender identity. (See Appendix E on page 61.)

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overview of findings

Percent of participants that answered “yes” to each criterion, if applicable.

Criterion 1a

83.7%

Criterion 1b

29.2%

Criterion 2a

31.8%

Criterion 2b

32.3%

Criterion 3

53.4%

Criterion 4a

93.8%

Criterion 4b

52.2%

“Sexual Orientation” in Patients’ Bill of Rights and/or Non-Discrimination Policy

“Gender Identity” in Patients’ Bill of Rights and/or Non-Discrimination Policy

Equal Visitation Access for Same-Sex Couples

Equal Visitation Access for Same-Sex Parents

LGBT Cultural Competency Training for Staff

“Sexual Orientation” in Equal Employment Opportunity Policy

“Gender Identity” in Equal Employment Opportunity Policy

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overview of findings

Number of Facilities Represented by State

This yearâ&#x20AC;&#x2122;s results include facilities from 21 states and the District of Columbia. For the first time, the HEI rated facilities from Maine, Missouri, Pennsylvania, Texas and Virginia. California has the most rated facilities with 35, followed by Oregon (26 facilities), Michigan (22), Iowa (19) and Ohio (19). A complete list of HEI 2010-rated facilities by state is available as Appendix B on page 39.

l 1-4 Participant(s)

l 5-10 Participants

l 11-20 Participants

l 21+ Participants

10 States & D.C.

6 States Florida Massachusetts New York North Carolina Virginia Washington

2 States

3 States

Iowa Ohio

California Michigan Oregon

D.C. Georgia Hawaii Illinois Louisiana Maine Maryland Missouri Pennsylvania Tennessee Texas

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overview of findings

HEI 2010 Top Performers

Forty-two facilities (one network representing 31 hospitals, 8 individual hospitals and 3 clinics) responded “yes” to each of the rated questions applying to them. Advocate Illinois Masonic Medical Center

Chicago, IL

Baystate Medical Center

Springfield, MA

Beth Israel Medical Center

New York, NY

Callen-Lorde Community Health Center

New York, NY

Dana-Farber Cancer Institute

Boston, MA

Group Health Central Hospital

Seattle, WA

Kaiser Permanente Network (31 hospitals)

Oakland, CA

L.A. Gay & Lesbian Center

Los Angeles, CA

Penobscot Community Health Care

Bangor, ME

Rush University Medical Center

Chicago, IL

UCSF Medical Center

San Francisco, CA

The University of Texas MD Anderson Cancer Center

Houston, TX

BEST HEALTHCARE FACILITY FOR LGBT FAMILIES Each Top Performer in this report is recognized as a “Best Healthcare Facility for LGBT Families” and is welcome to use this distinction in its advertising efforts. See www.hrc.org/best-health-facilities.

Testimonials

To further illustrate LGBT inclusion within these institutions, this report includes testimonials from the eight top-performing individual hospitals. These testimonials describe in greater detail how these hospitals provide a welcoming environment and competent care for their LGBT patients and support their LGBT employees. The testimonials are available in Appendix D on page 51 and online at www.hrc.org/best-health-facilities.

pg. 52

Advocate Illinois Masonic Medical Center

Making the Business Case for LGBT Inclusion

pg. 53

Baystate Medical Center

Protecting all LGBT Patients from Discrimination

pg. 54

Beth Israel Medical Center

Leveraging LGBT and Allied Employees: The LGBT Employee Group

pg. 55

Dana-Farber Cancer Institute

Demonstrating Commitment to LGBT Staff & Families

pg. 56

Group Health Central Hospital

Translating Inclusive Practice into Policy

pg. 57

Rush University Medical Center

Creating a Culture of Inclusion: The Hospital Diversity Council

pg. 58

UCSF Medical Center

Bringing Policies Alive: LGBT Cultural Competency Staff Training

pg. 59

The University of Texas MD Anderson Cancer Center

Ensuring Successful Participation in the Healthcare Equality Index: An Incremental Approach

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methodology & rating criteria Methodology

The Healthcare Equality Index was created in partnership with the Gay and Lesbian Medical Association in 2007 as an annual survey focused on healthcare facilities’ LGBT-related policies and practices. The goals of the HEI are: 1) to benchmark healthcare facilities on identified best practices and policies with respect to equal treatment of LGBT patients and families; and 2) to share, implement and recognize these best practices with healthcare industry leaders. Now in its fourth year, the survey continues to address basic components of the healthcare experiences of LGBT people, including patient non-discrimination, visitation policies and cultural competency training, and the protection of LGBT employees through fair employment policies. Invitations to complete the HEI 2010 survey were sent to facility contacts nationwide in October 2009. If a facility had previously participated in the HEI, the survey was sent to the individuals responsible for the previous submission. If a facility had not previously participated in the HEI, the survey was sent to contacts found through research by HRC Family Project staff; generally, these contacts were the facility’s chief administrative officer, diversity or human resources professional or a marketing/ communications representative. Participating facilities submitted their responses through an online survey. Staff members from the HRC Family Project provided additional assistance and advice throughout the process.

Healthcare Equality Index Rating Criteria

The HEI 2010 survey included 31 questions, seven of which pertain to LGBT-specific policy criteria and are rated in this report. The remaining questions were included for informational purposes only. The HEI focuses on the following four policy criteria for rating purposes: 1. Patient Non-Discrimination Policies a. Patients’ Bill of Rights and/or non-discrimination policy includes “sexual orientation” b. Patients’ Bill of Rights and/or non-discrimination policy includes “gender identity

or expression” or “gender identity” 2. Visitation Policies a. Visitation policies grant same-sex couples the same visitation access as

different-sex couples and next of kin b. Visitation policies grant same-sex parents the same visitation access as different-sex parents for their minor children 3. Cultural Competency Training and Client Services

Provide cultural competency training addressing healthcare issues relevant to the lesbian, gay, bisexual and transgender community 4. Employment Policies and Benefits a. Equal employment opportunity policy includes “sexual orientation” b. Equal employment opportunity policy includes “gender identity

or expression” or “gender identity”

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testimonial

“[Our] relationship with Chicago’s North Side LGBT community … has attracted hundreds (if not thousands) of new patients to the medical center annually ... Advocate Illinois Masonic Medical Center invests in the LGBT community, while the LGBT community recognizes that trust with clinical use. Doing the right thing truly does pay off.” Marc A. Senesac, vice president of human resources, and Michael Swarzman, vice president of business development at Advocate Illinois Masonic Medical Center, discuss the business case for LGBT inclusion.

Read more in their testimonial on page 52.

methodology & rating criteria

Healthcare Equality Index 2010: Changes from 2009

The Healthcare Equality Index survey is updated annually to capture practices identified as emerging or positive trends in healthcare equality for LGBT patients and their families. Many new questions and the data that are gathered from them are used for informational and reporting purposes only. In some cases, new questions may become rated criteria for future HEI surveys. Below is an outline of updates made to the HEI 2010 survey. Visitation Policies

The HEI 2010 survey required documentation of explicitly inclusive visitation policy language that grants equal access to same-sex couples and/or same-sex parents. Decision-Making Policies

The decision-making policy section of the HEI 2010 survey has been updated to focus on compliance training for staff related to advance healthcare directives. These questions are not rated this year. Cultural Competency Training

The HEI 2010 survey asked participants to provide more details describing their LGBT cultural competency training, including information about topics covered, the mode in which training is delivered and the frequency of training. In addition, the survey asked these training questions specifically for five staff groups: administrative staff, medical assistants and technicians, allied health professionals, nursing staff and physicians. For credit on this criterion, training must be offered for every group applicable but need not be mandatory. Employment Policies & Benefits

For the first time, the HEI 2010 survey asked participants whether or not they offer at least one health insurance plan that does not exclude coverage for medically necessary, transgender-related treatment and care. These questions are asked for informational purposes only and are not rated. The survey continues to ask questions pertaining to partner benefits. These questions are also asked for informational purposes only and are not rated this year. For more information about these changes and to view the complete HEI 2010 survey, visit www.hrc.org/issues/hei-2010-updates.htm.

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testimonial

“At The University of Texas MD Anderson Cancer Center, everything we do is connected to our core values of caring, integrity and discovery. Participating in the HEI survey supports these values. … In 2008, we participated in our first HEI survey. … This helped us identify our needs and build upon our strengths.” John Mendelsohn, M.D., president of The University

of Texas MD Anderson Cancer Center, on the incremental approach the center took to participating in the HEI and achieving Top Performer status. Read more in his testimonial on page 59.

findings hei 2O1O ratING criteria Patient Non-Discrimination Policies

All patients deserve care free of discrimination, but the reality is that lesbian, gay, bisexual and transgender people face discrimination daily in healthcare settings. These experiences of discrimination often prevent LGBT patients from accessing care in the future and, when they do, they may not discuss their sexual orientation or gender identity with their healthcare providers for fear of another negative encounter. Healthcare facilities alleviate this problem by implementing patient nondiscrimination policies that include both “sexual orientation” and “gender identity.” These policies make it clear that LGBT inclusion is a priority for facility staff and communicate a welcoming and affirming message to the LGBT community. For more information on patient non-discrimination policies, including model policy language: www.hrc.org/issues/patient_rights.htm.

Criteria

1a Patients’ Bill of Rights and/or non-discrimination policy includes “sexual orientation” 1b Patients’ Bill of Rights and/or non-discrimination policy includes “gender identity

or expression” or “gender identity” Number of Hospitals that Responded “Yes”

83.7%

29.2%

83.7 percent of HEI-rated facilities (149 of 178) include sexual orientation in their Patients’ Bill of Rights and/or non-discrimination policy, while less than 30 percent (52 of 178 facilities) of those policies include “gender identity or expression” or “gender identity.”

Similar to the 2009 report, these survey results show a large disparity between the number of policies inclusive of sexual orientation and those inclusive of gender identity. And since participation in the HEI is voluntary, it is expected that responses from HEIrated hospitals actually tend to be more LGBT-inclusive than the U.S. hospital industry as a whole. This year, to get a clearer sense of where the industry stands, research independent from the HEI survey was conducted on the patient non-discrimination policies of 200 of the largest hospitals in the country. The results confirm that LGBT patient protections are even weaker within U.S. hospitals than a review of the HEI survey data alone would lead one to conclude. Only 58 percent of the hospitals researched include “sexual orientation” in their patient non-discrimination policies. And only 7 percent include “gender identity.” Twelve of the 14 hospitals researched that included “gender identity” in their policies have participated in the HEI either individually or as part of a network. More information on this research, including a list of the 200 hospitals and their policy information, is available in Appendix E on page 61.

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testimonial

“When the HEI 2009 report was published, our Patients’ Bill of Rights did not include ‘gender identity or expression’ … We recognized this as an opportunity to improve. This gap helped us realize that our Patients’ Bill of Rights did not fully align with our mission and our operating principles. Having this commitment in print, now as part of our system-wide policy, gives us something to point to that says, ‘Yes, we support you and accept you wholly.’ It also gives us support when providing internal education: It shows that education about transgender issues and care is supported by the leadership of the organization.” Visael “Bobby” Rodriguez, chief diversity officer of Baystate Health, on updating its Patients’ Bill of Rights to include “gender identity or expression.” Read more in his testimonial on page 53.

findings

Visitation Policies

HEI 2O1O rating criteria

The LGBT community has a long and rich history of challenging our society’s traditional understanding of family. Some of these earliest challenges involved hospital visitation access. And still today, LGBT families, including same-sex couples (partners/spouses/significant others) and same-sex parents, are not always recognized as family due to inadequate visitation policies and staff training, leading to tragic circumstances of loved ones being denied visitation access. President Obama acted to eliminate this inequality in April 2010 with a memorandum directing the Secretary of Health and Human Services to issue regulations requiring hospitals receiving Medicare and Medicaid funding to respect the right of all patients to designate visitors and to prohibit the denial of visitation access based on several factors, including sexual orientation and gender identity. Best-practice visitation policies include a definition of family that is explicitly inclusive of same-sex couples and same-sex parents. This explicit policy language decreases the possibility of staff members interpreting these policies based on their own biases. The more explicit the policy, the better it ensures inclusion is translated into practice, protecting all patients’ and families’ rights. For more information on visitation policies, including model policy language: www.hrc.org/issues/visitation-policies.htm.

