Patient Non-Discrimination

Patient Non-Discrimination

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Why an LGBTQ+ Inclusive Patient Non-Discrimination policy?

LGBTQ+ people experience many forms of discrimination in healthcare because of their sexual orientation (lesbian, gay, and bisexual people) and/or their gender identity (transgender people).

A large survey by Lambda Legal, “When Health Care Isn’t Caring” revealed that:

  • 56% of lesbian, gay, and bisexual respondents had experienced serious discrimination in healthcare
  • 70% of transgender respondents had experienced serious discrimination
  • 73 percent of transgender respondents and 29 percent of lesbian, gay and bisexual respondents reported that they believed they would be treated differently by medical personnel because of their LGBTQ+ status

Adding the words “sexual orientation” and “gender-identity or expression” to a facility website, patient bill of rights poster or brochure can help to alleviate these very real worries LGBTQ+ patients face when receiving care. Explicitly inclusive language not only allows LGBTQ+ patients and families to feel safe and welcomed at a facility – it can be the deciding factor for an LGBTQ+ patient when determining where to receive care.

Creating and broadly communicating a patient non-discrimination policy that includes both “sexual orientation” and “gender identity or expression” is a crucial step in ensuring equitable, high-quality care for LGBTQ+ patients. It sends an important message to patients and employees alike: LGBTQ+ people must receive equal treatment. In addition, Section 1557 of the Affordable Care Act prohibits sex discrimination in any hospital or health program that receives federal funds, and the U.S. Department of Health & Human Services, Office of Civil Rights, has issued regulations that this prohibition extends to claims of discrimination based on gender identity and sex stereotyping.

It has become common for organizations’ non-discrimination statements to include the terms “sexual orientation” and “gender identity.” For example, leading healthcare provider organizations have adopted policies that prohibit discrimination against LGBTQ+ people by including the terms “sexual orientation” and “gender identity.”

In some cases, inclusion of these terms reflect state law, affirming that the organization is aware of and committed to legal requirements of non-discrimination. In areas without a state law prohibiting LGBTQ+ discrimination, adding “sexual orientation” and “gender identity or expression” to a non-discrimination policy signals a clear and welcome commitment to equity and inclusion.

Joint Commission Standard

This HEI requirement reflects Joint Commission standard RI.01.01.01, EP 29, which calls on accredited facilities to prohibit discrimination based on both “sexual orientation” and “gender identity or expression.” The HEI criteria also reflects the recommendations of The Joint Commission LGBT Field Guide.

An explicitly LGBTQ+ inclusive patient non-discrimination policy, together with comprehensive staff training, can do much to reduce the discrimination that LGBTQ+ patients experience in healthcare settings.

It is important to note that The Joint Commission Standard on patient non-discrimination does not currently require the adoption of a written non-discrimination policy. This is a requirement of the HEI. However, a written policy is one of the surest ways to confer adherence to The Joint Commission Standard and it conveys an organizational commitment to LGBTQ+ non-discrimination.

To receive credit in the HEI:

  • An organization must document that both terms, “sexual orientation” and “gender identity or expression” are included in their Patient Non-Discrimination policy.
  • The policy must be communicated to patients in at least two of the following ways:
    • Posted on facility website
    • Posted or displayed in waiting rooms and other public areas of the facility
    • In materials routinely given to patients at admitting/registration
    • In materials routinely given to patients at other time(s)
    • In materials routinely available for take-away in patient waiting areas
    • Posted in patient waiting area(s)
  • The policy must be communicated to employees in at least one of the following ways:
    • Posted on facility intranet site
    • Posted in employee work area(s)
    • In materials routinely given to employees at orientation
    • Reviewed in in-person employee training
    • Reviewed in online employee training

HEI Scored Questions