This criteria is designed to familiarize an organization with best practices, from The Joint Commission and other sources, to promote equity and inclusion for LGBTQ+ employees.
Reviewing the practices implemented by other organizations and recommended by experts, an organization can identify and address gaps in their policies and practices. A healthcare organization’s LGBTQ+ employees play a vital role in ensuring LGBTQ+ patient-centered care by informally educating their co-workers about patient concerns, offering feedback about organizational policies and practices, and conveying to the local community their organization’s commitment to equity and inclusion.
It is critical that LGBTQ+ employees, like LGBTQ+ patients, receive equal treatment, particularly vis-à-vis health-related benefits and policies. Competitive employer-provided benefits’ packages are critical to attracting and retaining talent. From healthcare coverage to retirement investments and more, ensuring LGBTQ+ inclusive benefits to employees and their families is an overall low-cost, high-return proposition for businesses. In addition, equitable benefits structures align with the principle of equal compensation for equal work. Apart from actual wages paid, benefits account, on average, for approximately 30 percent of employees’ overall compensation. Therefore, employers should ensure that this valuable bundle of benefits is equitably extended to their workforce, irrespective of sexual orientation and gender identity. When denied equal benefits coverage, the cost to LGBTQ+ workers and their families is profound.
These policies are also informed by the HRC Foundation’s Corporate Equality Index, or CEI. The CEI is the national benchmarking tool on corporate policies and practices pertinent to lesbian, gay, bisexual and transgender employees.
This criterion is divided into two scored subsections. The first subsection consists of 19 scored questions and like the other criterion sections you can either receive full or partial credit depending upon how many initiatives you have in place. The second subsection is related to the provision of transgender healthcare benefits for your employees and is worth 5 points.
There are 19 scored questions in this section, In order to receive full 15 points in this subsection, a facility must have at least 7 or more of these best practices in place. Facilities with 3 to 6 of these best practices in place will receive a partial score of 10 points.
Scored best practices include:
Healthcare benefits impacting gender diverse employees
The question in this subsection is scored independently and must be met in order to attain Leader status.
Equal health coverage for gender diverse individuals for medically necessary care. Baseline coverage MUST include the following items:
Covered transgender-inclusive treatments and procedures must be clearly listed in the contract documentation and the scope of each benefit must be described clearly in the employee benefits materials so that employees and their eligible dependents can easily understand what is covered
The plan must eliminate other barriers to coverage.
To receive credit, your facility must:
Upload current documentation of domestic partner coverage that clearly indicates unmarried domestic partners are eligible for healthcare benefits.
More information:
Learn more about why HRC strongly recommends continued provision of domestic partner benefits. See our white paper on this topic for more information.
Examples:
To receive credit, your facility must:
Upload documentation that describes your non-clinical family formation benefit options.
More information:
Inclusive financial assistance benefits for family formation benefits consist of a range of services that may include:
Surrogacy
Adoption
Foster Care Assistance
Assisted Reproductive Technologies (ART) including intrauterine insemination (IUI), in-vitro fertilization (IVF), and cryopreservation
Due to differences in laws and regulations from state to state, providing family formation benefits is crucial for access to these services for LGBTQ+ people. It is also important to remove barriers that limit LGBTQ+ people from accessing these benefits. For example, health plans often require a diagnosis of infertility for family formation benefits and have a definition for infertility that excludes many LGBTQ+ couples and hopeful single parents.
See our white paper on the importance of employers providing additional financial assistance for LGBTQ+ inclusive family formation
Examples:
Hunterdon Medical Center provides assistive family formation benefits that include both cryopreservation and adoption assistance.
To receive credit, your facility must:
Upload documentation that describes your fertility assistance benefits options and how they are LGBTQ+ inclusive.
More information:
RESOLVE: The National Infertility Association provides a variety of resources and information about insurance coverage, including a "Coverage at Work Toolkit" for Employers which includes an evidence-based guide on providing employee fertility benefits and a model policy.
Examples:
To receive credit, your facility must:
Must upload benefits documentation that clearly indicates coverage of HIV screening and PrEP
To receive credit, your facility must:
Upload a copy of your family and medical leave policy.
More information:
Examples:
To receive credit, your facility must:
Upload a copy of your paid family leave policy.
More information:
Fears of discrimination and financial concerns can prevent LGBTQ+ people from taking unpaid leave, which is why inclusive paid leave policies that consider the unique needs of LGBTQ+ people and diverse families are so important.
Examples:
To receive credit, your facility must:
Upload a copy of your bereavement leave policy.
Examples:
To receive credit, your facility must:
Upload a copy of your LGBTQ+ benefits guide or or upload materials that demonstrate how your benefits concierge service is promoted to employees.
More information:
While your facility may have LGBTQ+ inclusive benefits available, it is important that LGBTQ+ employees know about these benefits and how to access them. Insurance plan documentation can be complicated to understand and employees may not know how to access this information. A dedicated LGBTQ+ benefits guide or concierge service with an LGBTQ+ specialty can help remove these barriers and allow LGBTQ+ employees to understand and access important benefits.
Examples:
To receive credit, your facility must:
Provide who your healthcare insurer is, how the benefit is communicated to employees, and upload the summary plan documentation (or summary material modification documentation) that is readily available for all employees both prior to selecting and after enrolling in the plan that explicitly indicates coverage is available.
