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Healthcare Equality Index

The Healthcare Equality Index (HEI) is the national LGBTQ benchmarking tool that evaluates healthcare facilities’ policies and practices related to the equity and inclusion of their LGBTQ patients, visitors and employees. The HEI 2016 evaluates a total of 2,061 healthcare facilities nationwide.


HEI Scoring Criteria

The Healthcare Equality Index 2017 uses a new scoring criteria that was announced in 2015 and implemented during this survey cycle. Since its inception in 2007, the HEI has successfully encouraged hospitals and other healthcare facilities across the nation to adopt LGBTQ-inclusive patient, visitation and employment policies. Over time and due to decade of advancement in LGBTQ inclusion in daily life, healthcare facilities have worked harder than ever to increase their work to provide equitable care for the LGBTQ community -- and now the HEI survey reflects and promotes these efforts through its new scoring criteria.

Previously, in the HEI 2016 Survey, a facility would earn the designation of “Leader in LGBT Healthcare Equality” by meeting all of the HEI Core Four Leader Criteria. Under the new scoring system, a facility needs to receive a score of 100 points to be designated as a “Leader in LGBTQ Healthcare Equality.” Facilities receive points for meeting specific requirements and by having a certain number of best practices and policies in place.

Download a PDF summary of the HEI 2017 Scoring Criteria

The HEI 2017 implements four new core objectives:

  • Ensure foundational protection for patients, visitors and staff in patient and staff policies and provide cultural competency training on LGBTQ inclusion
  • Demonstrate progress toward inclusion on LGBTQ patient care and support
  • Cultivate an inclusive workforce by providing LGBTQ-inclusive employee support and benefits
  • Demonstrate public commitment to the LGBTQ community

The survey is divided into five scoring criteria:

  1. Non-Discrimination & Staff Training

  2. Patient Services & Support

  3. Employee Benefits & Policies

  4. Patient & Community Engagement

  5. Responsible Citizenship

With the exception of the Non-Discrimination & Staff Training criteria, which contains the previous Leader criteria, the scoring criteria for the HEI was intentionally designed to be flexible and to allow facilities to select from a menu of best practices in order to receive points for that section. Facilities may receive full, partial or no credit for each criteria depending upon how many of the policies and practices they have in place. In many cases, a facility will be required to upload documentation to validate implementation of the best practice.  Credit will not be given for policies and best practices that cannot be validated.

1.  Non-Discrimination & Staff Training - up to 40 points

The questions in this criteria reflect the previous “Core Four” Leader criteria. This section will keep its specific questions that must be met in order to receive the allotted points:

 A.  Patient Non-Discrimination Policy - 10 points

    a.  Patient Non-Discrimination Policy includes both Sexual Orientation & Gender Identity - (5 points)

    b.  Patient Non-Discrimination Policy is communicated in two documented ways to the public AND the policy is communicated to staff - (5 points)

B.  Equal Visitation Policy - 10 points

    a.  Equal Visitation Policy - (5 points)

    b.  Equal Visitation Policy is communicated in two documented ways to the public AND the policy is communicated to staff - (5 points)

C.  Employment Non-Discrimination Policy - 10 points

    a.  Employment Non-Discrimination Policy includes both Sexual Orientation & Gender Identity - (5 points)

    b.  Employment Non-Discrimination Policy is communicated in one documented way publicly.

D.  Staff training in LGBTQ Patient Centered Care - 10 points

    a.  Staff training requirement is met - (5 points)

    b.  Patient care services staff is informed of the free HEI training opportunities - (5 points)


2. Patient Services & Support - up to 30 points

The questions in this criteria all relate to best practices in the provision of LGBTQ Patient Services & Support. The 19 scored questions in this criteria come from the following sections of questions from the former Additional Best Practices Section of the HEI Survey:

A. LGBTQ Patient Services

B. Transgender Patient Services 

C. Patient Self-Identification

D. Medical Decision Making

  • In order to receive full credit (30 points) for this criteria, a facility must have implemented 10 or more of the best practices.
  • A facility may receive partial credit (15 points) for this criteria if it has implemented 5 to 9 of the best practices.


3. Employee Benefits & Policies - up to 20 points

The questions in this criteria all relate to best practices in the policies and benefits that most impact LGBTQ employees. The 16 scored questions in this criteria can all be found in the former Additional Best Practices' Section E. Employee Benefits & Policies.

  • In order to receive full credit (20 points) for this criteria, a facility must have implemented 9 or more of the best practices.
  • A facility may receive partial credit (10 points) for this criteria if it has implemented 4 to 8 of the best practices.


4.  Patient & Community Engagement - up to 10 points

The questions in this criteria all relate to how a facility engages with their LGBTQ patients and the larger LGBTQ community.  The 7 scored questions in this criteria can all be found in the former Additional Best Practices' Section F. LGBTQ Patient & Community Engagement

  • In order to receive full credit (10 points) for this section, a facility must have implemented 4 or more of the best practices.
  • A facility may receive partial credit (5 points) for this section if it has implemented 2 to 3 of the best practices.