Criteria

2a 2b

Visitation policies allow same-sex couples the same visitation access as different-sex couples and next of kin Visitation policies allow same-sex parents the same visitation access as different-sex parents for their minor children

Number of Hospitals that Responded “Yes”

31.8%

32.3%

Policies meeting these criteria are explicitly inclusive of the LGBT community by: zz Including an explicitly inclusive definition of family within their existing, standalone visitation policy zz Referencing an explicitly inclusive definition of family, as part of a companion “definitions” policy section, within their existing, standalone visitation policy zz Prohibiting discrimination in visitation access based on “sexual orientation” and “gender identity” 31.8 percent of HEI-rated facilities for which this question was applicable (42 of

132 facilities) report having visitation policies that grant same-sex couples the same visitation access as different-sex couples and next of kin. 32.3 percent (42 of 130 facilities) have visitation policies that grant same-sex parents the same visitation access as different-sex parents for their minor children.

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testimonial

“While we have long had a culture of inclusiveness and non-discrimination protections, participation in the HEI survey helped us see that our policies did not necessarily fully reflect our culture or set expectations of inclusive behavior and non-discriminatory practices for our staff … This realization moved Group Health forward in assuring … that hospital visitation policies included a definition of family that included spouses, domestic partners and both different-sex and same-sex significant others, and that the concept of parenthood was to be liberally construed without limitation for the purpose of visitation rights.” Desiray Bailey, M.D., chief of medical staff, and Erin Leff, M.B.A., hospital administrator at Group Health Central Hospital, on updating its visitation policy to ensure equal access for same-sex couples and same-sex parents.

Read more in their testimonial on page 56.

findings

Cultural Competency Training

HEI 2O1O rating criteria

Inclusive policies alone do not ensure LGBT individuals and families feel safe, welcome and respected in healthcare facilities. Everyone who works in healthcare facilities — not only clinicians — should receive training on LGBT cultural competency, because an individual’s experience while accessing healthcare is influenced by everyone they interact with in the process. For more information on cultural competency training: www.hrc.org/issues/cultural-competence.htm.

Criterion

3 Provide cultural competency training addressing healthcare issues relevant to the lesbian, gay, bisexual and transgender community Number of Hospitals that Responded “Yes”

53.4%

This criterion requires participants to train each of the following staff groups, as they apply to their facility: administrative staff, medical assistants and technicians, allied health professionals, nurses and physicians. 53.4 percent of HEI-rated facilities (95 of 178 facilities) provide cultural

competency training addressing healthcare issues relevant to the LGBT community to each applicable staff group. More specifically: zz 53.4 percent of HEI-rated facilities train administrative staff on LGBT cultural competency vv 44.2 percent of these facilities make these trainings mandatory for all administrative staff vv 8.4 percent require employees to update this training on an annual basis zz 65.7 percent train medical assistants and technicians vv 54.7 percent of these facilities make these trainings mandatory for all medical assistants and technicians vv 6 percent require an annual update zz 65.3 percent train allied health professionals vv 26.9 percent of these facilities make these trainings mandatory for all allied health professionals vv 5.2 percent require an annual update zz 65.7 percent train nursing staff vv 54.7 percent of these facilities make these trainings mandatory for all nursing staff vv 6.8 percent require an annual update zz 64 percent train physicians vv 9.6 percent of these facilities make these trainings mandatory for all physicians vv 7 percent require annual update Administrative staff are most likely to receive this training online, while for each other staff group, these trainings are most likely to be offered in person as stand-alone, LGBT-specific trainings, rather than as online trainings or as part of general orientation/diversity trainings.

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testimonial

“It’s one thing for people to read words on a page, and another for them to hear how those words actually help people have good healthcare and employment experiences … We would encourage all medical centers to consider LGBT training for their personnel. At UCSF, training has brought our LGBT policies and benefits alive, and played a vital part in creating a truly equitable and inclusive atmosphere.” Shane Snowdon, director of the LGBT

Resource Center at the University of California San Francisco, on the importance of LGBT cultural competency training. Read more in her testimonial on page 58.

testimonial

“We have been a multi-year sponsor of many LGBT events … to ensure that all members of the LGBT community know they can come to Dana-Farber for cancer care, education and prevention ... ... In 2009, Dana-Farber received the Outstanding Employer of the Year award from the Greater Boston Business Council, the LGBT ‘chamber of commerce’ in Boston, for its work in the community and in creating a safe and welcoming place for its staff, patients and their families.” Edward Benz, M.D., president and chief executive

officer of the Dana-Farber Cancer Institute, on the facility’s commitment to LGBT staff and families. Read more in his testimonial on page 55.

findings

Cultural Competency Training

HEI 2O1O rating criteria

The HEI 2010 survey also asked for information on topics covered in these trainings, focusing on the following core training topics: zz zz zz zz zz zz zz zz zz zz zz zz

LGBT terminology LGBT demographics LGBT community: history and background Stories of LGBT bias and substandard care Barriers to care for the LGBT community Applicable state and local laws for LGBT people with respect to healthcare LGBT health risks LGBT health disparities LGBT sub-populations Primary care issues Patient-provider interactions Patient-staff interactions

The most-covered topics for each staff group include: LGBT terminology, barriers to care for the LGBT community and patient-staff interactions. Information on LGBT sub-populations is the least likely topic to be addressed in these trainings, even though these populations face multiple barriers to care and can have specific, nuanced healthcare needs. An example of this would be addressing any specific healthcare needs of African-American LGBT patients or LGBT immigrants.

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findings

Employment Non-Discrimination Policies

HEI 2O1O rating criteria

Currently, federal law protects employees from discrimination on the basis of race, color, religion, sex (including pregnancy), national origin, age, disability and genetic information. Federal law does not yet protect employees from discrimination based on real or perceived sexual orientation or gender identity.

Twenty-one states and the District of Columbia have passed laws prohibiting employment discrimination based on sexual orientation; 12 states and the District of Columbia have passed laws prohibiting employment discrimination based on gender identity. At least 130 cities and counties throughout the U.S. prohibit employment discrimination based on both sexual orientation and gender identity. A clear and defined non-discrimination (equal employment opportunity) policy with respect to conditions of employment — including hiring, promotions, termination and compensation — that includes “sexual orientation” and “gender identity” is an essential baseline policy for LGBT inclusion in the workplace. For more information on statewide employment non-discrimination laws: www.hrc.org/about_us/state_laws.asp.

For more information on employment non-discrimination policies: www.hrc.org/about_equal_opportunity.asp.

Criteria

4a Equal employment opportunity policy includes “sexual orientation” 4b Equal employment opportunity policy includes “gender identity or expression”

or “gender identity” Number of Hospitals that Responded “Yes”

93.8%

52.2%

93.8 percent of HEI-rated facilities (167 of 178 facilities) bar

employment discrimination based on sexual orientation, while only 52.2 percent (93 of 178 facilities) prohibit employment discrimination

based on “gender identity or expression” or “gender identity.”

The Healthcare Equality Index primarily focuses on the experiences of LGBT patients and their families. However, a look at a facility’s employment policies and benefits pertaining to their LGBT employees can inform an assessment of its overall climate. The HEI rates facilities on two of the many policies and practices employers should implement to be inclusive of their LGBT employees. For more information on LGBT inclusion in the workplace: www.hrc.org/workplace.

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testimonial

“We strive to make Rush a place where personal differences are not just accepted, but understood, respected and valued … To advance this commitment, Rush established the Rush Diversity Leadership Group, which provides guidance about ways of promoting diversity, inclusion and equity. The DLG’s work reflects an understanding that the more we pay attention to and understand the diversity of our patients, staff, faculty and students, the more successful we will be as an institution of healing.” Larry J. Goodman, M.D., president and chief

executive officer of Rush University Medical Center, on the center’s commitment to fostering an LGBT-inclusive work environment. Read more in his testimonial on page 57.

findings additional best practices & policies In addition to questions related to the seven rated criteria discussed in this report, the HEI survey asked facilities for information on several other policies and practices related to the LGBT community. These questions focused on decision making, employee benefits, employee groups and data collection.

Advance Healthcare Directive Compliance Training

Advance healthcare directives (i.e., durable powers of attorney, healthcare proxies and living wills) allow individuals to express their healthcare wishes and designate surrogates who may make medical decisions on their behalf in the event of mental incapacity. Due to the lack of LGBT relationship recognition laws in most states, and because most default medical decision-making law is not inclusive of LGBT families, it is especially important that same-sex couples complete directives to ensure their ability to make medical decisions for incapacitated partners. Unfortunately, LGBT individuals come forward with tragic stories of hospitals failing to recognize these directives at critical moments of emergency and end-of-life medical treatment. The April 2010 memorandum sent by President Obama to the Secretary of Health and Human Services also clarifies that existing federal regulations require hospitals participating in Medicare or Medicaid to respect all patientsâ&#x20AC;&#x2122; advance healthcare directives. The failure to do so indicates a breakdown in compliance due to inadequate staff training or insufficient policy language. To better understand the implementation and enforcement of these policies and to identify best practices in this area, the HEI 2010 survey asked questions focused on advance healthcare directive compliance training. 45 percent of HEI-rated facilities provide advance healthcare directive compliance

training to all applicable staff groups. More specifically: zz 47.5 percent train administrative staff on compliance to advance healthcare directive policies vv 39.3 percent of these make this training mandatory for all administrative staff vv 17.9 percent require that this training be updated on an annual basis zz 49.2 percent train medical assistants and technicians vv 39.1 percent of these make this training mandatory for all medical assistants and technicians vv 17.2 percent require an annual update zz 51.4 percent train allied health professionals vv 36.3 percent make this training mandatory for all allied health professionals vv 17.6 percent require an annual update zz 56.5 percent train nursing staff vv 45 percent of these facilities make this training mandatory for all nursing staff vv 16 percent require an annual update zz 40 percent train physicians vv 36.3 percent make this training mandatory for all physicians vv 10 percent require an annual update

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â&#x20AC;&#x153;Historically, LGBT people have received healthcare from providers who have been disrespectful, judgmental and insensitive. As the premier LGBT health and social services organization in Southern California for 36 years, we have sought to heal the damage caused by discrimination based on sexual orientation and gender identity, in large part by providing high-quality health and mental health services in a compassionate, accepting and culturally sensitive manner.â&#x20AC;? Darrel Cumming

Chief of Staff, L.A. Gay & Lesbian Center HEI 2010 Top-Performing Clinic

findings

Advance Healthcare Directive Compliance Training

additional best practices & policies

The survey also asked what topics are covered in this training. The most frequently covered topics included: zz State law and policies on the recognition of valid advance healthcare directives zz State law and policies on default surrogate selection when no advance healthcare directive exists zz Procedure for documenting advance healthcare directives in medical records zz Reciprocal recognition of advance healthcare executed in another state These trainings are far less likely to discuss advance healthcare directive policies in relationship to the LGBT community. For example, in the case of nursing staff: zz Only 56 percent of HEI-rated facilities that train nurses on advance healthcare directive compliance include information on state relationship recognition law and surrogate decision-making rights for same-sex couples in this training. zz 21 percent include example scenarios related to advance healthcare directive policy and practice and only 7 percent include scenarios explicitly involving LGBT individuals/same-sex couples. Only one percent of the HEI-rated facilities train any nurses on the medical decision-making rights of same-sex parents for their minor children within these trainings. There remain significant gaps in the law when it comes to protecting the decision-making rights of same-sex parents. Due to the current patchwork of state parenting laws, this is an especially complex area for healthcare personnel to navigate â&#x20AC;&#x201D; especially without adequate training. For more information on advance healthcare directive policies: www.hrc.org/issues/decision-making-policies.htm.

