.. . . .. Virginia. ason?" membewuwez 022078 June 4, 2018 [Disiricis eCH?y CCU nor! Seattle City Councilmember Debora Juarez Seattle City Council P.O. Box 34025 Seattle, WA 98124?4025 Dear Councilmember Juarez, I am writing in response to your request for information about our health care equity program. I am pleased to share that this is an area on which we?ve been focused for multiple years. We are proud to provide respectful and compassionate services to individuals in a welcoming and supportive environment. The questions you asked in your letter requesting information about our program are repeated below followed by our answers. What policies and procedures do you have in place to ensure equitable access for transgender and gender-nonconforming patients? Our Patient Nondiscrimination Policy mandates that all Virginia Mason patients and Visitors be treated with equality in a welcoming manner that is free from discrimination based on age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability, veteran or military status. This policy also ensures that visitors receive equal visitation privileges" consistent with patient preference. Virginia Mason also has an anti-harassment policy that ensures employees are free from harassment of any kind, including discrimination. Where have you faced challenges, and where-have you seen successes? The primary challenges we have faced include: . A lack of clinical guidelines and absence of a standard knowledge base across - the medical professions. . In addition to clinical knowledge gaps, we are working through issues with our registration systems, which have not kept pace with the changing nature of the patients we serve. . Issues with payers covering services related to a patient's gender assignment at birth versus their gender identity. 0 Finally, the explicit and implicit biases we all have, which create impediments to equity in health care. . . In 2017, Virginia Mason signed the American Hospital Association Equity of Care Pledge to eliminate health disparities and increase health equity among patient populations. - In March of this year, Virginia Mason was named a 2018 Leader in Healthcare Equity after receiving a perfect score in the Human Rights Campaign Foundation?s Healthcare Equity Index. As part of our affirming work, Virginia Mason implemented training modules in patient-centered care for leaders and other team members to address diversity and inclusion as health issues. . The organization has also launched a Transgender Health Service Line including 21 physicians practicing in three locations. Earlier this year we hosted our first Transgender Health Service Line open house for the community. . We continue to increase our community engagement with sponsorships of the Seattle Pride Parade, Fun Home at the 5th Avenue Theater and the World AIDS Day Breakfast. We also have a dedicated ?Proudly Virginia Mason? committee that oversees much of our organization?s participation in community events. . Virginia Mason has partnered with the Seattle Police Department to become an official Safe Place for individuals and others who seek safety from threatening situations. . We are focused on educating our teams about health equity. Every Virginia Mason team member is required to complete an online health equity training module. Additionally, we?ve held training sessions in our Primary Care Clinics designed to help clinicians take an accurate sexual history. We also brought Kenya Beard, founding Director for the Center for Multicultural Education and Health Disparities at City University of New York, to Virginia Mason for training sessions on health equity. What has been your experience with making referrals to specialists, behavioral health professionals and/ or community-based resources? Since Virginia Mason physicians are employed by the organization, referrals are typically made to Virginia Mason clinicians including those in the Transgender Health Service line. What partnerships are you engaged in to better your service? Virginia Mason participates in the Washington State Hospital Association Health Equity Task Force. Through Virginia Mason?s Graduate Medical Education Program, residents participated in the Alliance of Independent Academic Medical Center?s national initiative focused on improving community health and health equity. As a result of their participation in this initiative, Virginia Mason residents became interested in focusing on meeting the needs of the community. Their enthusiasm prompted work across the organization to address the needs of this patient population. In 2017 we started the Virginia Mason-Humanity in Action Fellowship, one of two new professional fellowships to focus on housing, health care and rights in Seattle. because we understand the critical connection between access to housing and personal health. Two of our providers are leading a May 2019 Continuing Medical Education day of lectures aimed at discussing the social determinants of health (including access to healthy food, clean air and water, housing, racism/discrimination, costs of medications and treatments, and homelessness) that affect our patients. What can the City of Seattle do to support policies that create equity in access and care for the transgender community? Help to communicate care options for this community. If your institution has a patient?s bill of rights, can you share that with us? Virginia Mason?s Patient Rights and Responsibilities (enclosed per your request) states that Virginia Mason patients have the right to be free from any act of discrimination or reprisal. Further that Virginia Mason does not discriminate against any person on the basis of age, culture, employment, ethnicity, expression, gender identity, language, national origin, participation in programs, physical or mental disability, race, religion, services and activities, sex, sexual orientation, socioeconomic status or treatment. Are there any other guidelines or policies that you are currently working on or planning to' develop in the near future? We are currently developing clinical guidelines. As I noted earlier, we are also working on intake data in our registration system, since not all required fields are included in electronic health records. Finally, we are working with our teams to help them ask questions of patients in the most respectful way, given each individual?s health care needs. All of our work in this area is greatly enriched by the active involvement of transgender patient?family partners (volunteers) who are helping to co-design our processes. Thank you for the opportunity to share some of the work we are doing to serve our patients. Please don?t hesitate to reach out to Virginia Mason?s Senior Vice President of Quality and Safety and Chief Nursing Officer, Charleen Tachibana, DNP, MN, RN, who leads this work, if you have any questions or would like additional information. Sincerely, Suzanne T. Anderson President Virginia Mason Medical Center Patient Rights and Responsibilities enclosed