Hospitals across the country have a long way to go in serving the needs of lesbian, gay, bisexual and transgendered (LGBT) patients, according to the 2010 Healthcare Equality Index. pdf (HEI), which rates hospital systems on LGBT issues. The report, issued by the Human Rights Campaign (HRC), concluded that

Our nation’s hospital system is simply not meeting the needs of LGBT patients and their families.” 

HRC is one of the nation’s most influential gay and lesbian political organizations, with more than 750,000 members nationwide. The group sends its annual survey to members with a buying guide.

The 2010 survey examined the responsiveness of healthcare systems to the needs of LGBT patients and their families by reviewing  a representative sample of 200 of the nation’s largest hospitals and healthcare systems. It found that more than 40% of these institutions do not include “sexual orientation” in their patient non-discrimination  policies, and that 93 % do not include “gender identity.” The HEI also rated 178 participating healthcare facilities on four measures of equality: patient nondiscrimination, visitation, cultural competency training and employment nondiscrimination. Only a few facilities achieved satisfactory results for all four measures.

Top performers included:

• Advocate Illinois Masonic Medical Center; Chicago, Ill.
• 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 Medical Centers, throughout California
• 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 

The HEI conclusions heighten the significance of two other recent developments. First, in an important change of direction, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) has added respect for "residents' habits and patterns of living (including lifestyle choices related to sexual orientation)" to the requirements in its accreditation manual for assisted living facilities.

Second, on April 15, 2010 President Obama asked HHS to issue regulations that would require hospitals participating in Medicare or Medicaid to provide gay and lesbian partners the same rights to visit and make medical decisions on behalf of their hospitalized partners as other immediate family members.

According to the HEI, only 56% of rated facilities include information on decision-making rights for same-sex couples when they train nurses on complying with advance healthcare directives. While 21% of such facilities use scenarios as examples when teaching advance healthcare directive policy and practice, only 7% of the scenarios explicitly involve LGBT individuals or same-sex couples, and only 1% of the HEI-rated facilities train nurses on decision-making rights of same-sex parents for the medical needs of their minor children.

With new regulatory and accreditation requirements placing substantial importance on respect and sensitivity to the needs of LGBT patients and their families, the recent HEI findings indicate that most healthcare systems need a serious overhaul of their policies and training programs affecting these matters.

This entry was written by George O’Brien