CHSU Discovery

  Abstract

Members of the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, and intersex+) community have long faced discriminatory social policies and barriers to equitable healthcare. California has the highest population of LGBTQIA+ adults in the US, with 10% living in the Central Valley. UHC runs 31 clinics throughout Fresno and adjacent counties, making them a choice for individuals seeking healthcare. Through this project, we aim to identify shortcomings in care strategies within primary care clinics and provide recommendations on best practices for inclusive and equitable care. Using the “Checklist for Recommendations to Improve Primary Care for Sexual and Gender Minority Patients” from the Pacific Institute for Research and Evaluation, we evaluated the UHC Blackstone clinic for its LGBTQIA+ inclusive care. After assessing the clinic and related materials, a grade was assigned: Yes, No, N/A, and Unknown responses. Of the recommendation categories, the clinic had the most gaps in Creating a Welcoming Physical Environment and SO/GI Documentation. Within Section 1. Affirmative Policies and Procedures, the clinic satisfied 18 of the 20 requirements and were “unsure” regarding benefits for domestic partners of employees and insurance access that covers gender-affirming care. Section 2. Creating a Welcoming Physical environment, UHC did not display signage, posters, pamphlets, or flags within the clinic. However, it is worth noting that they did have single-stall restrooms without gender designation for patient use. For Section 3. SO/GI Documentation, the “No” responses demonstrated that Patient History Forms lacked gender-inclusive language, and the EHR locates a patient using their legal rather than their chosen name. Section 4. Employee Training and Competency, UHC fulfilled 11 of the 12 criteria. The response for “No” was for training regarding LGBTQIA+ language and terminology on an annual basis. Section 5. Workforce Development shows a majority “Yes” responses. The “No” responses in this section included offering puberty-blocking hormones, training for common conditions among these patients, and offering incentives for providers who take part in LGBTQIA+ patient care. While the UHC Blackstone clinic fulfilled 67% of the recommendations, there is room for improvement and implementation of care strategies to create a welcoming and accepting environment optimal for the care of LGBTQIA+ patients.