This webinar will cover key takeaways from the OIG’s recent General Compliance Program Guidance (GCPG) and share current trends and actionable practices Compliance professionals can implement in their programs. The presentation will cover ideas on promoting Compliance effectiveness by implementing analytics, adapting to the evolving AI landscape, and addressing cultural and behavioral considerations.

1. Ensuring Access
and Security for
LGBTQ+ Patients
Paul Sarnese, MAS, MSE, CHPA, CAPM
Owner, Secured and Prepared Consulting
Past President International Association for Healthcare
Security and Safety

2. • Paul is the owner of Secured &
Prepared Consulting. He is a Certified
Healthcare Protection Administrator
and a Certified Associate Project
Manager.
• He is the Past President for the
International Association for
Healthcare Security and Safety.
• He was recognized as the 2022 Campus
Safety-Healthcare Security Director of
the Year.
• He participated as a Technical Advisor
to the Joint Commission in developing
the Workplace Violence Prevention
Standards.
• He has had leadership positions
directing and managing safety,
security, emergency management and
operations in large health systems.
• Paul has a Bachelor’s Degree in
Criminal Justice from Rowan
University, a Master’s Degree in Safety
Engineering from Warren University
and a Master’s in Administrative
Science from Farleigh Dickinson
University.

3. Learning
Objectives
• Discuss some of the barriers to access
health services
• Discuss recent events of targeted violence
towards the LGBTQ+ community
• Discuss leading practices for creating an
inclusive environment for LGBTQ+ patients
• Discussing leading practices to design a
safe and secure environment

4. The Facts
• 3.5% of Americans identify as lesbian, gay, or
bisexual
• 0.3% of Americans identify themselves as
transgender
• The LGBTQ+ community is represented in every
race, religion, ethnicity and socioeconomic
group

5. LGBTQ+ Community Members
have a Higher Risk for:
• Substance abuse
• Sexually transmitted diseases
• Cancers
• Cardiovascular diseases
• Obesity
• Bullying
• Rejection
• Anxiety
• Depression
• Suicide

6. LGBTQ+ Community
Members and Healthcare
• Frequently receive poor healthcare services due
to:
• Lack of healthcare providers awareness
• Insensitivity to the unique needs of the
community
• Many do not feel welcomed
• Many do not feel safe

7. Targeted Violence
• In 2020, the Human Rights Campaign (HRC) tracked a
record number—44—of violent fatal incidents against
transgender and gender nonconforming people,
which at the time marked the most violent year on
record since the HRC began tracking these crimes in
2013.
• According to U.S. Department of Homeland Security,
the FBI’s hate crime statistics indicate that about 20%
of all hate crimes reported throughout the country in
2021 were motivated by bias linked to sexual
orientation and gender.

10. Recent Events
• A patient with HIV disclosed to a hospital that he had sex with other men, the hospital staff refused
to provide his HIV medication.
• A transgender teenager who was admitted to a hospital for suicidal ideation and self-inflicted
injuries was repeatedly misgendered and then discharged early by hospital staff. He later
committed suicide.
• An infant was turned away from a pediatrician’s office because she had same-sex parents.
• A business owner, was shot and killed after a gunman tore down an LGBTQ+ pride flag hanging
outside her store and shouted homophobic slurs.
• Employees at Johns Hopkins All Children’s Hospital, in Florida, at Akron Children’s Hospital, in
Ohio, and at Vanderbilt University Medical Center, in Tennessee, have been targeted by online
threats, threatening emails, and protests.
• Boston Children’s Hospital and its employees faced threats of violence in an online campaign
targeting clinicians who treat transgender adolescents and young adults.

11. Federal Protections
• The Executive Order on Preventing and Combating Discrimination on the Basis of
Gender Identity or Sexual Orientation was signed into law on January 20, 2021.
• The principles outlined in the order are based on the U.S. Constitution's promise of equal
protection under the law and are reflected in existing anti-discrimination laws, such as
Title VII of the Civil Rights Act of 1964.
• The Supreme Court's decision in Bostock v. Clayton County further affirmed that
discrimination on the basis of gender identity and sexual orientation is prohibited under
Title VII.
• The order also recognizes that discrimination based on gender identity or sexual
orientation can intersect with other forms of discrimination, such as race or disability.

