Jaime Jenett knows she’s been lucky.
One afternoon in the summer of 2008, her 4-month-old son Simon was rushed to the emergency room. By that night, he was in the ICU, and by the morning, on life support. Simon was diagnosed with a heart condition called cardiomyopathy, and would stay in the hospital for another four months.
As if that wasn’t enough to worry about, Jenett, who is gay, had another concern: Would she and her partner be treated as well as a straight couple in the medical setting? She had heard enough horror stories of same-sex couples being denied access to their children and partners in the hospital to be apprehensive.
“If you’re in an emergency like that, you have to introduce yourself to people over and over again,” Jenett said. “On top of having our child being maybe dying, there were all these points where we might have had to deal with homophobia.”
But that’s not what happened.
“The thing we were most struck by was how well we were treated,” Jenett said of their stay at Oakland Children’s Hospital. She and her now-wife, Laura Fitch, were impressed with the level of respect and sensitivity they felt from the staff. The couple was even married on the hospital grounds during their stint there (before California’s ban on same-sex marriage in 2008), with their doctors, nurses and even the hospital’s Catholic chaplain in attendance.
Still, Jenett knows that her family’s experience was unique; that not all lesbian, gay, bisexual and transgender people feel so welcomed in medical situations. So Jenett is now using her story as an opportunity to educate medical providers in neighboring Contra Costa County, in hopes that her positive experience can become the norm, and not the exception for LGBT health care.
Jenett works as a public health policy coordinator for the county’s health system, Contra Costa Health Services. She is also a member of CCHS’ Pride Initiative, a coalition founded in 2009 to help reduce health disparities among LGBT people in the county. Her voice is among the many that have culminated in updated policies and a shift in overall approach to patient relations.
The Pride Initiative’s efforts have recently paid off. Last month, the Human Rights Campaign Foundation named the Contra Costa Regional Medical Center in Martinez (part of CCHS) as a “Leader in LGBT Healthcare Equality” in its annual Healthcare Equality Index. The East Bay county hospital is among the ranks of 464 facilities nationwide that met the award’s criteria, which included non-discrimination policies for both patients and employees, equal visitation rights for same-sex parents and partners, and LGBT patient-centered health care education for staff.
Joanne Genet, a CCHS public health program manager and leader of the of the Pride Initiative, said that the honor was particularly significant for Contra Costa County, which she described as more “traditional” than nearby San Francisco.
“We saw that there were very few services in the county, despite being in the Bay Area, which has a large population of LGBT folks,” Genet said. In training the staff, she said it was important to “acknowledge where everybody starts from and give them the tools to learn how to meet populations they’re not used to serving.
“It takes a little bit of extra time and creativity to figure out how to help people change their language and their approach. Change doesn’t happen over night,” she said.
One of the big changes has been expanding the definition of family, particularly in terms of visitation rights. CCHS has also put an emphasis on mental health services for LGBT youth, as well as counseling for parents to learn how to be more accepting of their child’s sexual identity. Genet said these efforts can help reduce the risk of harmful behaviors among LGBT youth including smoking and sexually transmitted diseases. Other recent changes have been relatively simple but impactful, Genet said, such as designating unisex bathrooms to better accommodate transgender patients.
Though Genet is pleased with the Initiative’s successes so far, she knows there’s still a lot of work to do.
“Just because we have a leadership designation doesn’t mean we’re through,” she said. “We’re not finished yet. It’s a process of inclusion.”
The Healthcare Equality Index noted that despite an unprecedented number of facilities qualifying as LGBT healthcare leaders this year, disparities persist. The report cited a 2010 survey by Lambda Legal that found more than half the LGBT respondents reported having at least one of the following experiences: being refused needed care; health care professionals refusing to touch them or using excessive precautions; health care professionals using harsh or abusive language; being blamed for their health status; or health care professionals being physically rough or abusive. The survey also found 52 percent of transgender respondents and 9 percent of lesbian, gay, and bisexual respondents believed they would be outright refused medical services.
As Genet explained, sometimes the fear of being treated poorly can be a barrier to accessing health care — whether or not the skepticism is warranted.
“The LGBT community has a history of being excluded,” she said. “It’s not that it necessarily happens, but it’s partly the fear of that happening, because they’ve been excluded in so many different areas — in particular, family.”
Because of that history of exclusion, Genet said it’s been essential to make CCHS’ LGBT-friendly policies as visible as possible — which include everything from nondiscrimination posters depicting same-sex couples to rainbow flags staff can opt to wear on their name tags.
For CCHS, the idea is not just political — rather, that equitable and culturally competent interactions with patients can actually improve their overall health. As health director Dr. William Walker explained, the Pride Initiative’s efforts fit into a larger goal of creating more patient-centered services, an increasingly ubiquitous theme promoted under the health reform.
“It’s more than a doctor’s visit. It means getting enrolled in a system that gives them support they need — whether it’s health education or mental health counseling,” Walker said. “It produces better health outcomes. And part of that is making sure that people come back and that they are involved and feel respected in the system.”
Walker believes a more holistic approach will benefit all patients, not just members of the LGBT community.
“If folks don’t feel welcome in their health care provider network, then they are subject to the kind of disparities that result from a lack of appropriate access to health care.”
Jaime Jenett can personally attest to medical value of being allowed to have her family together during a stressful stay at the hospital.
“From my own experience, and what I’ve seen around me, is that psycho-social support is a huge component of somebody’s ability to stay out of the hospital,” she said.
“If you tell somebody that they can’t have their spouse with them while they’re critically ill in the hospital, or that a child can’t see one of their parents, there’s no way that is going to help their healing,” Jenett said. “And in fact, it would probably contribute to poorer outcomes, given the additional level of stress that’s happening.”
Indeed, Jenett believes that her son Simon was released earlier than he would have normally been, in part because the doctors could see a strong level of support from his parents.
“Part of good medical care is that you make sure they have a good support network,” Jenett said. “To not only not recognize that, but actually try to tear it apart is bad medicine.”