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

findings

Transgender Health Benefits

additional best practices & policies

Transgender-inclusive health insurance benefits — insurance that covers sex reassignment surgery and related treatment as defined by the World Professional Association for Transgender Health — are critically important for many transgender people and are historically of insignificant cost to an employer. But, because of pervasive “transgender exclusions,” many health insurance plans in the United States regularly deny transgender people coverage for even basic medical treatments unrelated to being transgender, or would only cover harmful, so-called “reparative therapy” and related treatments. Since 2006, the HRC Foundation has made it a primary goal to work with employers to end health insurance discrimination against transgender people by requiring Corporate Equality Index survey participants to examine their insurance policies for these transgender exclusions. The HRC Foundation began sharing this work with HEI participants this year and will continue to share related resources with HEI-rated facilities. Among HEI-rated facilities this year, 10.6 percent offer transgenderinclusive benefits, 19 facilities total (one individual hospital and one network which represents 18 facilities). For more information on transgender-inclusive health benefits: www.hrc.org/issues/transgender_inclusive_benefits.htm.

Partner Health Benefits

On average, roughly 20 percent of employees’ overall compensation is provided in the form of health insurance benefits for themselves and/or their families. For employees with partners and/or children not eligible for those benefits, the resulting disparity in compensation is profound. These are low-cost, high-value employment benefits and are now the norm among employers committed to recruiting and retaining LGBT employees. 88.2 percent of HEI-rated facilities (157 of 178 facilities) offer health insurance coverage to their employees’ domestic partners.

For more information on domestic partner benefits: www.hrc.org/issues/domestic_partner_benefits.htm.

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

â&#x20AC;&#x153;The Healthcare Equality Index is a critical tool in reforming healthcare delivery. As an LGBTfocused primary care center, we hear daily reports from patients about the lack of knowledge and sensitivity in the healthcare system at large. Cultural competency will be a critical component of successful expansion of healthcare access.â&#x20AC;? Wendy Stark

Executive Director, Callen-Lorde Community Health Center HEI 2010 Top-Performing Clinic

findings

LGBT Employee Groups

additional best practices & policies

LGBT employee groups can provide guidance and input on a facility’s policies and practices and help provide a sense of safety, acceptance and respect for LGBT employees within the facility by maintaining a visible presence and establishing a meaningful voice within the facility. 50 percent of HEI-rated facilities (89 of 178 facilities) have an officially recognized LGBT employee group.

For more information on employee groups: www.hrc.org/issues/employee-groups.htm.

Data Collection Policies

Intake Forms

All patient-history and intake forms should use language that is inclusive of LGBT patients and their families. For example, choices for relationship status should include terms such as “partnered” in addition to “single,” “married,” “divorced,” etc. Also, these forms should allow for flexibility in the options for gender identification, including an option for transgender (both male-to-female and female-to-male). zz 55.6 percent have intake forms that include information on their visitation policies zz 38.2 percent allow for the designation of domestic partnership or otherwise unmarried partnership or parental status within these forms zz 53.4 percent allow for the designation of domestic parner or other as next of kin on these forms zz 30.9 percent have intake forms that allow for the designation of domestic partner or others as medical decision maker zz 24.2 percent allow for designation of transgender status on intake forms zz 23 percent have intake forms that allow for flexibility in identification of name and gender Data Collection Systems

The value of inclusive intake forms is diminished when data collection systems do not allow providers to capture this information. Tracking LGBT status — while not requiring this information from patients who prefer not to disclose or have it in their medical records — facilitates the assessment of health outcomes according to sexual orientation and gender identity. zz 17.4 percent have data collection systems that allow people to self-identify as lesbian, gay or bisexual zz 5.6 percent have data collections systems that allow people to self-identify as transgender zz 72.5 percent have data collection systems that permit the tracking of persons other than legal spouses who have legal relationships to patients relevant to the healthcare facility For more information on data collection: www.hrc.org/issues/data-collection-policies.htm.

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

testimonial

“The goal of [our LGBT] committee is to establish and maintain a culture of inclusion within which all LGBT patients and staff feel that they are in a safe, supportive and non-judgmental setting ...

... The [LGBT] committee developed a list of ‘Top Ten Provider Tips for Serving the LGBT Patient Population’ … this was distributed to providers through a blast e-mail to all medical center staff, and was also posted in patient care areas. The tips list (as well as other resources) remains accessible to providers and staff via the medical center’s intranet website.” Members of the LGBT Committee describe their contributions to ensuring LGBT healthcare equality at Beth Israel Medical Center.

Read more in their testimonial on page 54.

appendix A

hei-rated facilities and breakdown of responses Healthcare Equality Index Rating Criteria 1a Patients’ Bill of Rights and/or non-discrimination policy includes “sexual orientation” 1b Patients’ Bill of Rights and/or non-discrimination policy includes “gender identity or expression” or “gender identity” 2a Visitation policies grant same-sex couples the same visitation access as different-sex couples and next of kin 2b Visitation policies grant same-sex parents the same visitation access as different-sex parents for their minor children 3

Provide cultural competency training addressing healthcare issues relevant to the lesbian, gay, bisexual and transgender community

4a Equal employment opportunity policy includes “sexual orientation” 4b Equal employment opportunity policy includes “gender identity or expression” or “gender identity”

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix A

HEI-rated facilities and breakdown of responses l yes

l no

l not applicable

Facility Name

City

State

A. Alfred Taubman Health Care Center

Ann Arbor

Advocate Illinois Masonic Medical Center

Chicago

Ames Center

Ames

Ankeny Center

Ankeny

Annie Penn Hospital

Top Performer

Reidsville

Barnes-Jewish Hospital

St. Louis

Baystate Medical Center

Springfield

Bedford Medical Center

Bedford

Behavioral Health Center

Greensboro

Beth Israel Deaconess Medical Center

Boston

Beth Israel Medical Center

New York

Brigham and Women’s Hospital

Boston

Brighton Health Center

Brighton

Bronx Health Center

Bronx

Brooks Rehabilitation Hospital

Jacksonville

Callen-Lorde Community Health Center

New York

Canton Health Center

Canton

Case Medical Center

Cleveland

Cedar Falls Center

Cedar Falls

Chelsea Health Center

Chelsea

Children’s Hospital of Philadelphia

Philadelphia

Cleveland Clinic

Cleveland

Clinton Memorial Hospital

Saint Johns

Commonwealth Neuropsychology Clinic

Ann Arbor

Conneaut Medical Center

Conneaut

Creston Center

Creston

Dana-Farber Cancer Institute

Boston

Dexter Family Medicine

Dexter

Domino’s Farms Health Center

Ann Arbor

Duke University Hospital

Durham

East Ann Arbor Ambulatory Surgery & Medical Procedures Center

Ann Arbor

East Ann Arbor Health & Geriatrics Center

Ann Arbor

East County Health Center

Gresham

Emory University Hospital

Atlanta

Euclid Hospital

Euclid

Fairview Hospital

Cleveland

Faulkner Hospital

Boston

Fort Dodge Center

Fort Dodge

Geauga Medical Center

Chardon

Geneva Medical Center

Geneva

George Washington University Hospital

Washington

Group Health Central Hospital

Seattle

Harborview Medical Center

Seattle

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix A

HEI-rated facilities and breakdown of responses l yes

l no

l not applicable

Facility Name

City

Harvard Vanguard Medical Associates

Newton

Healthy Connections

Des Moines

Hillcrest Hospital

State

Top Performer

Mayfield Heights

Howell Pediatrics and Teen Center

Howell

Huron Hospital

East Cleveland

Iowa City Center

Iowa City

Iowa Methodist Medical Center

Des Moines

Ireland Cancer Center

Cleveland

Jackson Memorial Hospital

Miami

Jackson North Medical Center

North Miami Beach

Jackson South Community Hospital

Miami

Joe DiMaggio Childrenâ&#x20AC;&#x2122;s Hospital

Hollywood

Johns Hopkins Hospital

Baltimore

Kaiser Permanente Anaheim Medical Center

Anaheim

Kaiser Permanente Baldwin Park Medical Center

Baldwin Park

Kaiser Permanente Bellflower Medical Center

Bellflower

Kaiser Permanente Fontana Medical Center

Fontana

Kaiser Permanente Fremont Medical Center

Fremont

Kaiser Permanente Fresno Medical Center

Fresno

Kaiser Permanente Hayward Medical Center

Hayward

Kaiser Permanente Los Angeles Medical Center

Los Angeles

Kaiser Permanente Manteca Medical Center

Manteca

Kaiser Permanente Moanalua Medical Center

Honolulu

Kaiser Permanente Oakland Medical Center

Oakland

Kaiser Permanente Panorama City Medical Center

Panorama City

Kaiser Permanente Redwood City Medical Center

Redwood City

Kaiser Permanente Richmond Medical Center

Richmond

Kaiser Permanente Riverside Medical Center

Riverside

Kaiser Permanente Roseville Medical Center

Roseville

Kaiser Permanente Sacramento Medical Center

Sacramento

Kaiser Permanente San Diego Medical Center

San Diego

Kaiser Permanente San Francisco Medical Center

San Francisco

Kaiser Permanente San Rafael Medical Center

San Rafael

Kaiser Permanente Santa Clara Medical Center (Kiely Campus)

