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May 2008 (To print, click the print icon on your browser
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Gay and Lesbian Medical Association, Human Rights Campaign Foundation Release First-of-Its-Kind Healthcare Equality Index
National report rates hospitals on healthcare and non-discrimination policies for gay, lesbian, bisexual and transgender Americans

WASHINGTON –  The Gay and Lesbian Medical Association, the nation's largest association of GLBT healthcare professionals, and the Human Rights Campaign Foundation, the nation’s largest gay, lesbian, bisexual and transgender (GLBT) civil rights organization, today announced the release of an industry-changing nationwide report—the Healthcare Equality Index (HEI)—which for the first time rates the nation’s hospitals on a set of baseline standards of patient care for GLBT Americans. 


The HEI is the first step toward establishing a nationwide set of standards to reduce discrimination and ensure quality hospital-based health care. The absence of federal protections, inadequate state laws and inconsistent hospital policies often result in discrimination and inadequate health care for GLBT patients and their families.   Too many times, a gay man has been unable to comfort his partner, a transgender person has been ridiculed instead of treated, or a lesbian mom has been barred from seeing her child at the hospital. 


The HEI is modeled after the Human Rights Campaign Foundation’s successful Workplace Project’s Corporate Equality Index, which rates corporations based on equality standards for GLBT workers and has led to over 50 percent of the Fortune 500 offering benefits to same-sex partners today, up from just a handful in 2000.   By shining a national spotlight on companies’ employment practices and educating GLBT community and all Americans on equality standards, these companies were moved toward equal treatment of all employees.   The HEI is expected to achieve similar results in the healthcare community by calling attention to discriminatory practices and, over time, establishing a “gold standard” of policies to ensure equality of treatment.


In a national conference call, Human Rights Campaign Foundation President Joe Solmonese and Gay and Lesbian Medical Association Executive Director Joel Ginsberg, as well as representatives from Vanderbilt University Medical Center, New York Presbyterian Hospital, Massachusetts General Hospital, and Advocate Illinois Masonic Medical Center, detailed the common barriers to quality care that GLBT patients and their families experience as a result of the lack of national protection, inadequate state laws, or healthcare providers’ insufficient training on the unique health issues faced by the GLBT community.  They also discussed the standards created by participating hospitals to overcome these barriers, such as implementing visitation and decision making policies that respect the wishes of same-sex couples.


“By publishing the Healthcare Equality Index, we not only shine a light on the top performing hospitals, but also draw attention to prejudices that GLBT Americans must face during some of their most critical moments,” said Human Rights Campaign Foundation President Joe Solmonese.  “With each subsequent edition of the HEI, we will move the health care industry closer to gold standard of national policies that will improve the treatment and prevent discrimination of GLBT Americans and their families.”


 “The strong participation we're seeing by hospitals across the country reflects a trend within the healthcare industry of focusing on GLBT patients as a specific patient population with some unique needs,” said Joel Ginsberg, executive director of the Gay and Lesbian Medical Association. “We're encouraged by this because this kind of private, voluntary action is one of the most important ways we're going to be able to reduce some of the health disparities that GLBT people currently experience.”


By creating a standard set of best practices that can be replicated by states, hospitals, and other healthcare services nationwide, the HEI is already moving the healthcare industry toward policies, standards, and training that ensure equal treatment for the GLBT community.


“We are proud to participate in the Healthcare Equality Index survey and honored to be the only Illinois hospital recognized in the report,” says Susan Nordstrom Lopez, president of Advocate Illinois Masonic Medical Center in Chicago. Illinois Masonic was among the 45 hospitals nationwide answering “yes” to each of the 10 questions published in the HEI report. “Located at the heart of Chicago's GLBT community, our medical campus has long been a leader in providing compassionate care for our neighborhood’s diverse population. We commend the work of the Human Rights Campaign and the Gay and Lesbian Medical Association for their work in supporting equality in health care.”


“We are pleased to participate in the Healthcare Equality Index, and help set a high standard so that healthcare discrimination is not practiced on any level,” said Martin P. Sander, M.D., associate vice chancellor for Hospital Affairs at Vanderbilt University Medical Center.  “Vanderbilt Medical Center is committed to providing an open and welcoming environment for our diverse patient population, as well as our faculty and staff. We welcome the results of the Healthcare Equality Index report and look forward to making improvements that may better serve our gay, lesbian, transgender and bisexual patients.  It's important that we provide the GLBT community with health care that respects their rights while understanding their unique needs.”


