The National LGBT Health

Education Center

Harvey J. Makadon, MD

Director, National LGBT Health Education Center, The Fenway Institute, Clinical Professor of Medicine, Harvard Medical School

Annual Community Health Institute

May 9-11, 2012

Resort & Conference Center of Hyannis

Hyannis, MA

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Massachusetts League of Community Health Centers Community Health Institute

May 11, 2012

Harvey J. Makadon, MD Director, National LGBT Health Education Center

The Fenway Institute Clinical Professor of Medicine

Harvard Medical School

Who We Are

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The National LGBT Health Education Center provides training, educational resources, and technical assistance to health care organizations in order to help them optimize their ability to provide accessible, high quality, and cost effective care to LGBT people.

We are a division within The Fenway Institute.

National Cooperative Agreement(NCA) 2011 award from HRSA’s Bureau of

Primary Health Care

The first and only NCA for LGBT health

Supports free trainings and technical assistance for all health centers (FQHCs & look-alikes)

Collaborations with other NCAs, Primary Care Associations, Departments of Health

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Needs Assessment: Preliminary Results 147 health centers, 9 PCAs, 21 state public health departments

60% urban, 40% rural health centers

Percentage responding that

at least 20% of their patients were:

African American, 40%

Latino/Hispanic, 60%

Asian/Pacific Islander, 4%

American Indian, 4%

Very high level of interest; 90% of respondents are interested in LGBT health education trainings on the topics we offer

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Needs Assessment: Respondents’ Perceptions and Practices 29% rarely/never see

LGBT patients in their health centers

78% probably have a lot more LGBT patients than they know

34% include sexual orientation on their intake forms

84% feel their governing board would support them in pursuing training in LGBT health care

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Needs Assessment: Typical Narrative Comments

“[Need training on] respectful and appropriate language, … especially for transgender individuals.”

“How to best serve non [LGBT]-identified men and women … in our primarily Latino population.”

“Stigma associated [with LGBT individuals] in this small rural community” is a barrier to offering training.

“[Our patients are] spread out over [thousands of] square miles. [A]ny LGBT adults here … would be

extremely reluctant to self identify.”

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What We Offer-Now Webinars and workshops

Grand Rounds

Publications

The Fenway Guide-A New

Second Edition

Learning about Sexual Health and Behavior: Implications

for Patient Centered Medical Home Innovation

(NACHC)

Website: www.lgbthealtheducation.org

Blog / LGBT health news

Archived webinars, CME

Links to Suggested Resources

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Core Content Who: LGBT Demographics

Why: LGBT Heath Disparities

Optimizing LGBT Care Throughout the Life Cycle (Youth, Mid-life, Older Adults)

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Transgender Identity and Health

HIV/STD Screening and Prevention

Creating an Environment of Inclusion

The ACA, PCMH’s and LGBT Health

Where We’re Working

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Affordable Care Act: Innovation to

Enhance Clinical and Cost Effectiveness

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Health Center Patient Centered

Medical Home

Our Work: Facilitating Change

Readiness Assessment

Creating an Inclusive Environment

Managing the Health of LGBT People

Developing Action Steps to Optimize Systems

and Care

Facilitating the Process

Education

Technical Assistance

In collaboration with health centers

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Creating Systems for Change!

How well do you know the patient’s seen

in your health center?

How do you find out?

New Patients New Lesbian/Gay or

Transgender Patients

How do people feel

and what do they do when

learning this?

Why gather data on sexual

orientation and gender identity?

Increases ability to screen, detect, and prevent

conditions more common in LGBT people

Helps develop a better understanding of patients’

lives

Allows comparison of patient outcomes with

national survey samples of LGBT people

Patients may feel safer discussing their

health and risk behaviors once they’ve disclosed

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LGBT data can be gathered at patient

contact points during the process of

care and integrated into the EHR

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Provider

Visit

Input From

History

Self Report of Information on Sexual

Orientation (S.O.) and Gender

Identity (G.I.)

Data

Input At

Home

Arrival Register

Onsite

SO

/GI

data

rep

ort

ed

SO

/GI

data

no

t

rep

ort

ed

Information

Entered

into EHR

Information

Entered Into

EHR

NO

YES

PCMH 2011 Core Standards

PCMH 1: Enhance Access and Continuity

PCMH 2: Identify and Manage Patient

Populations

PCMH 3: Plan and Manage Care

PCMH 4: Provide Self-Care and Community

Support

PCMH 5: Track and Coordinate Care

PCMH 6: Measure and Improve Performance

Implementing Change

Elements of Population Health

Define and Identify Populations

Understand Unique Health Issues

Develop Best Practices

• Quality

• Cost

LGBT Health-Creating Clinical Practice

Guidelines

Transgender Health Care

Behavioral Heath

HIV Prevention and Care 18

www.lgbthealtheducation.org

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“Like” us on Facebook…

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Questions?