Santa Clara

Kaiser Permanente Santa Rosa Medical Center

Santa Rosa

Kaiser Permanente Santa Teresa Medical Center

San Jose

Kaiser Permanente South Bay Medical Center

Harbor City

Kaiser Permanente South Sacramento Medical Center

Sacramento

Kaiser Permanente South San Francisco Medical Center

South San Francisco

Kaiser Permanente Sunnyside Medical Center

Clackamas

Kaiser Permanente Vallejo Medical Center

Vallejo

Kaiser Permanente Walnut Creek Medical Center

Walnut Creek

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix A

HEI-rated facilities and breakdown of responses l yes

l no

Facility Name

City

Kaiser Permanente West Los Angeles Medical Center

l not applicable State

Top Performer

Los Angeles

Kaiser Permanente Woodland Hills Medical Center

Woodland Hills

Knoxville Center

Knoxville

L.A. Gay & Lesbian Center

Los Angeles

La Clinica de la Buena Salud Health Center

Portland

LAC/USC Medical Center

Los Angeles

Lakewood Hospital

Lakewood

Legacy Clinic Battle Ground

Battle Ground

Legacy Clinic Canby

Canby

Legacy Clinic Emanuel

Portland

Legacy Clinic Firwood

Sandy

Legacy Clinic Fisher’s Landing

Vancouver

Legacy Clinic Good Samaritan

Portland

Legacy Clinic Mount Hood

Gresham

Legacy Clinic Northeast

Portland

Legacy Clinic Northwest

Portland

Legacy Clinic Salmon Creek

Vancouver

Legacy Clinic St. Helens

St. Helens

Legacy Clinic Tigard-King City

Portland

Legacy Clinic Tualatin

Tualatin

Legacy Clinic West Linn

West Linn

Legacy Clinic Woodburn

Woodburn

Legacy Emanuel Children’s Hospital

Portland

Legacy Emanuel Hospital & Health Center

Portland

Legacy Good Samaritan Hospital

Portland

Legacy Meridian Park Hospital

Tualatin

Legacy Mount Hood Medical Center

Gresham

Legacy Salmon Creek Hospital

Vancouver

Livonia Center for Specialty Care

Livonia

Lutheran Hospital

Cleveland

Lutheran Medical Center

Brooklyn

MacDonald Women’s Hospital

Cleveland

Massachusetts General Hospital

Boston

Medical Center of Louisiana

New Orleans

Memorial Hospital Miramar

Miramar

Memorial Hospital Pembroke

Pembroke Pines

Memorial Hospital West

Pembroke Pines

Memorial Regional Hospital

Hollywood

Memorial Regional Hospital South

Hollywood

Mid County Health Center

Portland

Moses H. Cone Memorial Hospital

Greensboro

New Hope Outreach Clinic

Ann Arbor

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix A

HEI-rated facilities and breakdown of responses l yes

l no

l not applicable

Facility Name

City

New York Presbyterian Hospital

New York

Newton Center

Newton

North Portland Health Center

State

Top Performer

Portland

Northeast Portland Health Center

Portland

Oregon Health & Science University Hospital

Portland

Pennsylvania Hospital

Philadelphia

Penobscot Community Health Care

Bangor

Piedmont Hospital

Atlanta

Psychiatry Ambulatory Services

Ann Arbor

Quad Cities Center

Bettendorf

Rainbow Babies and Childrenâ&#x20AC;&#x2122;s Hospital

Cleveland

Red Oak Center

Red Oak

Richmond Medical Center

Richmond Heights

Rosenfield Center

Des Moines

Rush University Medical Center

Chicago

Saline Health Center

Saline

Sentara Bayside Hospital

Virginia Beach

Sentara CarePlex Hospital

Hampton

Sentara Leigh Hospital

Norfolk

Sentara Norfolk General Hospital

Norfolk

Sentara Obici Hospital

Suffolk

Sentara Potomac Hospital

Woodbridge

Sentara Virginia Beach General Hospital

Virginia Beach

Sentara Williamsburg Regional Medical Center

Williamsburg

Sioux City Center

Sioux City

South Pointe Hospital

Warrensville Heights

Southeast Portland Health Center

Portland

Sparrow Hospital

Lansing

Sparrow Specialty Hospital

Lansing

Spencer Center

Spencer

St. Lawrence Hospital

Lansing

St. Mary Medical Center

Long Beach

Stanford Hospital and Clinics

Stanford

Storm Lake Center

Storm Lake

Susan Knapp Health Center

Des Moines

The Family Practice Center

Des Moines

UCSF Medical Center

San Francisco

UM Briarwood Medical Group

Ann Arbor

University Hospital

Ann Arbor

University Hospitals Extended Care Campus

Chardon

University of California San Diego Medical Center

San Diego

The University of Texas MD Anderson Cancer Center

Houston

University of Toledo Medical Center

Toledo

University of Washington Medical Center

Seattle

Vanderbilt University Medical Center

Nashville

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix B

hei-rated facilities by state Healthcare Equality Index Rating Criteria 1a Patients’ Bill of Rights and/or non-discrimination policy includes “sexual orientation” 1b Patients’ Bill of Rights and/or non-discrimination policy includes “gender identity or expression” or “gender identity” 2a Visitation policies grant same-sex couples the same visitation access as different-sex couples and next of kin 2b Visitation policies grant same-sex parents the same visitation access as different-sex parents for their minor children 3

Provide cultural competency training addressing healthcare issues relevant to the lesbian, gay, bisexual and transgender community

4a Equal employment opportunity policy includes “sexual orientation” 4b Equal employment opportunity policy includes “gender identity or expression” or “gender identity”

h e a lt h c a r e e q u a l i t y i n d e x 2 0 1 0

www.hrc.org/hei

APPENDIX B

HEI-RATED FACILITIES BY STATE ● YES

● NO

Facility Name

● NOT APPLICABLE City

Top Performer

CALIFORNIA

Kaiser Permanente Anaheim Medical Center

Anaheim

●

Kaiser Permanente Baldwin Park Medical Center

Baldwin Park

●

Kaiser Permanente Bellflower Medical Center

Bellflower

●

Kaiser Permanente Fontana Medical Center

Fontana

●

Kaiser Permanente Fremont Medical Center

Fremont

●

Kaiser Permanente Fresno Medical Center

Fresno

●

Kaiser Permanente South Bay Medical Center

Harbor City

●

Kaiser Permanente Hayward Medical Center

Hayward

●

St. Mary Medical Center

Long Beach

●

Kaiser Permanente Los Angeles Medical Center

Los Angeles

●

Kaiser Permanente West Los Angeles Medical Center

Los Angeles

●

L.A. Gay & Lesbian Center

Los Angeles

●

LAC/USC Medical Center

Los Angeles

●

Kaiser Permanente Manteca Medical Center

Manteca

●

Kaiser Permanente Oakland Medical Center

Oakland

●

Kaiser Permanente Panorama City Medical Center

Panorama City

●

Kaiser Permanente Redwood City Medical Center

Redwood City

●

Kaiser Permanente Richmond Medical Center

Richmond

●

Kaiser Permanente Riverside Medical Center

Riverside

●

Kaiser Permanente Roseville Medical Center

Roseville

●

Kaiser Permanente Sacramento Medical Center

Sacramento

●

Kaiser Permanente South Sacramento Medical Center

Sacramento

●

Kaiser Permanente San Diego Medical Center

San Diego

●

University of California San Diego Medical Center

San Diego

●

Kaiser Permanente San Francisco Medical Center

San Francisco

●

UCSF Medical Center

San Francisco

●

Kaiser Permanente Santa Teresa Medical Center

San Jose

●

Kaiser Permanente San Rafael Medical Center

San Rafael

●

Kaiser Permanente Santa Clara Medical Center (Kiely Campus)

