NYC Public Advocate Releases Report on LGBT Access to Public Healthcare

[DonnaL]

<p>This is an email that I received yesterday, with a copy of a press release announcing that the NYC Public Advocate, Betsy Gotbaum, has released her report ([a</a> copy of which](<a href=“http://pubadvocate.nyc.gov/policy/documents/LGBThealthrecsreportfinal_pdf.pdf]a”>http://pubadvocate.nyc.gov/policy/documents/LGBThealthrecsreportfinal_pdf.pdf) can be found at the Public Advocate’s website), concerning the problems that LGBT people face in accessing public healthcare in New York City, and giving various recommendations for trying to solve those problems.</p>

<p>I had the privilege of being at least somewhat involved in the preparation of this report earlier this year when I was still on the NYC Bar Association’s LGBT Committee; I gave my comments to several drafts, and I participated in a telephone conference concerning the draft report with Ms. Gotbaum, representatives of her office, and representatives of various LGBT advocacy groups. I strongly advocated the idea (included in the report) of designating an LGBT liaison person at each facility, with prominent displays in waiting rooms and other public areas giving information about the availability of that person, so that any problems that do arise can (hopefully) be taken care of quickly by someone familiar with LGBT issues and the facility’s nondiscrimination obligations.</p>

<p>I think it’s a great report, and certainly raises a lot of issues that are important to many people (whether or not they live in the New York area) so I thought I’d post about it in case anyone’s interested in taking a look at it. </p>

<p>The email and the press release (which can also be found at [12.10.08</a> LGBT HHC](<a href=“http://pubadvocate.nyc.gov/news/12.10.08LGBTHHC.htm]12.10.08”>http://pubadvocate.nyc.gov/news/12.10.08LGBTHHC.htm)) are reproduced below.</p>

<p>I have to admit that I’m sort of proud of having made at least some small contribution to this. (No, I’m not being humble – it was small!)</p>

<p>Donna</p>

<p>From: S----
Sent: Wednesday, December 10, 2008 1:23 PM
To: Donna
Subject: FW: NEWS: PA Gotbaum: LGBT New Yorkers Lack Adequate Health Care</p>

<p>Dear Donna and [the former chairman of the LGBT Committee],</p>

<p>The Public Advocate’s LGBT health access report was released today. Thank you for your support in putting the report together. The final press release and the report are now posted on our website (see the link below) and I have also pasted the text at the bottom of the e-mail (the report is attached). I will send you a hard copy of the report shortly. Please feel free to circulate the report and/or press release to your network. </p>

<p>[12.10.08</a> LGBT HHC](<a href=“http://pubadvocate.nyc.gov/news/12.10.08LGBTHHC.htm]12.10.08”>http://pubadvocate.nyc.gov/news/12.10.08LGBTHHC.htm)</p>

<p>Happy Holidays! </p>

<p>S----
Senior Policy Analyst
Office of the Public Advocate</p>

<p>

<strong>FOR IMMEDIATE RELEASE</strong> </p>

<p>December 10, 2008</p>

<p>Contact: Sarah Krauss</p>

<p>212.669.4193; 917.541.0936</p>

<p>Release #: 045-2008</p>

<p>LGBT New Yorkers Lack Adequate Health Care, says Gotbaum</p>

<p>HHC Clinics Need Mandatory Employee Training to Help End Disparity</p>

<p>MANHATTAN — Public Advocate Betsy Gotbaum released a report today, Improving Lesbian, Gay, Bisexual and Transgender Access to Healthcare at New York City Health and Hospitals Corporation Facilities, chronicling the barriers gay, lesbian, bisexual and transgender (LGBT) New Yorkers confront in obtaining health care from New York City Health and Hospitals Corporation (HHC) that is sensitive to their medical needs. In the face of homophobia and hostility from providers, many LGBT people in the city are not accessing basic healthcare services. </p>

<p>Public Advocate Betsy Gotbaum said, “All New Yorkers deserve equal access to public healthcare services, period. And every New Yorker should expect the quality of care to be the same no matter the sexual orientation or gender identity of the patient. This report points out areas of concern that LGBT organizations and I have regarding healthcare for gay and transgender New Yorkers. I have shared these concerns with HHC, as well as recommendations for addressing them, and I expect HHC to take the necessary steps to help LGBT New Yorkers receive quality care.”</p>

