The HEI 2022 survey will open at the beginning of June 2021 and close at the end of August 2021 for the majority of facilities. LGBTQ Healthcare Equality Leaders that are eligible for the recertification process will have a much shorter survey and an earlier deadline at the end of July 2021.

In 2019, the Human Rights Campaign Foundation’s Health and Aging program announced the launch of the Long-Term Care Equality Index in partnership with SAGE. Modeled after the HEI, the LEI will help long-term care residential communities become more LGBTQ inclusive. Because the amount of work to implement the HEI and similar surveys is quite substantial and we have a very small team, the HEI will be offered in alternating years to the LEI.

The foundational policies and training that comprise Criteria 1 have always been a key component to the HEI. For many years the policies and training of Criteria 1 determined HEI Leader status. In an effort to recognize facilities that are earlier in their LGBTQ inclusion journey and encourage their participation in the HEI, we created this tier of recognition.

In analyzing the HEI criteria over the past two years, we realized that facilities are capable of achieving a score of 80-95 while missing key foundational policies and practices from Criteria 1. The previous HEI criteria also allowed facilities to overlook areas of inclusion in Criteria 2, 3, and 4. In an effort to provide the LGBTQ community confidence that facilities are working with a well-rounded approach to LGBTQ inclusion, we now require full credit in Criteria 1 and at least partial credit in criteria 2, 3, and 4.

We believe that it is important for all staff at a healthcare facility to receive basic training in LGBTQ competent care, yet we have always only required a very minimal amount (25 hours) of training hours. Over time, we have noticed that our larger facilities (>500 employees) have been held to the same training hours requirement as some of our smaller critical access facilities and outpatient clinics. In an effort to provide fairness to our facilities (and encourage greater LGBTQ training), we increased the hours required for our largest facilities. Facilities with over 500 employees now must have 50 hours of training in LGBTQ patient-centered care.

We do not anticipate this higher threshold to be a hindrance to our larger participating facilities.

As more healthcare facilities begin to offer or require LGBTQ training to all of their employees, we have seen that the majority of our healthcare facilities are easily exceeding our minimum. Additionally, we are accepting any training completed since June 1, 2020, through the survey deadline of August 31, 2021, to meet this requirement.

If your facility participated in the HEI 2020, we will send the official submitter a Facility-Customized Needs Assessment in early 2021. This will include your 2020 responses, national benchmarks, a 2022 preliminary score calculation, and tier breakdown applying your HEI 2020 responses to the HEI 2022 criteria.

The HEI is an annual online survey. Created in 2007, the HEI has been designed to meet the needs of all healthcare organizations seeking to provide optimal care to LGBTQ patients and to meet CMS and Joint Commission requirements related to this underserved population.

The HEI scoring criteria rates hospitals and healthcare facilities on policies and best practices in LGBTQ patient centered care in four key areas: Non-discrimination and staff training; Patient services and support; Employee benefits and policies; and Patient and community engagement.

The HEI is open to all healthcare organizations in the U.S. with 100 or more employees, whether inpatient or outpatient, network or individual facility. Inpatient facilities are particularly encouraged to participate, and constitute the majority of participants.

Clinic organizations with multiple locations such as FQHCs (and FQHC look-alikes), Planned Parenthood Affiliates and other similarly structured organizations are eligible to participate - however, they have special guidelines related to meeting the training criteria.

LGBTQ patients face very significant challenges in healthcare: 56% of lesbian, gay, and bisexual people report experiences of serious discrimination in healthcare, while 70% of transgender people report serious discrimination. In response, CMS and The Joint Commission have issued requirements for LGBTQ equity and inclusion, and expert recommendations have now emerged for LGBTQ patient-centered care.

The HEI enables healthcare organizations to assess their own policies and practices vis-à-vis these requirements and recommendations, and equips them with the training and resources they need to remedy gaps. It also enables organizations to receive public recognition for their commitment to equity and inclusion.

Hundreds of healthcare organizations nationwide have participated in the HEI to:

• Increase patient safety and satisfaction
• Comply with CMS and Joint Commission requirements
• Minimize risk and maximize quality
• Enhance their reputation for equity and inclusion

And HEI participants enjoy these unique benefits:

• Access to free, expert online training for staff at all levels
• Customized analysis of potential gaps, with resources for addressing them
• Public recognition for their commitment to equity and inclusion
• Tools for outreach to LGBTQ community members

As an online survey, participation in the HEI requires a login. If your organization does not already have a login, you can register to receive one and view the HEI survey with no obligation. The HEI can be completed by any number of people within an organization, as--the HEI login can be shared,—but each organization is asked to designate an “official submitter” to review and submit the HEI.

Organizations answer a series of questions about LGBTQ policies and best practices and are required to upload supporting documentation to validate many of their responses. Participating organizations will receive a summary of their score after the HEI staff has reviewed their submission and will have an opportunity to provide additional information or supporting documentation to address any deficiencies.

The HEI, including the extensive training offered to participating organizations, is offered free of charge, as an educational program of the HRC Foundation.

Since we are moving to an every other year cycle, the next HEI will be the HEI 2022. We are currently working on the timeline for the HEI 2022 and anticipate that the survey will open in the second half of next year. We will let you know once we finalize the timeline, criteria, etc. However, we do not expect major changes to the criteria questions so you can use the HEI 2020 criteria to help you prepare.

All organizations participating in the HEI may register staff for acclaimed, expert online training—in fact, training is required to be awarded HEI Leader status. Complete details are available within the HEI.

Survey participants that meet the new HEI Scoring Criteria are designated as a Leader in LGBTQ Healthcare Equality. The Leader designation signals to LGBTQ patients and allies that the healthcare facility has meet the foundational elements of LGBTQ patient-centered care. Prior to the release of the HEI report, Leaders receive the coveted HEI Leader logo for their use, as well as extensive resources for publicizing their achievement and conducting outreach to LGBTQ community members.

HEI staff will notify all survey participants whether or not they have received Leader status once the review of that facility’s survey is complete.

We are moving to an every other year cycle. We will let you know once we finalize the timeline and any changes to criteria. The HEI is revised each cycle to incorporate new issues and resources related to LGBTQ patient-centered care, and Leader status is determined by an organization’s responses to the HEI in that cycle.