Santa Clara

●

Kaiser Permanente Santa Rosa Medical Center

Santa Rosa

●

Kaiser Permanente South San Francisco Medical Center

South San Francisco

●

Stanford Hospital and Clinics

Stanford

●

Kaiser Permanente Vallejo Medical Center

Vallejo

●

Kaiser Permanente Walnut Creek Medical Center

Walnut Creek

●

Kaiser Permanente Woodland Hills Medical Center

Woodland Hills

●

Washington

●

Joe DiMaggio Children’s Hospital

Hollywood

●

Memorial Regional Hospital

Hollywood

●

Memorial Regional Hospital South

Hollywood

●

Brooks Rehabilitation Hospital

Jacksonville

●

Jackson Memorial Hospital

Miami

●

Jackson South Community Hospital

Miami

●

Memorial Hospital Miramar

Miramar

●

Jackson North Medical Center

North Miami Beach

●

Memorial Hospital Pembroke

Pembroke Pines

●

Memorial Hospital West

Pembroke Pines

●

Atlanta

●

DISTRICT OF COLUMBIA

George Washington University Hospital FLORIDA

GEORGIA

Emory University Hospital

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

APPENDIX B

HEI-RATED FACILITIES BY STATE ● YES

● NO

● NOT APPLICABLE

Facility Name

City

Piedmont Hospital

Atlanta

Top Performer

●

HAWAII

Kaiser Permanente Moanalua Medical Center

Honolulu

●

Advocate Illinois Masonic Medical Center

Chicago

●

Rush University Medical Center

Chicago

●

Ames

●

Ankeny Center

Ankeny

●

Quad Cities Center

Bettendorf

●

Cedar Falls Center

Cedar Falls

●

Creston Center

Creston

●

Healthy Connections

Des Moines

●

Iowa Methodist Medical Center

Des Moines

●

Rosenfield Center

Des Moines

●

Susan Knapp Health Center

Des Moines

●

The Family Practice Center

Des Moines

●

Fort Dodge Center

Fort Dodge

●

Iowa City Center

Iowa City

●

Knoxville Center

Knoxville

●

Newton Center

Newton

●

Red Oak Center

Red Oak

●

Sioux City Center

Sioux City

●

Spencer Center

Spencer

●

Storm Lake Center

Storm Lake

●

West Center

Urbandale

●

New Orleans

●

Baltimore

●

Beth Israel Deaconess Medical Center

Boston

●

Brigham and Women’s Hospital

Boston

●

Dana-Farber Cancer Institute

Boston

●

Faulkner Hospital

Boston

●

Massachusetts General Hospital

Boston

●

Harvard Vanguard Medical Associates

Newton

●

Baystate Medical Center

Springfield

●

ILLINOIS

IOWA

Ames Center

LOUISIANA

Medical Center of Louisiana MAINE

Penobscot Community Health Care

Bangor

●

MARYLAND

Johns Hopkins Hospital MASSACHUSETTS

●

MICHIGAN

A. Alfred Taubman Health Care Center

Ann Arbor

●

Commonwealth Neuropsychology Clinic

Ann Arbor

●

Domino’s Farms Health Center

Ann Arbor

●

East Ann Arbor Ambulatory Surgery & Medical Procedures Center

Ann Arbor

●

East Ann Arbor Health & Geriatrics Center

Ann Arbor

●

New Hope Outreach Clinic

Ann Arbor

●

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

APPENDIX B

HEI-RATED FACILITIES BY STATE ● YES

● NO

● NOT APPLICABLE

Facility Name

City

Psychiatry Ambulatory Services UM Briarwood Medical Group

Top Performer

Ann Arbor

●

Ann Arbor

●

University Hospital

Ann Arbor

●

West Ann Arbor Health Center

Ann Arbor

●

Brighton Health Center

Brighton

●

Canton Health Center

Canton

●

Chelsea Health Center

Chelsea

●

Dexter Family Medicine

Dexter

●

Howell Pediatrics and Teen Center

Howell

●

Sparrow Hospital

Lansing

●

Sparrow Specialty Hospital

Lansing

●

St. Lawrence Hospital

Lansing

●

Livonia Center for Specialty Care

Livonia

●

Clinton Memorial Hospital

Saint Johns

●

Saline Health Center

Saline

●

Ypsilanti Health Center

Ypsilanti

●

St. Louis

●

Bronx Health Center

Bronx

●

Lutheran Medical Center

Brooklyn

●

Beth Israel Medical Center

New York

●

Callen-Lorde Community Health Center

New York

●

New York Presbyterian Hospital

New York

●

Duke University Hospital

Durham

●

Behavioral Health Center

Greensboro

●

Moses H. Cone Memorial Hospital

Greensboro

●

Wesley Long Community Hospital

Greensboro

●

Women’s Hospital of Greensboro

Greensboro

●

Annie Penn Hospital

Reidsville

●

Bedford Medical Center

Bedford

●

Geauga Medical Center

Chardon

●

University Hospitals Extended Care Campus

Chardon

●

Case Medical Center

Cleveland

●

Cleveland Clinic

Cleveland

●

Fairview Hospital

Cleveland

●

Ireland Cancer Center

Cleveland

●

Lutheran Hospital

Cleveland

●

MacDonald Women’s Hospital

Cleveland

●

Rainbow Babies and Children’s Hospital

Cleveland

●

Conneaut Medical Center

Conneaut

●

Huron Hospital

East Cleveland

●

Euclid Hospital

Euclid

●

Geneva Medical Center

Geneva

●

Lakewood Hospital

Lakewood

●

Hillcrest Hospital

Mayfield Heights

●

Richmond Medical Center

Richmond Heights

●

University of Toledo Medical Center

Toledo

●

South Pointe Hospital

Warrensville Heights

●

MISSOURI

Barnes-Jewish Hospital NEW YORK

NORTH CAROLINA

OHIO

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

APPENDIX B

HEI-RATED FACILITIES BY STATE ● YES

● NO

Facility Name

● NOT APPLICABLE City

Top Performer

●

● ●

OREGON

Legacy Clinic Canby

Canby

Kaiser Permanente Sunnyside Medical Center

Clackamas

East County Health Center

Gresham

●

Legacy Clinic Mount Hood

Gresham

●

Legacy Mount Hood Medical Center

Gresham

●

La Clinica de la Buena Salud Health Center

Portland

●

Legacy Clinic Emanuel

Portland

●

Legacy Clinic Good Samaritan

Portland

●

Legacy Clinic Northeast

Portland

●

Legacy Clinic Northwest

Portland

●

Legacy Clinic Tigard-King City

Portland

●

Legacy Emanuel Children’s Hospital

Portland

●

Legacy Emanuel Hospital & Health Center

Portland

●

Legacy Good Samaritan Hospital

Portland

●

Mid County Health Center

Portland

●

North Portland Health Center

Portland

●

Northeast Portland Health Center

Portland

●

Oregon Health & Science University Hospital

Portland

●

Southeast Portland Health Center

Portland

●

Westside Health Center

Portland

●

Legacy Clinic Firwood

Sandy

●

Legacy Clinic St. Helens

St. Helens

●

Legacy Clinic Tualatin

Tualatin

●

Legacy Meridian Park Hospital

Tualatin

●

Legacy Clinic West Linn

West Linn

●

Legacy Clinic Woodburn

Woodburn

●

Children’s Hospital of Philadelphia

Philadelphia

●

Pennsylvania Hospital

Philadelphia

●

Nashville

●

PENNSYLVANIA

TENNESSEE

Vanderbilt University Medical Center TEXAS

The University of Texas MD Anderson Cancer Center

Houston

●

VIRGINIA

Sentara CarePlex Hospital

Hampton

●

Sentara Leigh Hospital

Norfolk

●

Sentara Norfolk General Hospital

Norfolk

●

Sentara Obici Hospital

Suffolk

●

Sentara Bayside Hospital

Virginia Beach

●

Sentara Virginia Beach General Hospital

Virginia Beach

●

Sentara Williamsburg Regional Medical Center

Williamsburg

●

Sentara Potomac Hospital

Woodbridge

●

Legacy Clinic Battle Ground

Battle Ground

●

Group Health Central Hospital

Seattle

●

Harborview Medical Center

Seattle

●

University of Washington Medical Center

Seattle

●

Legacy Clinic Fisher’s Landing

Vancouver

●

Legacy Clinic Salmon Creek

Vancouver

●

Legacy Salmon Creek Hospital

Vancouver

●

WASHINGTON

●

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

appendix C

hei-rated facilities by network Healthcare Equality Index Rating Criteria 1a Patients’ Bill of Rights and/or non-discrimination policy includes “sexual orientation” 1b Patients’ Bill of Rights and/or non-discrimination policy includes “gender identity or expression” or “gender identity” 2a Visitation policies grant same-sex couples the same visitation access as different-sex couples and next of kin 2b Visitation policies grant same-sex parents the same visitation access as different-sex parents for their minor children 3

Provide cultural competency training addressing healthcare issues relevant to the lesbian, gay, bisexual and transgender community

4a Equal employment opportunity policy includes “sexual orientation” 4b Equal employment opportunity policy includes “gender identity or expression” or “gender identity”

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

APPENDIX C

HEI-RATED FACILITIES BY NETWORK ● YES

● NO

Facility Name

● NOT APPLICABLE

City

State

Top Performer

Advocate Illinois Masonic Medical Center

Chicago

Barnes-Jewish Hospital

St. Louis

Baystate Medical Center

Springfield

Beth Israel Deaconess Medical Center

Boston

Beth Israel Medical Center

New York

●

Brigham and Women’s Hospital

Boston

●

Bronx Health Center

Bronx

●

Brooks Rehabilitation Hospital

Jacksonville

●

Callen-Lorde Community Health Center

New York

●

Children’s Hospital of Philadelphia

Philadelphia

●

NO NETWORK

● ● ●

● ●

●

Dana-Farber Cancer Institute

Boston

●

Duke University Hospital

Durham

●

Emory University Hospital

Atlanta

●

Faulkner Hospital

Boston

●

George Washington University Hospital

Washington

●

Group Health Central Hospital

Seattle

●

Harvard Vanguard Medical Associates

Newton

●

Iowa Methodist Medical Center

Des Moines

●

Johns Hopkins Hospital

Baltimore

●

L.A. Gay & Lesbian Center

Los Angeles

●

LAC/USC Medical Center

Los Angeles

●

Lutheran Medical Center

Brooklyn

●

Massachusetts General Hospital

Boston

●

Medical Center of Louisiana

New Orleans

●

New York Presbyterian Hospital

New York

●

Oregon Health & Science University Hospital

Portland

●

Pennsylvania Hospital

Philadelphia

●

Penobscot Community Health Care

Bangor

●

Piedmont Hospital

Atlanta

●

Rush University Medical Center

Chicago

St. Mary Medical Center

Long Beach

Stanford Hospital and Clinics

Stanford

UCSF Medical Center

San Francisco

University of California San Diego Medical Center

San Diego

The University of Texas MD Anderson Cancer Center

Houston

●

University of Toledo Medical Center

Toledo

●

Vanderbilt University Medical Center

Nashville

●

Cleveland Clinic

Cleveland

●

Euclid Hospital

Euclid

●

Fairview Hospital

Cleveland

●

Hillcrest Hospital

Mayfield Heights

●

Huron Hospital

East Cleveland

●

Lakewood Hospital

Lakewood

●

Lutheran Hospital

Cleveland

●

South Pointe Hospital

Warrensville Heights

●

Jackson Memorial Hospital

Miami

●

Jackson North Medical Center

North Miami Beach

●

Jackson South Community Hospital

Miami

●

● ●

●

CLEVELAND CLINIC FOUNDATION

JACKSON HEALTH SYSTEM

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

APPENDIX C

HEI-RATED FACILITIES BY NETWORK ● YES

● NO

Facility Name

● NOT APPLICABLE

City

State

Top Performer

Kaiser Permanente Anaheim Medical Center

Anaheim

Kaiser Permanente Baldwin Park Medical Center

Baldwin Park

●

Kaiser Permanente Bellflower Medical Center Kaiser Permanente Fontana Medical Center

Bellflower

●

Fontana

●

Kaiser Permanente Fremont Medical Center

Fremont

●

Kaiser Permanente Fresno Medical Center

Fresno

●

Kaiser Permanente Hayward Medical Center

Hayward

●

Kaiser Permanente Los Angeles Medical Center

Los Angeles

●

Kaiser Permanente Manteca Medical Center

Manteca

●

Kaiser Permanente Moanalua Medical Center

Honolulu

●

Kaiser Permanente Oakland Medical Center

Oakland

●

Kaiser Permanente Panorama City Medical Center

Panorama City

●

Kaiser Permanente Redwood City Medical Center

Redwood City

●

Kaiser Permanente Richmond Medical Center

Richmond

●

Kaiser Permanente Riverside Medical Center

Riverside

●

Kaiser Permanente Roseville Medical Center

Roseville

●

Kaiser Permanente Sacramento Medical Center

Sacramento

●

Kaiser Permanente San Diego Medical Center

San Diego

●

Kaiser Permanente San Francisco Medical Center

San Francisco

●

Kaiser Permanente San Rafael Medical Center

San Rafael

●

Kaiser Permanente Santa Clara Medical Center (Kiely Campus)

Santa Clara

●

Kaiser Permanente Santa Rosa Medical Center

Santa Rosa

●

Kaiser Permanente Santa Teresa Medical Center

San Jose

●

Kaiser Permanente South Bay Medical Center

Harbor City

●

Kaiser Permanente South Sacramento Medical Center

Sacramento

●

Kaiser Permanente South San Francisco Medical Center

South San Francisco

●

Kaiser Permanente Sunnyside Medical Center

Clackamas

●

KAISER PERMANENTE NETWORK

Kaiser Permanente Vallejo Medical Center

Vallejo

●

Kaiser Permanente Walnut Creek Medical Center

Walnut Creek

●

Kaiser Permanente West Los Angeles Medical Center

Los Angeles

●

Kaiser Permanente Woodland Hills Medical Center

Woodland Hills

●

Legacy Clinic Battle Ground

Battle Ground

●

Legacy Clinic Canby

Canby

●

Legacy Clinic Emanuel

Portland

●

Legacy Clinic Firwood

Sandy

●

Legacy Clinic Fisher’s Landing

Vancouver

●

Legacy Clinic Good Samaritan

Portland

●

Legacy Clinic Mount Hood

Gresham

●

Legacy Clinic Northeast

Portland

●

Legacy Clinic Northwest

Portland

●

Legacy Clinic Salmon Creek

Vancouver

●

LEGACY HEALTH SYSTEM

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

APPENDIX C

HEI-RATED FACILITIES BY NETWORK ● YES

Facility Name

● NO

● NOT APPLICABLE

City

State

Top Performer

Legacy Clinic St. Helens

St. Helens

●

Legacy Clinic Tigard-King City

Portland

●

Legacy Clinic Tualatin

Tualatin

●

Legacy Clinic West Linn

West Linn

●

Legacy Clinic Woodburn

Woodburn

●

Legacy Emanuel Children’s Hospital

Portland

●

Legacy Emanuel Hospital & Health Center

Portland

●

Legacy Good Samaritan Hospital

Portland

●

Legacy Meridian Park Hospital

Tualatin

●

Legacy Mount Hood Medical Center

Gresham

●

Legacy Salmon Creek Hospital

Vancouver

●

Joe DiMaggio Children’s Hospital

Hollywood

●

Memorial Hospital Miramar

Miramar

●

Memorial Hospital Pembroke

Pembroke Pines

●

Memorial Hospital West

Pembroke Pines

●

Memorial Regional Hospital

Hollywood

●

Memorial Regional Hospital South

Hollywood

●

Annie Penn Hospital

Reidsville

●

Behavioral Health Center

Greensboro

●

Moses H. Cone Memorial Hospital

Greensboro

●

Wesley Long Community Hospital

Greensboro

●

Women’s Hospital of Greensboro

Greensboro

●

East County Health Center

Gresham

●

La Clinica de la Buena Salud Health Center

Portland

●

Mid County Health Center

Portland

●

North Portland Health Center

Portland

●

Northeast Portland Health Center

Portland

●

Southeast Portland Health Center

Portland

●

Westside Health Center

Portland

●

Ames Center

Ames

●

Ankeny Center

Ankeny

●

Cedar Falls Center

Cedar Falls

●

Creston Center

Creston

●

Fort Dodge Center

Fort Dodge

●

Healthy Connections

Des Moines

●

Iowa City Center

Iowa City

●

Knoxville Center

Knoxville

●

Newton Center

Newton

●

Quad Cities Center

Bettendorf

●

Red Oak Center

Red Oak

●

Rosenfield Center

Des Moines

●

Sioux City Center

Sioux City

●

Spencer Center

Spencer

●

MEMORIAL HEALTH SYSTEM

MOSES CONE HEALTH SYSTEM

MULTNOMAH COUNTY HEALTH DEPARTMENT

PLANNED PARENTHOOD OF GREATER IOWA

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

APPENDIX C

HEI-RATED FACILITIES BY NETWORK ● YES

Facility Name

● NO

● NOT APPLICABLE

City

State

Top Performer

Storm Lake Center

Storm Lake

●

Susan Knapp Health Center

Des Moines

●

The Family Practice Center

Des Moines

●

West Center

Urbandale

●

SENTARA HEALTHCARE

Sentara Bayside Hospital

Virginia Beach

●

Sentara CarePlex Hospital

Hampton

●

Sentara Leigh Hospital

Norfolk

●

Sentara Norfolk General Hospital

Norfolk

●

Sentara Obici Hospital

Suffolk

●

Sentara Potomac Hospital

Woodbridge

●

Sentara Virginia Beach General Hospital

Virginia Beach

●

Sentara Williamsburg Regional Medical Center

Williamsburg

●

Clinton Memorial Hospital

Saint Johns

●

Sparrow Hospital

Lansing

●

Sparrow Specialty Hospital

Lansing

●

St. Lawrence Hospital

Lansing

●

Bedford Medical Center

Bedford

●

Case Medical Center

Cleveland

●

Conneaut Medical Center

Conneaut

●

Geauga Medical Center

Chardon

●

Geneva Medical Center

Geneva

●

Ireland Cancer Center

Cleveland

●

MacDonald Women’s Hospital

Cleveland

●

Rainbow Babies and Children’s Hospital

Cleveland

●

Richmond Medical Center

Richmond Heights

●

University Hospitals Extended Care Campus

Chardon

●

A. Alfred Taubman Health Care Center

Ann Arbor

●

Brighton Health Center

Brighton

●

Canton Health Center

Canton

●

Chelsea Health Center

Chelsea

●

Commonwealth Neuropsychology Clinic

Ann Arbor

●

Dexter Family Medicine

Dexter

●

Domino’s Farms Health Center

Ann Arbor

●

East Ann Arbor Ambulatory Surgery & Medical Procedures Center

Ann Arbor

●

East Ann Arbor Health & Geriatrics Center

Ann Arbor

●

Howell Pediatrics and Teen Center

Howell

●

Livonia Center for Specialty Care

Livonia

●

New Hope Outreach Clinic

Ann Arbor

●

Psychiatry Ambulatory Services

Ann Arbor

●

Saline Health Center

Saline

●

UM Briarwood Medical Group

Ann Arbor

●

University Hospital

Ann Arbor

●

West Ann Arbor Health Center

Ann Arbor

●

Ypsilanti Health Center

Ypsilanti

●

Harborview Medical Center

Seattle

●

University of Washington Medical Center

Seattle

●

SPARROW HEALTH SYSTEM

UNIVERSITY HOSPITALS OF CLEVELAND

UNIVERSITY OF MICHIGAN HEALTH SYSTEM

UNIVERSITY OF WASHINGTON MEDICINE

H E A LT H C A R E E Q U A L I T Y I N D E X 2 O 1 O

www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

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appendix D

testimonials from hei 2O1O top performers

Making the Business Case for LGBT Inclusion l

Top Performer: Advocate Illinois Masonic Medical Center Location: Chicago, Ill. Years rated in HEI: 3 Size: 1,668 full-time employees, 408 beds Years as Top Performer: 1

