First-ever index will measure treatment of LGBTQ+ residents in senior living


Elder advocacy group SAGE and the Human Rights Campaign Foundation today are announcing plans for what they believe is the first-ever nationwide tool to assess how well senior living and other long-term care facilities are treating residents who are lesbian, gay, bisexual, transgender or queer.

Plans for the voluntary Long-Term Care Equality Index, or LEI, will be unveiled today at the American Society on Aging’s annual Aging in America conference in New Orleans. It will be part of a broader partnership between SAGE and HRC that will include a nationwide campaign to raise awareness of the specific needs of LGBTQ+ older adults.

“All too often, LGBTQ+ elders do not receive the care and support they deserve,” HRC President Chad Griffin said in a statement. “With experts predicting that as many as 4.7 million LGBTQ+ elders will be seeking care and services by the year 2030, the time to act is now.”

Griffin called the effort “historic.”

The index, according to SAGE CEO Michael Adams, “will be an essential complement to the cultural competency training that SAGE provides across the country.”

Launching in 2021, the LEI survey and report will focus on a range of residential facilities for the elderly, including independent living, assisted living, memory care and continuing care retirement communities as well as skilled nursing and hospice facilities, Tari Hanneman, director of the HRC Foundation Health Equality Project, told McKnight’s Senior Living.

Hanneman said the groups anticipate, when the LEI is in place, a set period of three to four months during which communities will complete the online survey, submitting documentation, such as a copy of their LGBTQ+-inclusive nondiscrimination policies, to demonstrate that they meet the survey criteria. Training and technical assistance will be available before the launch and year-round afterward, to help facilities meet the survey criteria, she added.

Commitment to Caring pledge available now
Before the LEI is in use, senior living and other long-term care providers can choose to show their support by signing SAGE’s and the HRC Foundation’s “Commitment to Caring” pledge. The American Society on Aging is the first signatory to the pledge.

The pledge will be available after the survey is launched, too, Hanneman said, although providers that already have LGBTQ+-inclusive policies and practices and believe they are ready to complete the survey can skip the pledge step if they choose to do so.

Modeled after Healthcare Equality Index
The index is expected to be modeled after the HRC Foundation’s 12-year-old Healthcare Equality Index, or HEI, which scores healthcare facilities on their LGBTQ+-friendly policies and practices. An advisory council being formed will make decisions related to the process, Hanneman said.

Since the HEI’s debut in 2007, approximately 1,500 healthcare facilities — mostly short-term, acute-care hospitals but also some specialty facilities, including long-term care facilities (which will move to the new survey), and some outpatient facilities such as federally qualified health centers or specialty clinics covering reproductive health, HIV services and fertility care — have adopted LGBTQ+-inclusive policies and practices, Hanneman said. The number of active survey participants continues to increase each year, with 626 facilities participating in 2018, she added.

The HRC Foundation recently began scoring all of the best practices and policies that the foundation has been recommending for years and in the first year recorded “significant” increases related to facilities that were adopting them, Hanneman said.

For example, Hanneman said the foundation observed:

  • A 118% increase in the number of healthcare facilities that record sexual orientation information.
  • A 93% increase in the number of healthcare facilities that record gender identity information.
  • A 59% increase in hospitals that have written gender transition guidelines.
  • A 42% increase in hospitals with trans-inclusive benefits.
  • A 63% increase in the number of LGBTQ+ care training hours recorded.

Also, she said, 68% of facilities indicated that they provide access to pre-exposure prophylaxis for patients.

This article originally appeared in McKnight’s Senior Living on April 15, 2019.
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