On June 30, 2011, the Human Rights Campaign (HRC) released its 2011 Healthcare Equality Index. This is the fifth year that the HRC has surveyed healthcare providers nationwide to assess policies and practices related to lesbian, gay, bisexual and transgender patients and their families. This year, 87 healthcare systems and 375 medical facilities responded to the HRC survey; up from 50 systems and 178 facilities in 2010. According to the HRC, “an increasing number of healthcare facilities are working toward a more welcoming environment for lesbian, gay, bisexual and transgender patients, however, work remains to be done to end discrimination against LGBT people in America’s healthcare system”

The vast majority of responding health systems reported inclusion of sexual orientation in both the patient and employee bill of rights/equal opportunity policies. However, only half of respondents reported visitation policies expressly inclusive of same-sex couples and same sex parents. These percentages are bound to dramatically rise, however, because in January of this year, HHS issued its final regulations requiring all hospitals that receive federal Medicare and Medicaid funding to protect visitation rights of LGBT people. Although these regulations directly impact a provider’s visitation obligations, they do not address who is considered “next of kin,” thus eligible to make “end of life” or posthumous decisions for a loved one.

According to Tom Sullivan, Deputy Director, Human Rights Campaign Family Project and Editor, Healthcare Equality Index, the adoption of inclusive visitation standards are not only necessary to allow loved ones access to hospitalized family members, but also play a significant role in the actual ability to provide effective healthcare. In the past, “code words” were used by same sex partners and parents, such as “sibling” or “family friend,” thus depriving the medical provider of the opportunity to accurately understand family dynamics and relationships oftentimes important to medical decision making. The survey results also showed that inclusion of rights based upon “sexual identity,” both for employees and patients, lagged dramatically behind guarantees of equality based upon sexual orientation.

Survey respondents were evaluated on seven criteria: (i) sexual orientation in patient nondiscrimination policy; (ii) gender identity in patient nondiscrimination policy; (iii) visitation policy expressly inclusive of same-sex couples; (iv) visitation policy expressly inclusive of same-sex parents; (v) LGBT cultural competency training for all employees; (vi) sexual orientation in equal employment policy; and (vii) gender identity orientation in equal employment policy. The HRC states that each of the survey areas of inquiry, including employment nondiscrimination policies, directly relate to quality of patient care. According to Sullivan, the nexus between personnel policies and quality healthcare is clear: an inclusive and welcoming environment for employees results in a more productive and satisfied workforce. In addition, a culture of inclusion and nondiscrimination among employees creates the same environment for patient care. In addition, Sullivan stresses that scoring well on the Equality Index is good business, because an ever-increasing number of LGBT individuals and their family members will make decisions, as medical consumers, based upon a provider’s score on the Healthcare Equality Index.

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