Advocate Illinois Masonic Medical Center (IMMC), a clinically comprehensive teaching hospital located in Chicago’s Lakeview community, has been a community anchor for nearly 100 years and was named one of the top 100 major teaching hospitals in the United States in 2009. Its history and daily culture honor diversity and inclusion. Located within one of the largest LGBT communities in the United States, IMMC has a history of specialized service to this community that includes: one of the first inpatient HIV/AIDS units in the Midwest, specialized outpatient programs located in the community that focus on patient and provider education, and an innovative relationship with the Howard Brown Health Center, a large clinic that provides the LGBT community with healthcare and wellness programs. It’s often said that doing right is doing good business. IMMC’s relationship with Chicago’s North Side LGBT community is an example of such a community partnership in action. For years, IMMC has been a leading provider of clinical services to the LGBT community and highly values this key community partnership. Doing right means IMMC meets its values of responsible stewardship by providing healthcare services and resources to all members of its community. Providing quality and needed clinical services to Chicago’s LGBT community occurs through a variety of channels at IMMC. Continued investment in primary care physician practices — bringing services to the community — has attracted hundreds (if not thousands) of new patients to the medical center annually. Expanding specific specialty services such as general urology, colorectal disease and gynecology also serve to ally patients with the medical center and its services. Direct advertising, both in local media and in community events, has a positive economic effect in both new service launches and in maintaining a robust presence for physician practices, programs and institutional perception in the community. Sponsoring local LGBT events, including participation in the LGBT pride parade and a variety of organizational fundraising events, pays economic dividends in addition to fostering LGBT community partnership. The community recognizes IMMC’s ongoing presence and trusts us when in need of services. IMMC invests in the LGBT community, while the LGBT community recognizes that trust with clinical use. Doing the right thing truly does pay off. Marc A. Senesac

Vice President, Human Resources Michael Swarzman

Vice President, Business Development Advocate Illinois Masonic Medical Center

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Protecting All LGBT Patients from Discrimination

Top Performer: Baystate Medical Center Location: Springfield, Mass. Size: 4,338 full-time employees, 659 beds

Years rated in HEI: 2 Years as Top Performer: 1

Baystate Medical Center in Springfield, Mass., is the region’s only academic, research and teaching hospital. It is part of Baystate Health, the largest private employer in western Massachusetts with more than10,000 employees, serving a population of 800,000 residents, and is one of the largest not-for-profit healthcare systems in New England. We are acutely aware of the diversity within the region and are committed to addressing the needs and concerns of all people appropriately. Our charitable mission is to improve the health of the people in our communities every day, with quality and compassion. We use national best practices and often use benchmarking tools to understand how well we’re doing in meeting the needs of those we serve. HEI 2009 was one of those tools and it helped us to identify a gap in our communication with our LGBT patients and with our LGBT care providers. When the HEI 2009 report was published, our Patients’ Bill of Rights did not include “gender identity or expression.” We were in the company of 89 percent of HEI 2009-rated facilities. We recognized this as an opportunity to improve. This gap helped us realize that our Patients’ Bill of Rights did not fully align with our mission and our operating principles. Transgender individuals face discrimination daily in varied forms, and our goal is to ensure that their experiences are consistent with the high-quality, compassionate care that is the hallmark of our organization. I explained the issue to the Patient Care Policy Committee that oversees our Patients’ Bill of Rights. I shared with them the importance of ensuring physical and emotional safety to transgender patients, not only in practice, but also in our policies.

The group quickly agreed that this policy should include “gender identity and expression.” A week later, the updated policy was available online, making it accessible for all employees, with protections for transgender individuals identified in the first sentence. Having this commitment in print, now as part of our system-wide policy, gives us something to point to that says, “Yes, we support you and accept you wholly.” It also gives us support when providing internal education: It shows that education about transgender issues and care is supported by the leadership of the organization.

In November 2009, we held a full-day regional conference on transgender healthcare for providers within our organization as well as those external to Baystate Health. Educational programs provide the opportunity to share the knowledge we possess about the transgender community and transgender healthcare. We will continue to learn and share information so all care providers can improve the services delivered to the transgender community. At Baystate Medical Center, our commitment is to provide the best possible healthcare in an environment that treats our patients with dignity and respect. We are proud to provide an environment of care that supports each individual and their needs, including our LGBT community members. Visael “Bobby” Rodriguez

Chief Diversity Officer Baystate Health

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Leveraging LGBT & Allied Employees: The LGBT Employee Group Top Performer: Beth Israel Medical Center Location: New York, N.Y. Size: 7,289 full-time employees, 1,111 beds

Years rated in HEI: 1 Years as Top Performer: 1

Beth Israel Medical Center’s LGBT Committee was formed in 2008 as a subcommittee of the medical center’s Diversity Council. The goal of our committee is to establish and maintain

a culture of inclusion within which all LGBT patients and staff feel that they are in a safe, supportive and non-judgmental setting. The committee’s membership has grown

quickly since its inception and includes front-line staff, administrators, providers from several disciplines, a hospital trustee and representatives from external affiliate organizations. In 2009, a subcommittee was formed and charged with reviewing Beth Israel’s existing policies and procedures to ensure LGBT healthcare equality in policy and practice, and to evaluate whether we would meet the criteria outlined by the Healthcare Equality Index. Many of the medical center’s policies were already in line with the HEI recommendations, and a few needed some minor updating. Some policies were amended with the full support and assistance of the medical center administration. Additionally, the committee developed a list of “Top Ten Provider Tips for Serving the LGBT Patient Population” based on available literature from reliable sources, such as the Gay and Lesbian Medical Association. This was distributed to providers through a blast e-mail to all medical center staff, and was also posted in patient care areas. The tips list (as well as other resources) remains accessible to providers and staff via the medical center’s intranet website. Hard-working members of the committee are also currently working on a similar provider-education tool specifically geared toward our transgender patient population. In recognition of National LGBT Health Week, on April 13, 2010, providers from Beth Israel donated their time and expertise to provide a panel presentation regarding issues related to LGBT medical and mental health, and issues of importance to LGBT individuals seeking healthcare. This panel presentation was given to members of the diversity councils of KPMG LLP and several of their affiliate organizations. The committee is also in the process of bringing in a consultant to conduct transgender sensitivity trainings at the medical center in order to foster awareness and sensitivity toward this patient population. Lastly, since the LGBT committee was formed, there have been two after-work LGBT networking/social events. All staff are invited to attend these events through blast e-mails (as well as staff from our affiliate hospitals), and the events have been quite well-attended. The committee is planning to participate in several upcoming community events, including sponsorship in the 2010 New York City LGBT Pride Parade in June. LGBT Committee

Beth Israel Medical Center

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Demonstrating Commitment to LGBT Staff & Families

Top Performer: Dana-Farber Cancer Institute Location: Boston, Mass. Size: 5,118 full-time employees

Years rated in HEI: 2 Years as Top Performer: 1

Dana-Farber Cancer Institute has long been active in its commitment to LGBT staff and families. In 2009, we strengthened this commitment by including LGBT-inclusive language in our Patient Rights and Responsibilities document and by including LGBT topics in our Schwartz Rounds and other cultural competency programs. Externally, we have been a multiyear sponsor of many LGBT events, including the annual Boston Pride Festival, to ensure that

all members of the LGBT community know they can come to Dana-Farber for cancer care, education and prevention. In addition to our research on cancer, Dana-Farber is the

only cancer center to be a federal Center for AIDS Research. In 2009, Dana-Farber received the Outstanding Employer of the Year award from the Greater Boston Business Council, the LGBT â&#x20AC;&#x153;chamber of commerceâ&#x20AC;? in Boston, for its work in the community and in creating a safe and welcoming place for its staff, patients and their families. We are proud of our past commitment to the LGBT community and know we will continue to create a more welcoming healthcare experience for all who come to Dana-Farber for their cancer care. Edward Benz, M.D.

President and Chief Executive Officer Dana-Farber Cancer Institute

h e a lt h c a r e e q u a l i t y i n d e x 2 O 1 O

www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Translating Inclusive Practice into Policy Top Performer: Group Health Central Hospital Location: Seattle, Wash. Size: 104 full-time employees, 326 beds

Years rated in HEI: 3 Years as Top Performer: 2

Group Health is very proud to be one of the top performers in the Healthcare Equality Index again this year! Assuring healthcare equality for our LGBT members and their families is essential to their health and well-being. From the beginning, Group Health has attracted caring, innovative people who step up and ask, “What’s next for our patients’ health?” Additionally, Group Health has a long history of providing non-discrimination protections in employment and healthcare benefits for domestic partners and families of LGBT staff. These practices are core to our values at Group Health. While we have long had a culture of inclusiveness and non-discrimination protections, participation in the HEI survey helped us see that our policies did not necessarily fully

reflect our culture or set expectations of inclusive behavior and non-discriminatory practices for our staff. Policies that set expectations for care and behavior allow the

organization to take corrective action if those expectations are not achieved. This realization moved Group Health forward in assuring that non-discrimination policies included gender identity and expression as well as sexual orientation for both employees and patients. We made sure that hospital visitation policies included a definition of

family that included spouses, domestic partners and both different-sex and same-sex significant others, and that the concept of parenthood was to be liberally construed without limitation for the purpose of visitation rights.

We understand how important it is to incorporate cultural competence around LGBT members into our practices. It is a strategy that we believe enhances the quality of care our patients receive, positions us well for growth and delivers on the Group Health promise of integrated, compassionate care. Desiray Bailey, M.D.

Chief of Medical Staff Erin Leff, M.B.A.

