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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.


Patient Non-Discrimination

The Non-Discrimination and Staff Training criteria in HRC’s national Healthcare Equality Index represents policies and practices that are considered foundational to LGBTQ patient-centered care. The first requirement is to have an LGBTQ-inclusive Patient Non-Discrimination policy.

To meet this requirement, healthcare organizations must implement and document a patient non-discrimination policy (or patients’ bill of rights) that:

  • Uses the terms “sexual orientation” and “gender identity” AND
  • Is communicated to patients in at least two documented ways

This HEI requirement reflects Joint Commission standard RI.01.01.01, EP 29 [PDF], 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.

Including the Terms “Sexual Orientation” & “Gender Identity” in Policy

When a healthcare organization includes the terms “sexual orientation” and “gender identity” in its patient non-discrimination policy, it sends an important message to patients and employees alike: LGBTQ people must receive equal treatment. In some cases, inclusion of these terms reflects 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” to a non-discrimination policy signals a clear and welcome commitment to equity and inclusion. As The Joint Commission LGBT Field Guide notes, explicit statements that healthcare organizations are committed to LGBTQ non-discrimination are deeply appreciated by LGBTQ members of the community and provide important guidance to employees.

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

Explicit prohibition of discrimination is foundational to LGBTQ patient-centered care. But as The Joint Commission LGBT Field Guide notes, it is also important to review patient services to ensure that LGBTQ people are treated equitably. Please see our page on Patient Services and Support for more information on how to conduct this review.

Informing Patients & Employees of Policy

As recommended by The Joint Commission LGBT Field Guide, the first requirement of the Non-Discrimination and Staff Training criteria also requires healthcare organizations with explicitly LGBTQ-inclusive patient non-discrimination policies to communicate those policies to their patients in two documented ways. This practice provides very welcome assurance to patients and important guidance to employees. To learn more about publicizing your policy, visit our page on Publicizing Your Patient Non-Discrimination and Equal Visitation Policies.

To receive full credit, HEI participants must document that they communicate their explicitly LGBTQ-inclusive non-discrimination policy to patients in at least two of the following ways:

  • Posted on facility website
  • 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)

HEI participants are also asked to communicate their LGBTQ-inclusive non-discrimination policy to employees.