By Sandra Basu
WASHINGTON – VHA facilities were recognized for their efforts to provide equal treatment to lesbian, gay, bisexual and transgender (LGBT) patients in VHA facilities in a newly released annual report.
The Healthcare Equality Index (HEI) 2013 survey, which asks participants questions regarding LGBT patient and employee nondiscrimination at their facilities, was released by the Human Rights Campaign (HRC) Foundation last month.
For the HEI 2013 survey, 718 facilities from around the country participated, including 121 of the 151 VHA facilities. Nearly 80% of the participating VHA facilities were awarded “Leader in LGBT Healthcare Equality” status in 2013.
Speaking at an event at VA headquarters where the report was released, VHA Principal Deputy Under Secretary for Health Robert L. Jesse, MD, PHD, said that VHA was “extremely proud” of the widespread participation of its facilities in the survey, especially given that in 2012 only one VHA facility had participated in the survey.
He explained that among the more than 8 million veterans who are enrolled to receive care at the VA, many identify themselves as lesbian and gay, bisexual or transgender.
“Many VA medical centers now have a LGBT special emphasis group and a designated LGBT special emphasis program manager to assist in increasing LGBT awareness, cultural competency, community outreach and recruitment and retention efforts,” he said.
The HRC Foundation developed the Healthcare Equality Index to meet “the need for equitable knowledgeable, sensitive and welcoming healthcare, free from discrimination based on LGBT status,” the report explained.
Survey participation offers healthcare facilities a way to affirm that they are complying with standards set forth by The Joint Commission and the Centers for Medicare and Medicaid Services in providing care for LGBT patients, according to the report.
The 2013 HEI survey period spanned late 2012 to early 2013. One part of the survey, the “Core Four Leaders Criteria” section asked participants about their policies in four areas: patient nondiscrimination, equal visitation, employment nondiscrimination and training in LGBT patient-centered care.
Participants were asked not only to provide documentation of these policies but also to demonstrate how these policies are being made known to patients and staff. For example, medical facilities were asked not only to document that their visitation policy provides equal visitation to LGBT patients and their visitors but that this policy is readily accessible to patients and employees. In addition, participants were asked to provide information about training to key facility employees in LGBT patient-centered care.
In order to achieve “Leader in LGBT Healthcare Equality” status, as 91 VHA facilities achieved for 2013, the medical centers had to meet the criteria and show documentation for all Core Four criteria for LGBT patient-centered care. Overall, 464 healthcare facilities from around the country achieved the designation.
The widespread participation in the survey by VHA facilities came in the wake of the 2011 repeal of “Don’t Ask, Don’t Tell,” when VHA created a workgroup to identify ways to “optimize care” for LGBT veterans, according to report. One of the group’s recommendations was that VHA medical facilities should be encouraged to participate in the survey.
The agency has implemented several policies in recent years to address the needs and concerns of the LGBT community, the agency says. Since 2009, VA has included equal employment opportunity protections for employees on the basis of sexual orientation in the Secretary’s Annual EEO, Diversity, and No FEAR Policy Statement. VHA has also issued a policy statement providing for patient visitation rights in support of the needs of LGBT family members. Additionally, the agency has also issued a policy directive on delivery of health care to transgender and intersex individuals.
According to VA’s Office of Diversity and Inclusion website, “future activities planned include expanded cultural competency training on LGBT issues, developing an inclusive language guide, and standing up an Office of Health Equity to address LGBT health care issues, among others.”
A 2011 Institute of Medicine report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, noted that one of the barriers to accessing quality health care for LGBT adults is “a lack of providers who are knowledgeable about LGBT health needs as well as a fear of discrimination in health care settings.” That report pointed to the need for more research on this population to understand their health needs.