Advocacy Efforts and Partnerships To Improve LGBT Care

No study or organized body of literature exists documenting the success or failure of managed care relationships formed between LGBT focused programs and MCOs. What is known is that some MCOs and many LGBT providers are reaching out to one another to improve care for LGBT individuals. Some examples are listed below, and contact information is provided in the box at the end of the chapter.

• In researching written information from managed care organizations that indicated a sensitivity to LGBT competency, some clearly stated language was found within the body of a proposal of one managed care organization stating that it will apply cultural competency standards and be “sensitive to diversity brought about by a variety of factors including ethnicity, language, lifestyle, age, sexual preference and socioeconomic status.” This proposal is to manage behavioral health care for a public sector county-based contract.

• More than 14 MCOs have formed contractual relationships for primary physical health care services with the new Lambda Medical Group in Los Angeles (Jean, 1998). The major insurance plans accepted by it include Blue Cross, CIGNA, Medi-Cal, and MediCare. The Lambda Medical Group expects to serve 4,400 patients per year.

• In Washington, D.C., The Lambda Center, with its comprehensive continuum of inpatient, partial hospitalization, and outpatient services that have been made available via a joint-venture partnership, has been highly successful in attracting the attention of MBHCOs and other MCOs in the Mid-Atlantic region. Contracted rates with more than 10 MCOs have been established for The Lambda Center’s acute care services (inpatient hospitalization, detoxification, ambulatory detoxification, partial hospitalization, and intensive outpatient programs), and future plans will include contractual arrangements with a therapist network for the outpatient services component of the continuum. Part of the success is due to a full-scale LGBT sensitivity and –competency training and education campaign for MCO case managers and senior staff of the MCOs that is being conducted by The Lambda Center in collaboration with the Lesbian Health and Wellness Network (LHWN).

• LHWN, also based in Washington, D.C., is working closely with District of Columbia public sector programs through the Addiction Prevention and Recovery Administration, the D.C. Public Benefits Corporation, the Women’s Health Initiative, and the District of Columbia’s Medicaid program to incorporate training programs in the District’s managed behavioral health care readiness program. In addition, LHWN will be integrally involved in further network expansion efforts, and the LHWN network of providers will actually be listed in the provider directories as a block of lesbian-competent providers.

• The Pride Institute, founded in Minneapolis, Minnesota, began as a residential treatment facility for gay men and lesbians. Today, the Pride Institute manages mental health and addiction programs for LGBT individuals in several cities, including Fort Lauderdale, Chicago, Minneapolis, and New York, and in the Dallas area. Admission to Pride Institute programs is offered through a nationally advertised toll-free number. It is one of the only programs for LGBT individuals with a long-term residential treatment component; these components are based in Minnesota and Fort Lauderdale.

• ALTERNATIVES, founded in 1998, offers a dual diagnosis program for LGBT communities in Los Angeles and, now, in the San Francisco Bay area. Similar to the Pride Institute, ALTERNATIVES contracts with hospitals to manage and staff separate inpatient units for gay men and lesbians.