Earlier this year when President Barack Obama signed a memorandum, calling for and end to discrimination against gay men and lesbians in hospital visitation policies, he set in motion potential changes that will significantly alter how LGBT people interact with the healthcare system.
But a new report of the nation's LGBT health care practices, released this week, found that far too many of medical care facilities have some way to go in implementing policies that are fully inclusive of gay people.
Representatives of the Human Rights Campaign ( HRC ) detailed results of the survey and report, called the Healthcare Equality Index 2010 ( HEI ) , for reporters last week during a telephone press conference. The analysis is included in a 72-page document, accessible at www.hrc.org/hei2010/index1.html . Working with the Gay and Lesbian Medical Association, the HRC Foundation produced the fourth annual HEI survey report and its findings.
Conducted October through December 2009, the HEI 2010 reviewed a representative sample of 200 of the largest healthcare facilities nationwide. The report found that in all 50 states—and even in historically LGBT-friendly cities like San Francisco and New York—some facilities still do not fully protect LGBT people from healthcare discrimination. In fact, a whopping 93 percent of healthcare facilities included in the study do not have fully inclusive policies while 42 percent fail to include "sexual orientation" in their non-discrimination policies for patients' bill of rights.
And yet there are success stories, including two Chicago-area health care facilities: Rush University Medical Center and Advocate Illinois Masonic Medical Center, both top performers that are national leaders in LGBT patient care.
This is the first year that Chicago-based Advocate Illinois Masonic, a 1,668 full-time employee, 408-bed facility, ranked as a top performer.
"Doing the right thing, really does pay off," wrote the hospital's vice president of human resources Marc A. Senesac and vice president of business development Michael Swarzman in a testimonial provided to HRC, adding, " [ Our ] relationship with Chicago's North Side LGBT community ... has attracted hundreds, if not thousands of new patients to the medical center annually.
Similarly, Rush, for the second time, ranked as a top performer. "We strive to make Rush a place where differences are not just accepted, but understood, respected, and valued," wrote Larry J. Goodman, MD, vice president and chief executive officer of the 7,502 full-time employee, 676-bed hospital, in his testimonial. "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."
But two other Chicagoland health care facilities failed to pass muster. Evanston Hospital, for example, does not include explicit mention of "sexual orientation" and "gender identity" in its non-discrimination policy, while Northwestern Memorial does not explicitly include "gender identity," according to the survey.
HEI 2010 also includes data from 178 facilities nationwide that voluntarily provided information about patients' bill of rights that are not only inclusive of sexual orientation and gender identity, but also about visitation policies granting same-sex couples the same access as opposite-sex ones and next of kin, and about LGBT cultural competency offered for training staff.
And for first time, HEI 2010 asked participants whether the health care facility offers at least one heath insurance plan that does not exclude coverage for transgender-related treatment and care that is medically necessary.
Of the 178 facilities nationwide, 11 individual facilities and one network of 36 hospitals received perfect ratings. Many have made advances over the last three years since the HEI began for years ago, according to the survey's findings
Meanwhile, Obama's presidential memorandum directs the Department of Health and Human Services to require all hospitals participating Medicare and Medicaid—private and non-profit facilities included—to respect the rights of patients to designate hospital visitors, having the same rights as immediate family members, and to assign representatives to make informed medical decisions for patients' care.
"The healthcare landscape for LGBT patients and their families is about to change dramatically," said Joe Solmonese, president of the HRC. "We all know horror stories of loved ones torn apart, already heart-wrenching decisions made even harder, and basic human rights denied."
Solomonese's comments refer to one of the most egregious examples of health-care policy insensitivity: the case of Lisa Pond. When Pond, a mother of four, was rushed to a Florida hospital emergency with a brain aneurysm, officials at Miami's Jackson Memorial Hospital initially denied visitation rights to her domestic partner of 18 years, Janice Langbehn—even though the couple produced a healthcare proxy. Finally, after hours of waiting and persistence, Langbehn accompanied a priest who said last rites for Pond.
During a telephone interview after the press conference, Langbehn voiced praise for the president's leadership. "Everything is moving in the right direction," she said. "I was worried that some piecemeal approach would be but together," adding, "But for couples like Lisa and me who had all the paper work, and it didn't work, it's too late."
Hospital officials also denied the couples' jointly adopted children from saying good-bye to their mother. "In the end, holding Lisa's hand had nothing to do with gay rights. It was about human rights."
To date, hospital administrators have still not offered an apology to the Ponds-Langbehn family. But the president called Langbehn from Air Force One April 15. "I am so sorry for what your family had to go through," said Langbehn, recalling Obama's comforting words. "For the president to say he was sorry, that was huge for me in moving on," she said. "It was a sincere apology."
Copyright 2010 by Chuck Colbert. All rights reserved.