12. Guidelines for Care of Lesbian, Gay, Bisexual
and Transgender Patients
• Provide clues in healthcare spaces that help patients determine what
information they may comfortably share with their health care
provider.
• Provide inclusive reading material to provide a sense of authenticity.
• Subscribe to local LGBTQ+ newspapers or magazines to include in
waiting rooms.
• Display photographs or posters that depict LGBTQ+ families, and
display brochures that highlight LGBTQ+ health concerns.
• Single-occupancy unisex or all-gender restrooms outfitted with
wheelchair accessibility are ideal. For facilities not in a position to
retrofit existing bathrooms, planning departments may consider
including a preference for all-gender restrooms in future new
construction.

13. Guidelines for Care of Lesbian, Gay, Bisexual
and Transgender Patients
• The single most important step facilities professionals
should be taking is training all staff members on
LGBTQ+ competency.
• LGBTQ+ inclusivity is not simply for care providers.
All patient-facing positions, from maintenance
supervisors to environmental services staff, should
have basic training on LGBTQ+ identities,
terminology, health disparities, and competency.
• It is equally important to establish a clear process for
reporting and responding to any instances of
discrimination or other concerns that may arise.

14. Physical Security for Facilities that Specifically Serve the LGBTQ+
Community
• Identify a safe room. A safe room, also known as a panic room, is a fortified room that
provides a safe hiding place in the event of an emergency.
• Identify a primary and secondary relocation destination where all staff can safely meet in
the event of an emergency or evacuation of the facility.
• Provide local law enforcement with a tour of the facility, the safe room, and the
relocation destinations.
• Periodically meet with local law enforcement to nurture the relationship and to provide
updates, as necessary.

15. Physical Security for Facilities that
Specifically Serve the LGBTQ+ Community
• Determine your exterior private–public property line. Identify an alternate parking location for
your employees and patients in the event of protesters.
• Identify a way to provide transportation services during protest activities.
• Program the security department’s phone number and/or 911 on all phones throughout the facility.
• Ensure that the caller ID on facility phones have the correct dispatchable location.
• Ensure that there is a secure separation between the patient waiting area and the treatment area to
prevent unauthorized access to the treatment and staff areas.

16. Physical Security for Facilities that
Specifically Serve the LGBTQ+ Community
• Secure all staff-only areas and offices to prevent unauthorized access.
• Identify all staff areas with signs stating, “Staff Only “or “Authorized Personnel Only.”
• Install signs explaining items that are prohibited (such as weapons) and the behavioral
expectation for all who enter the facility.
• Ensure that reception desk staff can directly monitor the entrance and entire waiting area.
Use mirrors or cameras as needed.
• Ensure that staff can lock down access into the facility without jeopardizing their own
safety.
• Provide an emergency communication device (phone, panic button, duress button) at the
reception desk, cash collection, social worker/behavioral health specialist office, and
medication-distribution areas.

17. Physical Security for Facilities that
Specifically Serve the LGBTQ+ Community
• Install public view monitors (PVMs) at all public entrances.
• Label all exterior doors utilizing International Fire Code numbering scheme for first
responders. Numbering allows for easy identification for responders.
• Be sure that the landscaping does not interfere with direct lines of sight, visibility,
lighting, or cameras.
• Ensure that exterior lighting meets industry standards and is well maintained.

18. Physical Security for Facilities that
Specifically Serve the LGBTQ+ Community
• Ensure existing security equipment (access control, cameras, panic buttons, and so on)
and software is being tested and maintained and up to date.
• Consider deploying a mass notification system for routine and emergency
communication to staff and patients.
• Ensure exam and treatment rooms are set up to avoid entrapment of staff. Staff should
keep their back to the exit and avoid having others between them and the exit path.
• Staff should attend training on the identification and management of aggressive behavior
and know how to report concerns.

19. Resources
GLMA: Health
Professionals
Advancing LGBTQ+
Equality
https://www.glma.org/
International
Association for
Healthcare Security and
Safety
IAHSS.org

21. • Services Provided
• Workplace Violence Assessments
• Security Program Assessments
• Emergency Management Program Development
• Joint Commission Accreditation Assessments
• Temporary Leadership Positions
• OSHA Compliance Audits
• Safety, Security and Emergency Management Training and Exercise
Management
• Litigation Support/Expert Witness Support

22. Contact Information
Paul Sarnese, MSA, MSE, CHPA, CAPM
856-305-9204
paul@securedandprepared.com
www.securedandprepared.com