Hospital Administrator Group Health Central Hospital

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www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Creating a Culture of Inclusion: The Hospital Diversity Council l Top Performer: Rush University Medical Center Location: Chicago, Ill. Size: 7,052 full-time employees, 676 beds

Years rated in HEI: 2 Years as Top Performer: 2

Compassion and understanding are at the core of medicine. The capacity to heal people inherently requires understanding that health is influenced by more than physical factors alone, including emotional, sociological and cultural factors. These principles underlie Rush University Medical Center’s commitment to fostering a culture of inclusion. This commitment also is essential given that Rush serves wide-ranging and diverse communities. In order for members of the Rush community to work well together and to provide our patients with effective, appropriate care, we strive to make Rush a place where personal differences are not just accepted, but understood, respected and valued. This culture of inclusiveness is also an essential part of preparing the students of

Rush University to provide care for the country’s increasingly diverse population. To advance this commitment, Rush established the Rush Diversity Leadership Group, which provides guidance about ways of promoting diversity, inclusion and equity. The DLG’s work reflects an understanding that the more we pay attention to and understand the diversity of our patients, staff, faculty and students, the more successful we will be as an institution of healing. Members of the DLG are drawn from all areas of Rush and represent the many communities we serve, including the lesbian, gay, bisexual and transgender community. Updates from the LGBT community are included in each meeting agenda. The non-discrimination policy is the cornerstone of Rush’s formal culture of inclusion and goes beyond what is required in federal and Illinois law. We specifically forbid discrimination, harassment or unequal treatment in 14 categories, including sexual orientation and gender identity and/or expression. Rush’s initial participation in the Healthcare Equality Index prompted the formal addition of language to our non-discrimination policy and all other relevant policies to cover gender identity and/or expression explicitly. All medical center policies define “family members” to include any person with whom a patient has a significant relationship, which ensures same-sex partners and same-sex parents have the identical rights as different-sex partners and parents regarding patient visitation in the hospital and in decision-making about their partner’s or child’s medical care. Rush’s commitment to inclusiveness is evident in our employee health benefits. More than a decade ago, Rush became one of the first medical centers in the city to offer same-sex domestic partner benefits to employees. Rush took proactive steps and made the financial

commitment to provide these benefits because we equally value all of our employees and their relationships and seek to support their needs.

Along with taking steps to ensure that LGBT patients, employees, faculty and students are treated equally, Rush is taking a lead role in advancing medical care in areas of concern for the LGBT community. A Rush researcher directs a consortium of Chicago health providers in a collaborative center for HIV/AIDS research that is funded by the National Institutes of Health. In another example, Rush nursing faculty members have partnered with the Howard Brown Health Center in Chicago to develop a program for training nurses to provide care for geriatric LGBT and HIV-positive individuals. In taking steps to create and maintain a culture of inclusion, Rush aims to better understand and communicate with patients from all communities in order to provide culturally sensitive care that addresses their unique needs and concerns. In addition, Rush’s diversity commitment upholds the respect for human dignity that is fundamental to the way medicine should be.

For more information about any of these initiatives and how Rush went about achieving them, please contact the Rush Office for Equal Opportunity at 312-942-7093. Larry J. Goodman, M.D.

President and Chief Executive Officer Rush University Medical Center

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www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Bringing Policies Alive: LGBT Cultural Competency Staff Training Top Performer: UCSF Medical Center Location: San Francisco, Calif. Size: 7,800 full-time employees, 722 beds

Years rated in HEI: 3 Years as Top Performer: 3

At UCSF Medical Center, our work for LGBT equity and inclusion is multi-level. We view the policies and benefits evaluated by the HEI as the essential institutional bedrock on which all of our other LGBT-related efforts are based. And we have layered a number of other initiatives on top of these foundational policies and benefits to ensure their effectiveness.

One of our key initiatives to ensure the ongoing effectiveness of the HEI-rated policies and benefits is LGBT training for our medical center personnel. We design this training not only to make our personnel aware of the policies and benefits we offer but also to explain what those policies and benefits actually mean in the lives of LGBT patients and their families. It’s

one thing for people to read words on a page, and another for them to hear how those words actually help people have good healthcare and employment experiences.

We’ve gotten very positive feedback on the LGBT training we offer. Our personnel tell us that, after the training, they feel much more knowledgeable and comfortable vis-à-vis LGBT patients and colleagues — and appreciate feeling that way. In fact, even personnel who are LGBT themselves or who have LGBT friends and family members tell us how much they learn from the training. All of the training we offer provides general information about LGBT people and their healthcare concerns, as well as about UCSF’s policies and benefits. For example, our training explains what the “LGBT” acronym stands for, provides demographic information about LGBT people, and discusses the history of “coming out.” It goes on to describe the healthcare concerns of LGBT people as a group, including worries about encountering bias, being denied visitation and losing confidentiality. It also discusses the particular healthcare challenges faced by transgender patients and LGBT parents, youth and elders. The training is always customized to meet the needs of particular medical center personnel. For example, registration staff learn about various ways that LGBT patients

identify themselves, so that they can respond knowledgeably and record information accurately. Billing personnel receive information about potential snafus like name and gender mismatches with transgender patients, so that they can resolve them quickly and sensitively. Nursing supervisors learn about best practices in working with perceived and actual bias on the wards, while human resources staff discuss how best to respond to LGBT discrimination complaints. And, of course, medical personnel receive information about LGBT health risks and disparities that may well not have been part of their training. Based on our experience at UCSF, we would encourage all medical centers to consider LGBT training for their personnel. At UCSF, training has brought our LGBT policies and benefits alive, and played a vital part in creating a truly equitable and inclusive atmosphere. Shane Snowdon

Director, LGBT Resource Center University of California San Francisco

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www.hrc.org/hei

appendix D

testimonials from hei 2O1O top performers

Ensuring Successful Participation in the Healthcare Equality Index: An Incremental Approach Top Performer: The University of Texas MD Anderson Cancer Center Location: Houston, Texas Years rated in HEI: 1 Size: 17,058 full-time employees, 571 beds Years as Top Performer: 1

At The University of Texas MD Anderson Cancer Center, everything we do is connected to our core values of caring, integrity and discovery. Participating in the HEI survey supports these values and provides a lens from which to benchmark our progress in meeting the needs of our LGBT patients and work force. We are honored to be among the “Top Performers” recognized by the Human Rights Campaign Foundation’s Healthcare Equality Index 2010. Being a Top Performer is a great indicator that we are meeting our institutional mission to serve the unique needs of our patients, their loved ones and our work force. Every patient and member of our work force is critical to our success in fighting cancer, so it is imperative that we provide a welcoming and respectful environment. In 2008, we

participated in our first HEI survey to benchmark ourselves against the best practices of other top-performing organizations. This helped us identify our needs and build upon our strengths. As a result, a multi-disciplinary committee composed of key stakeholders was convened to review our performance. The major findings of this committee led to many significant changes such as: zz Expanding the Patient Bill of Rights by using more inclusive language that supports our LGBT patients and their loved ones; zz Ensuring that our Equal Employment Opportunity policy is fully inclusive of our LGBT community; zz And creating diversity education programs that focus on sexual orientation and gender identity in the workplace and the patient population.

Our success would not have been possible without the advocacy and support of the MD Anderson Diversity Council and our Gay, Lesbian, Bisexual and Transgender Employee Network. MD Anderson sponsors the network, which is the first of its kind within the Texas

Medical Center. The network’s mission is to identify the issues and concerns of LGBT employees while focusing on MD Anderson’s core values and mission. Created in 2004, the purpose of the network is to: zz Ensure that sexual orientation and gender identity/expression are not barriers to full participation in the professional and academic workplace; zz Present recommendations for increasing awareness of the unique concerns of LGBT employees and patients; zz And foster a sense of community for LGBT employees and patients.

The network has made great strides in accomplishing its goals by sponsoring educational forums and networking opportunities that are open to all MD Anderson employees. The network has actively promoted external engagement by: zz Sponsoring guest speakers to provide employee and community education about LGBT issues; zz And promoting MD Anderson’s cancer mission at public events, such as the 2009 pride festival, where the network provided free melanoma screenings and education.

On behalf of MD Anderson, I thank the Human Rights Campaign Foundation for this opportunity to participate in the Healthcare Equality Index 2010 survey. We hope our involvement will continue to promote the value of diversity, equality and inclusion in the workplace and in our relationships within the communities we serve. John Mendelsohn, M.D.

President The University of Texas MD Anderson Cancer Center

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appendix E

lgbt patient protections within 2OO of the largest u.s. hospitals Table indicates if Patients’ Bill of Rights/non-discrimination policy is inclusive of “sexual orientation” and “gender identity” for 200 of the largest hospitals in the U.S. The table includes at least one hospital from every state and the District of Columbia. Policy information was collected from two sources:

1. Patients’ Bill of Rights/non-discrimination policy information that hospitals self-reported through the Healthcare Equality Index survey

2. Publicly available Patients’ Bill of Rights/ non-discrimination policies

58 percent include “sexual orientation” 7 percent include “gender identity”

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appendix E

2OO of the largest U.S. hospitals l yes

l no

Hospital Name

HEI 2010

City

State

Sexual Orientation

Gender Identity

Abbott Northwestern Hospital

Minneapolis

Alaska Regional Hospital

Anchorage

Albert Einstein Medical Center

Philadelphia

Avera McKennan Hospital

Sioux Falls

Banner Desert Medical Center

Mesa

Banner Good Samaritan Medical Center

Phoenix

Baptist Hospital of Miami

Miami

Barnes-Jewish Hospital

St. Louis

Springfield

Beaumont Hospital - Royal Oak

Royal Oak

Beebe Medical Center

Lewes

Benefis Healthcare

Great Falls

Baystate Medical Center

Beth Israel Deaconess Medical Center

Boston

Beth Israel Medical Center

New York

Bloomington Hospital

Bloomington

Boston Medical Center

Boston

Brookdale University Hospital and Medical Center

Brooklyn

Brookwood Medical Center

Birmingham

Broward General Medical Center

Fort Lauderdale

Buffalo General Hospital

Buffalo

California Pacific Medical Center

San Francisco

Cape Fear Valley Health

Fayetteville

Carilion Medical Center

Roanoke

Carolinas Medical Center

Charlotte

Case Medical Center

Cleveland

Cedars Medical Center

Miami

Cedars-Sinai Medical Center

Los Angeles

Centra Health

Lynchburg

Central Texas Veterans Health Care

Temple

Charleston Area Medical Center

Charleston

Christiana Care

Newark

Christus Schumpert Health

Shreveport

Christus Spohn Memorial Hospital

Corpus Christi

CJW Medical Center

Richmond

Clarian Health

Indianapolis

Cleveland

Community Medical Center

Fresno

Covenant Medical Center

Lubbock

Brigham and Womenâ&#x20AC;&#x2122;s Hospital

Cleveland Clinic

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appendix E

2OO of the largest U.S. hospitals l yes

l no

Hospital Name

HEI 2010

City

State

Sexual Orientation

Gender Identity

Crozer-Chester Medical Center

Upland

Dartmouth-Hitchcock Medical Center

Lebanon

Duke University Hospital

Durham

Emory University Hospital

Atlanta

Erie County Medical Center

Buffalo

Erlanger Medical Center

Chattanooga

Evanston Hospital

Evanston

Fletcher Allen Health Care

Burlington

Florida Hospital

Orlando

Forsyth Medical Center

Winston-Salem

George Washington University Hospital

Washington

Greenville Memorial Hospital

Greenville

Hackensack University Medical Center

Hackensack

Seattle

Hartford Hospital

Hartford

Hospital of the University of Pennsylvania

Philadelphia

Huntington Memorial Hospital

Pasadena

Huntsville Hospital

Huntsville

Inova Fairfax Hospital

Falls Church

Harborview Medical Center

Iowa Methodist Medical Center

Des Moines

Jackson Memorial Hospital

Miami

Mountain Home

James H. Quillen VA Medical Center Johns Hopkins Hospital

Baltimore

Kaiser Permanente Los Angeles Medical Center

Los Angeles

Kaiser Permanente Moanalua Medical Center

Honolulu

Kettering Medical Center-Sycamore

Kettering

Kingsbrook Jewish Medical Center

Brooklyn

LAC/USC Medical Center

Los Angeles

Lakeland Regional Medical Center

Lakeland

Lancaster General Hospital

Lancaster

Lee Memorial Hospital

Fort Myers

Lehigh Valley Hospital

Allentown

Lewis-Gale Medical Center

Salem

Loma Linda University Medical Center

Loma Linda

Long Island Jewish Medical Center

New Hyde Park

Brooklyn

Maimonides Medical Center

Brooklyn

Malcom Randall VA Medical Center

Gainesville

Manatee Memorial Hospital

Bradenton

Lutheran Medical Center

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2OO of the largest U.S. hospitals l yes

