HHS has taken many steps to strengthen the health resources available to LGBTQ+ Americans. The following are some of those steps and how they have impacted the LGBTQ+ community:
Agencies across HHS are working with health care providers, grantees, employees and others to improve cultural competency with respect to LGBTQ+ populations.
Cultural Competency Training : Agencies within HHS have undertaken a number of training efforts designed to help administrators, clinicians and service providers focus on the importance of recognizing and addressing the unique health experiences and needs of the LGBTQ+ population.
Cultural Competency Curricula: Curricula have been developed for health care professionals and students that focus on teaching cultural competency in the assessment and care of LGBTQ+ patients.
Cultural Competency Resources: HHS has developed a number of resources such as publications and videos that help improve communication and care to LGBTQ+ patients.
Youth and Families
HHS has developed a number of programs and resources to help understand and address the specific needs of LGBTQ+ youth and their families.
- The Substance Abuse and Mental Health Services Administration (SAMHSA), working with the Family Acceptance Project, developed and released a resource document for practitioners who work with LGBTQ+ youth in multiple service sectors (e.g., behavioral health, child welfare, juvenile justice, primary care, schools, homeless and runaway programs). This document helps practitioners understand the role of family acceptance/rejection in the overall health, behavioral health, and well-being of youth, as well as implement best practices for engaging and creating supportive families.
- The Administration for Children and Families (ACF) Family and Youth Services Bureau funded two grantees to conduct a systematic review of practices and services aiming to improve the well-being of Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) individuals, and to lay a foundation for improving such services and practices. One grantee, funded in September 2013 with a 3-year grant, is targeting its efforts at LGBTQ runaway and homeless youth by developing a blueprint to build the capacity to better serve homeless youth by strengthening their efforts to understand and address the needs of this population. The project will conduct a systematic review of existing literature; a comprehensive needs assessment; and a systematic identification and analysis of screening and assessment tools, existing and emerging practices/interventions, and trainings for RHY providers. The project is guided by the Youth Intervention Model and an Implementation Science framework to identify the core intervention components and core implementation drivers that are necessary to implement and sustain evidence-informed practices with LGBTQ youth experiencing homelessness. The project will culminate with the development of products that synthesizes key findings and recommendations to inform and advance policies and practices with LGBTQ homeless youth.
- ACF has modified its Office of Refugee Resettlement (ORR) Matching Grant Program Guidelines to include waiver language allowing people to transfer enrollees from one resettlement agency to another (within or across States) if there are special needs that are not being met. LGBTQ+ populations were specifically mentioned as part of this waiver.
- ACF has partnered with the Department of Housing and Urban Development (HUD) on a pilot project to prevent homelessness among LGBTQ+ youth. The goal of the LGTBQ Youth Homelessness Prevention Initiative is to help federal agencies and local communities learn more about implementing community-wide strategies for (1) preventing homelessness for LGBTQ youth at risk of becoming homeless and (2) quickly resolving homelessness for LGBTQ youth presenting as homeless for the first time. The initiative will also assist the federal partners in developing national guidance and recommendations to improve their programs.
Through this effort, two communities are developing strategic action plans to focus on this population within their Emergency Shelter Grant Programs (administered by HUD) and with improved collaboration and technical assistance involving federal, state, and local service systems and programs and local stakeholders. HHS is facilitating linkages with our Runaway and Homeless Youth Program grantees in the participating communities and will assist with technical assistance as needed through both the ACF’s Runaway and Homeless Youth Training and Technical Assistance Center and through a SAMHSA technical assistance center that focuses on assisting substance abuse and mental health treatment providers improve their cultural competence in serving LGBTQ populations.
- The Office of The Assistant Secretary for Planning and Evaluation (ASPE) is working with the Administration for Children and Families (ACF) on a Research Development Project on the Human Services Needs of LGBTQ+ Populations. As part of this effort, a sub-study was funded under which site visits were conducted at four runaway and homeless youth programs to examine how these programs collect data and target services for homeless LGBTQ+ youth.
- Violence affects everyone regardless of sexual orientation. The CDC reports that LGBTQ+ persons experience intimate partner violence at rates equal to or higher than those of heterosexuals. The Family Violence Prevention and Services Program administers the Family Violence Prevention and Services Act (FVPSA), the primary federal funding stream dedicated to the support of emergency shelter and supportive services for victims of domestic violence and their children, including LGBTQ+ survivors. Since 2013, ACF has funded FVPSA's Capacity-building Learning Center dedicated to Improving Service Accessibility for Lesbian, Gay, Bisexual, Transgender and Questioning Victims of Domestic Violence. Over the course of the 3-year grant period, the Learning Center will develop and identify effective approaches for serving LGBTQ survivors of intimate partner violence and their children.
HHS collaborated with five other federal departments to establish a federal task force on bullying. One of the results was the creation of the website –www.StopBullying.gov. The site includes resources and assistance for LGBTQ+ youth, including examples of community groups that offer support and options to seek counseling. The task force also funded a video called “It Gets Better” to address LGBTQ+ youth who have been bullied and are at risk of depression and suicide.
HHS has also created the National Action Alliance for Suicide Prevention with a wide range of public and private partners to coordinate suicide prevention efforts, particularly among at-risk groups, such as LGBTQ+ youth.
National HIV/AIDS Strategy
HHS has announced the National HIV/AIDS Strategy, a rigorous effort to increase access to care and lower the number of new HIV cases in the United States. The CDC allocated $30 million in resources to support the National HIV/AIDS strategy. These funds are helping states and communities in their HIV prevention efforts among high-risk populations. The funds are also helping fill critical gaps in data, knowledge, and understanding of the epidemic. The Substance Abuse and Mental Health Services Administration (SAMHSA) gave $42.6 million in grants to provide behavioral health services in communities most impacted by HIV/AIDS.
HHS funded the Services and Advocacy for GLBT Elders (SAGE) to establish the first national resource center for older LGBTQ+ individuals. This center supports communities across the country as they aim to serve the estimated 1.5 to 4 million LGBT individuals who are 60 and older. This center provides information, assistance and resources at the state and community levels.
Resettlement of LGBTQ+ Refugees
The Administration for Children and Families (ACF) created a resource center to support the resettlement of LGBTQ+ refugees who have faced persecution and discrimination in their home countries. The center provides resources to resettlement workers who are helping refugees assimilate in America in key locations, and training to staff on issues specific to LGBTQ+ refugees.
HHS released a department-wide strategic action plan to reduce tobacco use. To address higher smoking rates among LGBTQ+ individuals, this plan emphasizes the need for more research, and calls for the development of evidence-based, population-specific treatments and interventions.
Below are examples of efforts to reduce tobacco use within the LGBT population:
- The Centers for Disease Control and Prevention (CDC) is working with The Network of LGBT Health Equity to advance tobacco control among specific target populations. CDC has also worked with the network on LGBTQ+-specific paid and earned media efforts.
- CDC’s Tips from Former Smokers national tobacco education campaign included specific messaging and outreach to the LGBTQ+ community.