Recommended Standards of Practice for the Provision of Quality Health Care
and
Social Services for Gay, Lesbian, Bisexual and Transgender Clients
Developed by the City of Tucson Commission on Gay, Lesbian Bisexual and
Transgender Issues
Research has indicated that fear of discrimination and stigma causes many Gay, Lesbian, Bisexual and Transgender (hereafter abbreviated to GLBT) individuals to postpone or decline seeking medical care or social service assistance. Others, once in care, sometimes withhold from their providers personal information that may be critical to their well being. The purpose of this document is to provide a set of recommended guidelines for service providers to help them better meet the needs of their GLBT clients and patients. it is also intended to provide a list of criteria against which providers can measure their effectiveness in meeting the needs of the GLBT population. Finally, it is our hope that the use of this document will assist and support GLBT individuals in understanding and obtaining the quality of care they need and deserve.
Health care and social services for GLBT people in Tucson and southern Arizona are not always provided in a welcoming, culturally competent and responsive manner. A past survey of health care and social service providers in Pima County found that only a little more than one-third of respondents provided protection against discrimination to gay men, lebians and bisexuals by their inclusion of sexual orientation in their nondiscrimination policies and only 10% provided protection to the transgender population by including gender identity. Another survey of the Tucson GLBT population found that 37% of respondents had changed a service provider because of perceived bias exhibited by the provider against the respondent’s sexual orientation and/or gender identity.
GLBT people live in and seek health care and social services from most of the agencies and providers in the Tucson area. Eliminating barriers to care requires both an educated and empowered consumer base and a skilled, culturally competent, sensitive and welcoming provider community that is openly supportive of GLBT people and their families. The following standards provide one tool for achieving more effective health care for all.
It is our hope that, by using this document, your organization will be able to accomplish the following four goals.
- The elimination of bias and discrimination on the basis of sexual orientation and gender identity in the delivery of services.
- The promotion and provision of full and equal access to services by GLBT clients and patients.
- The elimination of stigmatism of GLBT people and their families.
- The creation of human service environments where it is safe for GLBT clients to disclose their sexual orientation and/or gender identity when appropriate.
Revised January 2005
Indicators and Criteria
The following questions are to help you assess how well your agency’s policies and procedures serve GLBT populations.
1. Are the terms Sexual Orientation and Gender Identity included in your agency’s anti-discrimination policy?
Sexual Orientation Yes No
Gender Identity Yes No
2. Are these two terms included in your agency’s written forms and policies, including the Policy and Procedure Manual for staff?
Sexual Orientation Yes No
Gender Identity Yes No
3. Does your agency provide for optional self-identification on intake
forms for categories of gender identity, sexual orientation, marital
and/or partnership status?
Sexual Orientation Yes No
Gender Identity Yes No
Marital/Partnership Status Yes No
4. Does your agency give GLBT clients/patients the option to involve the participation of domestic partners and family members, as defined by the client, in intake, assessment, case manage
ment and treatment plans? Yes No
5. Does your agency have a grievance procedure in place for
GLBT clients and staff who feel they may have been discriminated
against on the basis of their sexual orientation or gender identity?
Sexual Orientation Yes No
Gender Identity Yes No
6. Is the grievance procedure for clients/patients posted publicly? Yes No
7. Has your agency staff received training on issues of sexual orientation, gender identity, and the mental health and physical health
risks faced by GLBT people as a result of social stigmatization? Yes No
8. Does the staff continue to receive such training on a regular basis? Yes No
9. When your agency staff receives training on cultural competency issues, are sexual orientation and gender identity included in
that training? Sexual Orientation Yes
No
Gender Identity Yes No
Recommended Standards of Practice and Client Rights
Standard 1. Provider shall assure that comprehensive policies are implemented to prohibit discrimination in the delivery of services on the basis of sexual orientation and gender identity for clients/patients and their families. Such non-discrination policies shall be posted in all languages representing the populations served. For the purpose of these standards the terms “family” and “families” shall be broadly construed and shall include, but not be limited to, relatives by blood, adoption, marriage or declaration (either written or oral) of domestic partnership.
Standard 2. Provider shall provide written notice to employees that discrimination in the delivery of services based on sexual orientation or gender identity violates standards of good care and is subject to appropriate discipline.
Standard 3. Provider shall develop or revise intake and assessment forms to provide for optional self-identification in categories of gender identity; sexual orientation; marital, partnership and family status.
Standard 4. Provider shall ensure that it has comprehensive and accessible procedures in place for filing and resolving complaints alleging discrimination based on sexual orientation or gender identity. One or more persons within the agency should be designated as being responsible for the agency’s compliance.
Standard 5. Provider shall develop and/or revise existing staff training on cultural diversity, harassment and anti-discrimination to include the issues of sexual orientation and gender identity and to ensure that agency staff have familiarity with these issues as they affect case management and treatment plans of GLBT clients/patients.
Standard 6. Provider shall provide training for direct care staff on how, when, and where to make appropriate referrals for health care, social services, and community resources for GLBT clients and their families. The agency shall maintain a comprehensive resource list for appropriate referrals.,
Standard 7. Provider shall ensure the confidentiality of client data, including information about sexual orientation and gender identity. Such information is to be considered highly sensitive and treated accordingly.
Standard 8. Providers who serve minors shall provide appropriate, safe, and confidential treatment to GLBT youth to the appropriate legal limits as defined by state statutes. All GLBT minors shall be informed of their legal rights and advised of any statutory or otherwise mandated reporting.
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