Hospital Name

l no HEI 2010

State

Sexual Orientation

Gender Identity

Boston

Medical Center of Central Georgia

Macon

Medical University of South Carolina

Charleston

Memorial Hermann Hospital

Houston

Hollywood

Mercy Medical Center

Des Moines

MeritCare Medical Center

Fargo

Methodist Hospital

Houston

Methodist Hospital

San Antonio

Methodist University Hospital

Memphis

MetroHealth Medical Center

Cleveland

Miami Valley Hospital

Dayton

Michael E. DeBakey VA Medical Center

Houston

Mid Coast Hospital

Brunswick

Mission Hospital

Asheville

Mississippi Baptist Medical Center

Jackson

Montefiore Medical Center

Bronx

Morristown Memorial Hospital

Morristown

Morton Plant Hospital

Clearwater

Greensboro

Mount Sinai Medical Center

Miami Beach

Nassau University Medical Center

East Meadow

Nebraska Medical Center

Omaha

New Hanover Regional Medical Center

Wilmington

New York

Massachusetts General Hospital

Memorial Regional Hospital

Moses H. Cone Memorial Hospital

New York Presbyterian Hospital

City

Newark Beth Israel Medical Center

Newark

North Mississippi Medical Center

Tupelo

North Shore University Hospital

Manhasset

Northside Hospital

Atlanta

Northwestern Memorial Hospital

Chicago

Oakwood Hospital & Medical Center

Dearborn

Ohio State University Medical Center

Columbus

Portland

Oregon Health & Science University Hospital

OSF St. Francis Medical Center

Peoria

OU Medical Center

Oklahoma City

Our Lady of the Lake Regional Medical Center

Baton Rouge

Palmetto Health Richland

Columbia

Parkland Health and Hospital

Dallas

Parkview Hospital

Fort Wayne

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appendix E

2OO of the largest U.S. hospitals l yes

l no

Hospital Name

HEI 2010

State

Sexual Orientation

Gender Identity

Atlanta

Pitt County Memorial Hospital

Greenville

Rex Healthcare

Raleigh

Rhode Island Hospital

Providence

Riverside Methodist Hospital

Columbus

Robert Wood Johnson University Hospital

New Brunswick

Chicago

Piedmont Hospital

Rush University Medical Center

City

Salem Hospital

Salem

San Francisco General Hospital

San Francisco

San Pedro Peninsula Hospital

San Pedro

Sarasota Memorial Hospital

Sarasota

Scripps Mercy Hospital

San Diego

Shands at the University of Florida

Gainesville

Shands Jacksonville Medical Center

Jacksonville

Sharp Memorial Hospital

San Diego

South Texas Veterans Health Care

San Antonio

Southcoast Hospitals

Fall River

Lansing

Spectrum Health

Grand Rapids

St. Anthony Hospital

Oklahoma City

St. Barnabas Hospital

Bronx

St. Barnabas Medical Center

Livingston

St. Francis Hospital

Memphis

St. John’s Hospital

Springfield

St. John’s Hospital

Springfield

St. John’s Mercy Medical Center

Saint Louis

St. Joseph’s Hospital

Tampa

St. Joseph’s Hospital & Medical Center

Phoenix

St. Joseph’s Regional Medical Center

Paterson

St. Luke’s Hospital

Chesterfield

St. Luke’s Medical Center

Milwaukee

St. Luke’s Regional Medical Center

Boise

St. Mary’s Hospital

Rochester

St. Vincent Infirmary Medical Center

Little Rock

St. Vincent’s Medical Center

Jacksonville

Palo Alto

Staten Island University Hospital

Staten Island

Strong Memorial Hospital University of Rochester

Rochester

Sunrise Hospital & Medical Center

Las Vegas

Sparrow Hospital

Stanford Hospital and Clinics

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appendix E

2OO of the largest U.S. hospitals l yes

Hospital Name

l no HEI 2010

City

State

Sexual Orientation

Gender Identity

Swedish Health Services

Seattle

Tampa General Hospital

Tampa

Temple University Hospital

Philadelphia

Thomas Jefferson University Hospital

Philadelphia

Touro Infirmary

New Orleans

Trinity Health

Minot

UAMS Medical Center

Little Rock

UCLA Medical Center

Los Angeles

San Francisco

Worcester

Ann Arbor

University Hospital

Albuquerque

University Medical Center

Las Vegas

University of Alabama Hospital

Birmingham

University of California Davis Medical Center

Sacramento

University of Colorado Hospital

Denver

University of Iowa Hospitals & Clinics

Iowa City

University of Kentucky Hospital

Lexington

University of Maryland Medical Center

Baltimore

University of Minnesota Medical Center

Minneapolis

University of Mississippi Medical

Jackson

University of North Carolina Hospitals

Chapel Hill

University of Texas Medical Branch Hospitals

Galveston

University of Utah School of Medicine

Salt Lake City

UPMC Presbyterian

Pittsburgh

VA Eastern Kansas Health Care

Topeka

VA Greater Los Angeles Health Care

Los Angeles

VA Maryland Health Care

Baltimore

VA New Jersey Health Care

East Orange

VA North TX Health Care

Dallas

VA Palo Alto Health Care

Palo Alto

VA Puget Sound Health Care

Seattle

Vanderbilt University Medical Center

Nashville

VCU Health

Richmond

Veterans Affairs Medical Center

Cleveland

Veterans Affairs Medical Center

Martinsburg

Via Christi Regional Medical Center

Wichita

Wake Forest University Baptist Medical Center

Winston-Salem

WakeMed Raleigh Campus

Raleigh

UCSF Medical Center

UMass Memorial Medical Center University Hospital

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healthcare equality index 2O1O Creating a National Standard for Equal Treatment of Lesbian, Gay, Bisexual and Transgender Patients and Their Families

Editors

Ellen Kahn, HRC Family Project Director Tom Sullivan, HRC Family Project Deputy Director

Author

Alison Delpercio, HRC Family & Workplace Project Coordinator

About the HRC Foundation Family Project

The Human Rights Campaign Foundation Family Project aims to serve as a comprehensive resource for lesbian, gay, bisexual and transgender families. The project provides information on a wide range of issues, including adoption, civil unions, custody and visitation, donor insemination, family law, marriage, parenting, schools, senior health and housing, state laws and legislation, straight spouses and transgender issues. In addition to maintaining the most inclusive and up-to-date resources for LGBT families in the U.S., the project provides guidance to those who work closely with these families in various fields, such as adoption and foster care agencies, elementary schools and healthcare facilities.

Acknowledgments

Thank you to HRC interns Patrick Ahern for his assistance in outreach to facilities; and Melanie Chambers, Linnae Oâ&#x20AC;&#x2122;Flahavan and Liz Cooper for their assistance in report preparations. We also acknowledge the contributions to this report by HRC staff Samir Luther for assistance in data analysis and Janice Hughes, Carolyn Simon and Robert Villaflor for editorial and design guidance. A special thank you to Tony Frye for design. Thank you to the many representatives of our HEI 2010 Top Performers for their dedication to LGBT healthcare equality and their assistance in writing the testimonials and statements that appear in this report. Finally, thank you to the HRC Workplace Project for its pioneering work on the Corporate Equality Index and the many LGBT workplace resources linked to in this report. This report was funded in part by a generous grant from Pfizer Inc.

Endorsing Partner The Gay & Lesbian Medical Association is the countryâ&#x20AC;&#x2122;s largest group representing LGBT healthcare professionals. www.glma.org

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healthcare equality index advisory council The Healthcare Equality Index Advisory Council supports the Human Rights Campaign Foundationâ&#x20AC;&#x2122;s Healthcare Equality Index initiative. While not serving as official representatives of their employers, members provide expert advice and counsel on LGBT healthcare issues based on their professional experience and knowledge. Rebecca Allison, M.D.

Hutson W. Inniss

CIGNA Medical Group of Arizona

Tapestry Health Systems Inc.

Desiray Bailey, M.D.

Touro Infirmary

Kevin Jordan, M.D.

Group Health Central Hospital Dana Beyer, M.D.

Office of Councilmember Duchy Trachtenberg, Montgomery County, Md., Council

Ritchie Miller

Deloitte Financial Advisory Services LLP Julian Myers Benton

Independent Consultant

Diane Bruessow, RPA-C

LGBT Physician Assistant Caucus of the American Academy of Physician Assistants

Randall Sell

Sonya Bruton

Altarum Institute

LGBT Center, University of California San Francisco

Leslie Calman

David Staats, M.D.

Drexel School of Public Health Shane Snowdon

The Mautner Project

University of Oklahoma

Mary Foley

Matthew Stiff, J.D.

UCSF School of Nursing

Katz, Marshall & Banks LLP

Rebecca Fox

Paul Wertsch, M.D.

National Coalition for LGBT Health

Wildwood Family Clinic

Robert Garofalo, M.D.

The Joint Commission

Amy Wilson-Stronks

The Howard Brown Health Center Romana Hasnain-Wynia, Ph.D.

Feinberg School of Medicine

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A Dedication The Healthcare Equality Index 2010 is dedicated to the memory of Lisa Pond and the advocacy of her surviving partner, Janice Langbehn. The healthcare landscape for all lesbian, gay, bisexual and transgender people has significantly changed, thanks in no small way to these two women. We first shared the story of Lisa and Janice in the inaugural edition of the Healthcare Equality Index. The couple were on vacation in Florida with their children in February 2007 when tragedy struck. Lisa suffered a brain aneurysm and was rushed to the emergency room at Jackson Memorial Hospital in Miami.

The Langbehn-Pond Family,1998. Michael (standing), Lisa, Janice, Katie, David and Danielle.

When Janice arrived at the hospital with the children, she was told she was in an “antigay city and state” and would need a healthcare proxy before being allowed to see her partner of nearly 18 years or know of her condition. Even after the documents were faxed to the hospital by a friend, it took hours before Janice was finally allowed to see Lisa. Janice was accompanied by a priest, who performed last rites. In the three years since Lisa’s death, Janice has worked tirelessly to ensure that no other family should have to suffer these indignities. Represented by Lambda Legal, Janice sued the hospital and spoke at community events in Florida and around the country. As Janice has maintained throughout, this is not about a “gay right; it’s about a human right” to decide who should be with you in sickness and death. In early 2010, after intense lobbying efforts and discussions between hospital administrators and a coalition of local and national LGBT activists, the hospital finally announced the implementation of new policies protecting the rights of LGBT patients and their families. These policy changes include an LGBT-inclusive definition of family and are reflected in Jackson Memorial Hospital’s rating in the HEI 2010 report. The hospital’s announcement did not, however, address the need for grievance procedures or include a formal apology to the Langbehn-Pond family. Then, on April 15, 2010, Janice received a phone call from President Obama, who had just signed a memorandum ordering the development of federal rules directly addressing the type of discriminatory treatment her family had experienced in Miami. “In those short minutes of speaking with our president, it was clear he got the issue, and now in reading his memorandum, he understood what happened to Lisa, the kids and I was wrong on many levels — especially on the human level,” Janice wrote later in her blog. “None of this brings Lisa back. But what it does do — for the next gay couple — is that, hopefully, if your partner is dying, you won’t be locked behind a door for eight hours as they slip from this earth and not be allowed to say goodbye.” We all owe a great deal of thanks to Janice and her family. Janice’s efforts in the aftermath of personal tragedy have made the healthcare industry take notice of the type of discrimination that LGBT families face in healthcare settings. More importantly, it has changed the landscape so that in the future, no person is subjected to this treatment. We are indebted to Janice for her advocacy.

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