Rainbow Health Initiative
What has been most instrumental to your progress?
We convened an advisory board with members from throughout the health and human services sector. These board members were also either members of the LGBTQ community or they had strong ties to the community. This was a crucial aspect of our process as the advisory board was able to strengthen and refine proposed standards as their various perspectives were synthesized into a unified document. The advisory board was also able to tap into their intersecting identities (of race, gender, national origin, age, social class) allowing us to provide comprehensive standards that speak to the entire lifecycle of care an LGBTQ client or patient will need in their lifetime. Finally, their professional perspectives allowed us to prioritize what standards would need to be implemented first and what to expect from hospitals, clinics and care providers as the implementation process begins. This resulted in the development of a user guide to accompany the original Standards of Inclusion document.
To understand the best strategies for implementing the LGBTQ Standards of Inclusion given the current political and economic realities, we facilitated conversations with community leaders, elected officials and their staff, our advisory board, as well as partner organizations to generate implementation ideas. Participants included: Lauren Gilchrist, Health Policy Advisor to Governor Mark Dayton; Sen. Scott Dibble; OutFront Minnesota; Minnesota AIDS Project; Clare Housing; Family Tree Clinic. Having these facilitated conversations with the community clarified that a phased-approach is necessary. 14 implementation strategies were identified and classified into short, mid-term, and long-term strategies. This accentuated what was needed and feasible to accomplish, versus what would be “nice” to see accomplished.
Key lessons learned
A key lesson about doing our work is that there is a real hunger and need for us to convene these type of projects in Minnesota. Going in we knew there was a need, but we were struck by how often providers, especially, reported to us through our advisory board or through community conversations feeling “alone” or “isolated” in their work to address LGBTQ health disparities. Through this grant, we came to understand how deeply the need is, not only for this particular community innovation, but to have a facilitator like RHI convene resources, conversations, and network people together. This profound expression for resources helped lead us to develop an evaluation process for the Standards of Inclusion so that we could better do our work with clinics and hospital systems; in addition, through this learning, we launched our annual Opportunity Conference and are seeking to create a professional network of care providers in Minnesota.
Reflections on the community innovation process
The iterative process of the model was the most essential part for RHI. Convening the advisory board and community conversations generated solutions in the form of the LGBTQ Standards of Inclusion. Yet to better understand implementation, it was necessary to return to the community to understand how LGBTQ communities and health and human services need and want the LGBTQ Standards of Inclusion implemented over the next few years.
Progress toward an innovation
We feel the innovative breakthrough is that we now have a community-based evaluation process to assist clinics and healthcare providers as it relates to LGBTQ health equity. The standards are not only an expectation of what providers should be doing, but also what LGBTQ clients should expect as they interact with health and human services organizations. By implementing the Standards through our evaluation process we can better help these organizations understand where they are in terms of LGBTQ cultural responsiveness with their clients. We can help them champion existing work they are doing, as well as identify areas for increasing their LGBTQ cultural responsiveness, which includes educational/training opportunities.
Rainbow Health Initiative has a working document of 14 implementation strategies. These strategies are divided into short-term, mid-term, and long-term actions. Some strategies we are currently pursuing, others we are identifying either strategic partnerships, and/or funding, so that we can implement them.
If you could do it all over again...
If we could back to the start, the piece of advice we would give ourselves would be to design the process in a way that allowed for the development of a professional network of care providers. Immediately after being awarded this grant, care providers approached us asking us to develop a statewide professional network so that we could share with them the resources and strategies we would ultimately identify through the grant period. If we had been able to create this network, we could have facilitated the project in such a way as to 1) deepen our collective understanding of the issue; 2) generate even more ideas; and, 3) allow us access to sites for testing solutions.