Before the July move of the Brown Elephant resale shop on Halsted to a new location at 3020 N. Lincoln Ave, Howard Brown Health Center ( HBHC ) staff are holding a series of six community town-hall meetings at the store that, according to the HBHC, will help the organization "assess our strategies and champion better systems of care for the diversity of the LGBTQ community."
The first of those meetings was held May 12 and dealt with the healthcare concerns of older members of the LGBTQ community. "This is about listening to you talk about what you like about Howard Brown and what you don't," HBHC Vice President of Development and Communications Barbara Tieder said before introducing the evening's two facilitatorsMedical Director Dr. Magda Houlberg, MD, and Director of Geriatric Education Cecilia Hardacker.
The pair was armed with easel pads and magic markers to take down the issues and suggestions raised by attendees from across the spectrum of the community who filled every seat that had been placed in a window-front corner of the grand building. "Hopefully this will be something that helps develop programming and policy at HBHC," Hardacker said. "I think that's the fundamental reason that we're all here."
Among the questions raised was what can be done to further competency training for medical staff and social service agencies that are not always aware of the respectful way to address and deal with patients. "I recently got married and it's been suggested that I carry my marriage-license ID in my billfold for medical care," one attendee named Andy said. "We have laws in place, but the discrimination is still really bad. General services in the country need to be tolerant and supportive of us."
The issue was also highlighted as a problem for the trans* community whoat bestare often mispronouned when seeking medical help. Some are even both mentally and physically abused by their providers. "We may end up in a nursing facility struggling with dementia or Alzheimer's," a trans client at HBHC noted. "For somebody to go after you because you're not appearing physically as you should is something I am fearful of."
Attendees expressed an overall need to increase access to knowledge about services and programs while strengthening collaboration among existing partners. Other concerns included the over-medication of patients by doctors, the need for comprehensive health care and an increase in support and social groups for elder members of the community.
"I'm really excited because most of the things we are talking about here are already things we are doing at Howard Brown," Hardacker said. "For example our cultural competency training specifically for health care providers is very in depth and includes an intensive module on trans* health and covers the spectrum of issues that are out there for aging LGBTQ individuals."
Hardacker added that a primary goal has been providing a list of medical resources and sites that are LGBTQ competent. One such directory will be accessible on both the HBHC and Center on Halsted websites within the next couple of weeks; however Hardacker noted that securing participants has been difficult. HBHC reached out to about one hundred long-term care providers within the Chicago city limits and only 15 respondents had any kind of LGBTQ awareness with many not responding at all or replying 'we don't have anyone gay here.' However, list developers assured attendees that this was "just the beginning of the conversation."
Houlberg admitted thatwhen it comes to assessing, monitoring and measuring LGBTQ competencyno assumptions should be made about medical providers. "Certainly individual care providers may view themselves as competent," she said. "But many timeswhile they may be well meaningthey don't know what they don't know. I think you can teach people a lot but motivation from service providers is the biggest issue."
In terms of law as it relates to trans* discrimination in health care, Houlberg noted that one of the most valuable things about health care reform has been a lot of specific language around gender discrimination. "But it isn't defined very well," she said. "The way it's conceptualized is more like 'if you offer it for a man, you need to offer it for a woman.' But that language can be turned on its head. Certainly, you'll see more and more of those battles being fought in terms of coverage for trans* health care."
She went on to say that the Human Rights Campaign's Health Equality Index has held organizationssuch as area hospitalsaccountable for the way they treat their LGBTQ patients. "It's clearly on someone's radar in the leadership sense, but not every hospital has recognized that [the index] is a valuable thing," she asserted.
There seemed to be a general consensus among attendees thatfor nowthe threat of a lawsuit remains the most effective weapon against discrimination or incompetent care of the LGBTQ community.
"When are we going to try and search for a comprehensive solution?," an attendee named David asked. "Comprehensive health care for all? We have a strong community but we've been battered around with all kinds of health issues and if we don't fight for it, who the hell is going to?"