More information:
Equal health coverage for transgender individuals for medically necessary care. Baseline coverage MUST include the following items:
Covered transgender-inclusive treatments and procedures must be clearly listed in the contract documentation and the scope of each benefit described clearly in the employee benefits materials so that employees and their eligible dependents can easily understand what is covered. The plan must eliminate other barriers to coverage.
For the HEI, facilities must submit three different documents to validate and prove the availability of these benefits.
More information:
Examples:
To receive credit, your facility must:
Provide who your healthcare insurer is, and how the benefit is communicated to employees, and upload the summary plan documentation (or summary material modification documentation) that is readily available for all employees both prior to selecting and after enrolling in the plan that explicitly indicates coverage is available. Coverage must be provided for at least three of the following:
Examples:
In order to receive credit, a facility must:
Upload a copy of the gender transition guidelines.
More information:
It is often said that when a person transitions gender, everyone around them transitions along with them. In other words, a workplace transition involves change not only for the employee but also for their manager, colleagues and clients.
Business leaders know the importance of proper planning, communication and training in implementing successful organizational change. A successful gender transition is no different. A little planning can go a long way to ensuring a successful outcome for all involved — the transitioning employee, managers, colleagues and clients/customers.
Gender transition guidelines, a written set of guidelines to manage an on-the-job gender transition, outline protocols for gender transitions that clearly delineate responsibilities and expectations of transitioning employees, their supervisors, colleagues and other staff.
Here are some examples of gender transition guidelines:
In order to receive credit, a facility must:
Provide the contact information of the group and either provide a public webpage for the group or upload other documentation demonstrating how employees are made aware of this group.
More information:
Visit our comprehensive page on LGBTQ+ employee groups to learn about the different types of groups organizations have, the objectives of such groups, see example established employee resource groups, and more information on establishing an employee group or expanding your existing group.
Examples:
In order to receive credit, a facility must:
Provide a link to a website describing the work of this office/council OR upload a document demonstrating that LGBTQ+ diversity is part of its mission.
Examples:
In order to receive credit, a facility must:
Upload a copy of the survey and/or the results demonstrating the inclusion of LGBTQ+ demographic measures.
More information:
Examples:
In order to receive credit, a facility must:
Upload a copy of the survey and/or the results demonstrating the inclusion of LGBTQ+ specific questions.
More information:
Examples:
In order to receive credit, a facility must:
Provide a screenshot of the demographic section of its HRIS showing sexual orientation and gender identity options.
More Information
Examples:
In order to receive credit, a facility must:
Provide validation of an internally held and employee-focused LGBTQ+ awareness day such as newsletter article, photos, flyer.
More information:
Some LGBTQ+ awareness days your facility might celebrate include (but are not limited to):
International Transgender Day of Visibility
Observed each year on March 31st to celebrate the courage it takes to live openly and authentically while also recognizing the leadership of transgender and gender nonconforming trail blazers who have led the charge in the fight for equality.
LGBTQ+ Pride Month
Occurs annually during the month of June (although Pride celebrations may be held during other times of the year). Pride is a time when many cities and towns host Pride parades, movie screenings, symposia, and more to celebrate LGBTQ+ history and identities.
Celebrate Bisexuality Day
Falls on September 23rd annually as a day to recognize and celebrate the bisexual community.
LGBT History Month in October
Celebrates the achievements of lesbian, gay, bisexual or transgender icons. The month provides role models, builds community and makes the civil rights statement about the LGBTQ+ community’s national and international contributions.
National Coming Out Day
Occurs on October 11th every year as a day to celebrate coming out as lesbian, gay, bisexual, transgender, queer or as an ally.
Spirit Day
Observed annually on October 16th where millions of people wear purple to stand against bullying and show their support for LGBTQ+ youth.
Transgender Day of Remembrance
Occurs annually on November 20th as an opportunity for communities to come together and mark the passing of transgender and gender-variant individuals—or those perceived to be transgender—who have been murdered because of hate.
Examples:
NYC Health and Hospitals – North Central Bronx held an internal celebration before they attended New York City Pride.
VA Robley Rex Medical Center’s internal ceremony to celebrate their Leader designation to celebrate Pride.
View Anderson County Hospital’s internal event with cupcakes to celebrate LGBT History Month.
Clinical staff at Crittenton Children’s Center created an interactive presentation at their “Dance to Your Own Music” event to celebrate LGBT History Month.
Northwell Health celebrated National Coming Out Day while also promoting their employee resource group and HEI participation.
To receive credit, your facility must:
Describe how hiring efforts are proactively LGBTQ+ inclusive and upload any related materials. Simply having an employment non-discrimination statement that includes “sexual orientation” and “gender identity” posted on job descriptions or career website does not count for this criterion.
More information:
See our page on LGBTQ+ professional recruitment events to find recruitment or career events with a national focus. You can also reach out to your local LGBTQ+ community center to see if there is an LGBTQ+ job fair in your area.
Examples:
To receive credit, your facility must:
Provide the name of the person and their position. This must be a senior/executive-level administrator at your facility.
More information:
The presence of visible LGBTQ+ employees in management communicates to the LGBTQ+ employees of your company that their company is open and accepting and enables LGBTQ+ employees to be open at work, which in turn improves their engagement and retention.
Check out HRC's "The Cost of the Closet and Rewards of Inclusion" report which finds that despite a changing social and legal landscape for LGBTQ+ people, still over half (53%) of LGBTQ+ workers nationwide hide who they are at work.
