The changes are simple yet significant.
There are more unisex bathrooms. The visitation policy has been tweaked to make it clear that visitation privileges will not be denied based on gender identity. On the hospital’s admission sheet, patients can now list their preferred name in addition to their legal name.
For Saratoga Hospital, these steps have paid off. In July, the hospital was recognized as a leader in LGBT health care equality by the Human Rights Campaign, a Washington-based organization that advocates for the rights of lesbian, gay, bisexual and transgender people.
The HRC puts out an annual Healthcare Equality Index listing medical facilities throughout the country that provide sensitive, welcoming and accessible care to the LGBT community.
For inclusion on the list, health care providers must meet criteria in four key areas:
• patient non-discrimination policies
• visitation policies
• employment non-discrimination policies
• training in LGBT patient-centered care
Mary Jo LaPosta, senior vice president of patient care and organizational excellence at Saratoga Hospital, said the hospital’s effort to improve services for LGBT patients aligns with its long-standing mission and values.
“We want to serve the people of the region by providing health care in a supportive and caring environment,” she said. “The LGBT community represents one area of diversity in the community.”
The catalyst for Saratoga Hospital’s focus on LGBT health care concerns was Schenectady resident Chad Putman. Putman serves as vice president of the board of directors for the Rainbow Access Initiative, a local nonprofit organization that seeks to educate health care providers about LGBT health issues. In 2010, he approached Saratoga Hospital to see whether the institution would be interested in taking the steps necessary to be listed as a leader in LGBT health care by the HRC.
“We felt his desire to speak to us was very, very, important,” LaPosta said.
After meeting with Putman, Saratoga Hospital established a steering committee focused on LGBT health care. The hospital performed a self-assessment, using HRC guidelines, to determine which areas might need improvement. The hospital then began to address these areas, adding language about gender identity to policies for staff and patients, changing the admission form and adding unisex bathrooms.
Putman said it’s important for medical providers to give patients the opportunity to disclose their sexual orientation and gender identity. Another key to ensuring LGBT patients receive adequate health care is training medical staff to address their needs. He said transgender people often encounter problems at the front desk, because staff might not recognize or acknowledge their gender identity.
On the Rainbow Access Initiative’s website, members of the LGBT community share their experiences with the health care system. One of the people featured is Evan, a 58-year-old southern Washington County resident who requested his last name be withheld. Evan is a female-to-male transsexual; he was born a woman, but has identified as a man since 1996.
“Generally, my experience with the health care world has been pretty good,” Evan said, “but there have been times when it has been awkward.”
Evan said he lacks the funds to undergo gender reassignment surgery and requires the medical care middle-aged women typically receive, such as mammograms.
“I still have to make sure I don’t have cervical cancer,” he explained.
In general, doctors have been sensitive to his needs, Evan said, “but the staff might not be. They might call me she or her, even if I ask them not to.”
On one occasion, an administrator at a local hospital referred to him as a young lady, which Evan found problematic for two reasons: The administrative was younger than him, and “that’s not how I present myself and not how I see myself.” He said he told the administrator she was being insensitive, and if she had referred to him as a patient or a person, he wouldn’t have objected.
“She was very apologetic,” he recalled. “I try to correct people when I feel it’s appropriate.”
Albany Medical Center has also been recognized for its commitment to LGBT patients. Like Saratoga Hospital, the hospital was named a leader in LGBT health care equality in the Human Rights Campaign’s 2013 list.
“This recognition confirms Albany Med’s commitment to treating all of our patients with the dignity and respect they deserve,” Steven Frisch, executive vice president of Albany Medical Center, said at the time.
Saratoga Hospital and Albany Medical Center were among 23 hospitals in New York listed in the HRC’s health care equality index for 2013. Also listed was Albany’s Stratton VA Medical Center.
According to the HRC, a growing number of health care facilities are seeking inclusion on the group’s annual report. This year, 718 facilities are listed, a 153 percent increase from 2012.
“The Human Rights Campaign Foundation developed the Healthcare Equality Index to meet a deep and urgent need on the part of lesbian, gay, bisexual and transgender Americans: the need for equitable, knowledgeable, sensitive and welcoming health care, free from discrimination based on LGBT status,” the HRC explains in its report. “No one, when concerned about their health, should also be concerned about receiving inequitable or otherwise substandard care. Yet it is clear that many LGBT Americans have exactly these concerns when seeking health care.”
For Saratoga Hospital, the effort to improve services to the LGBT community is ongoing. A subcommittee comprising hospital staff, from doctors and nurses to administrative assistants, meets regularly, and the hospital recently established a partnership with the Pride Center of the Capital Region.
Curran Streett, executive director of the Pride Center, said her organization will provide training for the entire Saratoga Hospital staff. This training will take place in 2014, she said.
“One of the bigger challenges our community faces is finding adequate health care,” Streett said. “One issue is access to health insurance. Another is that providers do not receive training [in LGBT health care issues].”
Some LGBT people simply opt out of health care because they fear discrimination, she said.
Streett praised Saratoga Hospital’s decision to provide training for everyone on staff. She said health care providers seldom make such training mandatory, and as a result, they are often attended only by people already interested and knowledgeable about the topic.
LaPosta said Saratoga Hospital is continuing to work on improving care for LGBT patients. A subcommittee open to hospital staff, as well as members of the community, meets regularly to discuss LGBT-related issues.
“We have the opportunity to move from good to great,” LaPosta said. The HRC designation “is not the end of the story. ... We are committed to consistent improvement. We want to hear from the LGBT community about what they want.”