If a healthcare organization follows a religious directive or has a policy in place that prevents them from providing specific medically necessary treatments, such as hysterectomy or mastectomy, to some patients based on a diagnosis of gender dysphoria, but allows them to provide the same treatment to other patients based on other diagnoses, this may result in discriminatory treatment that is in conflict with their non-discrimination policy. However, there are ways to mitigate the risk of discriminatory treatment to LGBTQ patients. This option outlines the steps a hospital must take in order to only receive a 5-point deduction and be listed in the HEI.
Organizations with this type of directive or policy in place may only be subject to a five-point deduction (to offset the points received for the Patient Non-Discrimination Policy) if they take the following actions to mitigate the potential for discriminatory situations to occur. In order to only receive this 5 point deduction and to be listed in the HEI, the organization must take affirmative action to clearly communicate the existence of the directive or the policy and what services they do not provide to help prevent potential discriminatory situations.
- Provide a transparent and easy-to-find statement on their website (or the health system website) about what procedures and services they do not provide and why. If the organization has an LGBTQ services page, this statement must be on that page or very clearly linked to from that page; AND
- Have in place a clear referral mechanism to hospitals in the same geographic area that do provide these procedures and clearly communicate this referral process on the same webpage as above; AND
- Clearly communicate this limitation in their services to all area surgeons that would perform any of the procedures in question that have privileges at their hospital(s) and ensure that the surgeons know at what hospitals they should seek to provide these services.
After taking these communication steps an organization would only be assessed a 5 point deduction. If after this deduction, the organization has a final score of between 80-95 and meets the other criteria for earning the Top Performer designation (full credit in criteria 1 and at least partial credit in criteria sections 2, 3, & 4), the organization may earn the Top Performer designation.
Organizations that choose not to take these mitigating steps would be subject to the full 25 point deduction. Organizations that take these steps and later have a discriminatory incident may be subject to the full 25 point deduction.
HEI 2022 Exception
Typically, the HEI provides a minimum of a year’s advance notice prior to implementing any major scoring criteria change. Since this change to the Responsible Citizenship criteria has been announced during the HEI 2022 cycle, HEI participants that would receive the deduction have the option to completely opt-out of being listed in the HEI 2022 rather than being listed with the deduction. If an organization chooses to opt-out, they will not be counted as an HEI 2022 participant and they will not have a scorecard on our facility search website.