The HRC Foundation released the 11th edition of its annual Healthcare Equality Index (HEI), which scores healthcare facilities on policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ patients, visitors and employees. A record 626 healthcare facilities actively participated in this year’s survey, committing to LGBTQ-inclusive policies and practices. Of facilities surveyed, 418 earned a top score of 100, and received HRC’s coveted “Leader in LGBTQ Healthcare Equality” designation. In addition, the HRC Foundation proactively researched key policies at more than 900 non-participating hospitals across the nation.

The release of the 2018 HEI coincides with today’s deadline for public comments on the proposed Trump-Pence so-called “conscience” regulation at the U.S. Department of Health and Human Services. The measure will directly harm LGBTQ people and women by prioritizing physicians’ beliefs over life-saving patient care. If finalized, it would empower health care providers to deny LGBTQ people and women necessary care, and deter healthcare organizations and providers from taking necessary action to guarantee that all patients have access to the care they not only deserve, but are legally entitled to.

“At a time when health care and the rights of LGBTQ people are under attack by the Trump-Pence Administration and state legislatures across the country, hundreds of top healthcare facilities are driving progress toward equality,” said HRC President Chad Griffin. “These top-scoring facilities are not only establishing policies that save LGBTQ lives every day, they have become vocal advocates for equality in the public square. This year, we are heartened to see corporate champions, including many healthcare systems, not just speaking out, but also doubling down on their commitment to equality.”

The 11th edition of the HEI marks the second year that participants have been given a numerical score based on their LGBTQ-inclusive policies and practices. HEI participants are assessed on four criteria: LGBTQ Patient-Centered Care, LGBTQ Patient Services and Support, Employee Benefits and Policies, and LGBTQ Patient and Community Engagement.

In the 2018 report, an impressive 418 facilities earned HRC’s “LGBTQ Healthcare Equality Leader” designation, receiving the maximum score in each section and earning an overall score of 100. Another 95 facilities earned the “Top Performer” designation for scoring from 80 to 95 points. With 82 percent of participating facilities scoring 80 points or more, health care facilities are demonstrating concretely that they are going beyond the basics when it comes to adopting policies and practices in LGBTQ care.

The remarkable progress reflected in the 2018 HEI include:

• 59 percent increase in hospitals that have written gender transition guidelines;
• 42 percent increase in hospitals that offer trans-inclusive benefits;
• 21 percent increase in the number of participants that have transgender-specific policies;
• 63 percent increase in training hours recorded - clocking in at more than 70,000 hours of LGBTQ care training provided.

Of the hospitals that did not actively participate in the HEI, but were included based on HRC Foundation research, only 63 percent have patient non-discrimination policies that include both sexual orientation and gender identity, and only 53 percent were found to have an LGBTQ-inclusive employment non-discrimination policy. The equal visitation policy, at 93 percent, is the only one that comes close to matching the rate of the participating facilities.

“While the 2018 HEI shows a growing commitment across the nation to equitable and inclusive health care, it also illustrates work left to be done,” said Tari Hanneman, Director of the HRC Foundation’s Health Equality Project, and author of the HEI. “And that work has never been more urgent, given the all-out assaults on the LGBTQ community from the highest levels of government.”

The potential damage that could be caused by the proposed Trump-Pence “conscience” regulation -- another effort to allow a license to discriminate against LGBTQ people -- is already spreading fear through vulnerable communities. In comments submitted today to the administration, parents, spouses, nurses and physicians are among a growing chorus expressing alarm at the prospect of allowing health care workers to prioritize their beliefs over care -- whether it be for a transgender person, for a patient seeking life-saving access to PrEP, or LGBTQ couples needing fertility services to start their family.

“In small rural towns such as mine, it is hard enough to find competent health care, much less worry about the medical provider refusing to provide services based on his or her religious beliefs,” wrote a respondent from Wamego, Kansas. “I know I've withheld pertinent information regarding my sexuality from my physician, out of fear that he would refuse to retain me as a patient. That sort of fear puts my health very much at risk.”