<p>Liz Margolies, Founder and Executive Director of the National LGBT Cancer Network said, “I applaud the leadership of Betsy Gotbaum and her staff in addressing the LGBT community’s barriers to health care in this city and setting guidelines for addressing these inequities in HHC facilities. The current report is thorough, fair and accurately reflects our community voices and concerns. The National LGBT Cancer Network will do whatever is needed to help these recommendations be implemented. </p>

<p>Ray Carannante, Gender Identity Project Coordinator and Associate Director of Center CARE said, “We are very excited that the Public Advocate has prioritized healthcare access for lesbian, gay, bisexual and transgender people within New York’s city hospitals. We know firsthand of the numerous barriers to care that LGBT communities face when seeking services at every level, from the waiting room to the emergency room. We feel strongly that the mission of the Gender Identity Project and the Lesbian, Gay, Bisexual and Transgender Community Center matches that of the Health and Hospitals Corporation: to serve New York’s most marginalized and underrepresented communities. Taking steps to ensure the ongoing education and skill development of providers within the Health and Hospitals Corporation will greatly impact the quality of life of all LGBT New Yorkers.”</p>

<p>Michael Silverman, Transgender Legal Defense & Education Fund Executive Director said, “We applaud Public Advocate Gotbaum’s report for focusing on the health care needs of lesbian, gay, bisexual and transgender New Yorkers. Transgender people face tremendous discrimination in a health care system that simply fails to meet their most basic needs. This has led to a community-wide disengagement from the health care system that must be remedied. We look forward to working with the New York City Health & Hospitals Corporation and Public Advocate Gotbaum to ensure transgender New Yorkers have equal access to health care.”</p>

<p>An assessment of staff training conducted by HHC last year at the Public Advocate’s request shows great variation from facility to facility. Of the seven HHC networks, three (North Brooklyn, Queens, South Manhattan) indicated that sensitivity to LGBT patients is not explicitly covered in their staff training. The Central Brooklyn network provides staff sensitivity training regarding different sexual practices but no training specific to LGBT individuals. The Generations and Northern Manhattan network only requires Behavioral Health staff to complete LGBT sensitivity training. </p>

<p>The Public Advocate worked with LGBT organizations to identify the most widely shared concerns and formulate recommendations. The following organizations participated in the review process: Broadway Cares/Equity Fights AIDS; Bronx Community Pride Center; Callen-Lorde Community Health Center; Empire State Pride Agenda; Gay Men’s Health Crisis; National LGBT Cancer Network; The Lesbian, Gay, Bisexual & Transgender Community Center; Transgender Legal Defense & Education Fund, Inc.; and Services and Advocacy for GLBT Elders (SAGE). </p>

<p>Findings from these discussions with advocates and healthcare professionals include:</p>

<p>The healthcare environment is heterocentric and gender-normative. Providers lack knowledge about health disparities affecting LGBT people. </p>

<p>LGBT individuals experience hostility and discrimination in care.
Concerns about homophobia and transphobia keep LGBT individuals from using healthcare services. </p>

<p>Voluntary training does not reach all staff.</p>

<p>The Public Advocate’s report includes the following recommendations for HHC: </p>

<p>Require in-house LGBT sensitivity training for all HHC employees.
Designate an LGBT liaison in each HHC facility.
Establish, display, and enforce a zero-tolerance discrimination policy.
Establish a review process to monitor progress.</p>

<p>Additionally, Gotbaum recommends that the Department of Health and Mental Hygiene (DOHMH) should increase research on LGBT health issues to accurately assess the quality of healthcare services provided to LGBT individuals and to help medical providers address the needs of LGBT patients. </p>

<p>Health concerns common among gay and male bisexual patients include HIV/AIDS, depression, hepatitis, colon cancer, substance abuse, eating disorders, and HPV infection. Health concerns common among lesbian and female bisexual individuals include breast and some gynecological cancers, obesity, heart disease, and osteoporosis. For transgender individuals, the most pressing health concerns include HIV/AIDS and other STDs, substance abuse, depression and suicide. Transgender people also commonly face no insurance coverage for trans-health services or care that does not address transgender considerations like hormone therapy. </p>

<p>The report can be found at: <a href=“http://pubadvocate.nyc.gov/policy/documents/LGBThealthrecsreportfinal_pdf.pdf[/url]”>http://pubadvocate.nyc.gov/policy/documents/LGBThealthrecsreportfinal_pdf.pdf&lt;/a&gt;

</p>