“The MGH is deeply committed to providing equitable, compassionate and high quality care to our lesbian, gay, bisexual and transgender patients and their families, a level of care that is standard across our diverse patient population,” says Peter L. Slavin, MD, president of the Massachusetts General Hospital in Boston“We are proud to be able to highlight our commitment to these high standards of care, as well as our efforts to promote a supportive work environment for all our employees in the Healthcare Equality Index report.”


"UCSF Medical Center is very proud to have met each and every criterion of the Healthcare Equality Index—and, above all, proud that providing competent, equitable care for LGBT people and their families is part of what we do every day,” said Mark Laret, Chief Executive Officer of the University of California San Francisco Medical Center.


Through the HEI, the Human Rights Campaign Foundation surveyed 88 hospitals across the country and rated them on five areas of policy and practice: patient non-discrimination, hospital visitation, decision making, cultural competency training and employment non-discrimination.  With non-existent or incomplete state health laws and differing hospital policies that can lead to discrimination and inadequate health care for GLBT patients and their families, the HEI creates a baseline understanding of existing hospital policies, measures improvement from year to year, and establishes a gold standard for culturally competent care of GLBT Americans.


The 2008 Healthcare Equality Index is available online in PDF format: www.hrc.org/hei. The design and implementation of the report, to be released each spring, is conducted by the HEI Advisory Council, whose members include representatives from the healthcare industry and organizations serving the GLBT community.  The HEI will continue to expand its work on hospital policies to also include long-term care, assisted living, hospice, community health clinics and other branches of the healthcare industry in future editions.


The Gay and Lesbian Medical Association has been working since 1981 to ensure equality in healthcare for GLBT patients and healthcare providers, through advocacy, education, research and patient referrals.


The Human Rights Campaign Foundation is America’s largest civil rights organization working to achieve gay, lesbian, bisexual and transgender equality. By inspiring and engaging all Americans, HRC strives to end discrimination against GLBT citizens and realize a nation that achieves fundamental fairness and equality for all.



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State Healthcare Laws for GLBT Couples:  A Patchwork of Inequality


Due to incomplete and oftentimes inadequate state laws and differing hospital policies across the country, there are many challenges in guaranteeing equal health treatment for the GLBT community. The Healthcare Equality Index was created to help identify and promote the widespread adoption of standards that ensure equality and reduce discrimination in hospital-based healthcare.


Below is a list of state healthcare laws relating to the gay, lesbian, bisexual and transgender community:


      Laws governing medical decision making (i.e. whether or not one partner may make medical decisions for an incapacitated partner). These are laws that allow a partner, loved one, or caregiver to make decisions when no express advance directive exists.


Some states provide same-sex partners the same rights as different-sex spouses to make medical decisions for an incapacitated partner—these are: CO, CT (if partners enter into a civil union), DC (if partners enter into a DP), HI (if partners are reciprocal beneficiaries), ME, MA (if partners are married), NH (CU), NJ (CU), NM, OR (DP), VT (CU), WA (DP), and CA (DP)


Other states give same-sex partners second class status—e.g. if no “family member” is available, the partner can make a decision as a “close friend” (or similar term that may be used by the law).  These states are: AK, AZ, DE, FL, ID, IL, MD, MS, NY, ND, PA, SD, TN, UT, WV, WY


      Some states give partners equal hospital visitation rights on same terms as spouses—generally, are all states that recognize same-sex relationships in some way.  The states are:


CA (DP), CT (CU), DC (DP), HI (reciprocal beneficiaries), ME (DP), MA (marriage), NH (CU), NJ (CU), OR (DP), VT (CU), WA (DP)


Note: MD just passed a bill permitting partners to make medical decisions for incapacitated partners and providing equal visitation rights (same as spouse).  The Governor is expected to sign the bill into law.


      Every state, plus DC, permits express advance designation of a medical decision maker (e.g. through a health care power of attorney, a designated health care agent, or a living will).  That means someone can designate his or her partner as a decisionmaker as long as the designation is made in writing, often through a specific type of document like a living will or power of attorney.


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