Forest Community Health Center in Lansing is the "hub" for LGBTQ patient-centered care. BTL Photo: Todd Heywood

HRC Names Ingham Community Health Centers 'Leader in LGBT Healthcare Equality'

BY KATE OPALEWSKI

Elias Sivavajchaipong of Lansing said his history with past medical providers has been good and while his medical needs were met, he always felt uncomfortable discussing certain information with them.

"Since I have started seeing Dr. Wert, I have felt extremely comfortable discussing any of my medical concerns with him," said Sivavajchaipong about Dr. Erik Wert, medical director of the Ingham Community Health Centers in Lansing. "In turn, he has been able to get to know me personally. I feel that I am receiving some of the best medical care that I have had in a while."

Under Wert's leadership, healthcare providers at the ICHC have established a reputation for maintaining open and trusting relationships with their patients. This creates an environment where all patients feel welcome.

"We are committed to providing inclusive care to everyone in our community," said Ingham County Health Officer Linda S. Vail. "We will continue to strive for ways to support LGBTQ patients and community members and address LGBTQ health disparities."

The Ingham County Health Department's Community Health Centers recently participated in the 10th edition of the Healthcare Equality Index survey conducted by the Human Rights Campaign Foundation and was named a "Leader in LGBTQ Healthcare Equality."

Of the more than 1,500 facilities included in the 2017 HRC HEI survey, ICHC is one of just 302 nationwide to receive the top designation and is one of only two healthcare providers recognized as a leader in the state of Michigan.

The designation is based upon foundational elements of LGBTQ patient-centered care, LGBTQ patient services and support, employee benefits and policies, and LGBTQ patient and community engagement.

"Making clinics welcoming for LGBTQ people is important," said Wert, who has worked hard with Hope Dundas, a physician's assistant, to create an inclusive, affirming space for the LGBTQ and kink communities.

"Many people are afraid to tell someone about their lifestyle and they feel ashamed," he said. Wert often tells his kink patients, "As long as there is consent and that's what makes you happy, you have nothing to be afraid of. I often warn my patients or offer advice to make sure they make healthy and informed decisions."

Prep

Wert operates out of the Forest Community Health Center in Lansing where he is known for using the ground-breaking Pre-Exposure Prophylactics, or PrEP, program. The clinic, one of the few providers of PrEP in Ingham County, takes referrals from many private offices and organizations, including the Lansing Area AIDS Network.

The clinic at 2316 S. Cedar St. is the "hub," said Wert, for a majority of their LGBTQ healthcare. There are seven other Ingham County clinics in the group that offer primary healthcare, women's healthcare, school-based healthcare, children's healthcare and dental care. All of which display the HRC equal sign in the window, sending a message of support for equal rights.

Beyond this, the ICHC assists patients with insurance enrollment, transportation and behavioral health consulting. There is also a sliding fee discount program made possible by federal grants through the Bureau of Primary Health Care.

Training in culturally-competent care is mandatory for everyone at the clinics, said Wert. Front office staff learn how to sensitively collect sexual orientation and gender identity data. The office is designed so nobody can tell which doctor a patient is seeing.

Wert said that he and his team have created workarounds in rigid computer programs to better serve transgender patients. "If my medical assistant walks out to talk to a patient, a warning pops up so they know the name and the pronouns they want to go by," he said.

Sara Doherty of Lansing has been seeing Dundas since October 2016 for both transition and non-transition related care.

"It's so nice to see a provider and not have to worry about their response to my gender identity," said Doherty, a non-binary individual who runs a support group for LGBTQ teens at the Child and Family Charities agency in Lansing.

"We've had Hope come in as a guest speaker to help teens who are considering transition to understand their options. She is a great support for the kids," they said. "Without even talking about myself specifically, for a lot of people, if you're dealing with physical dysphoria, visiting a medical professional can be a stressful experience. Seeing someone like Hope who is aware of those issues and sensitive to them can make a huge difference. She asks helpful questions to engage your level of comfort, to help you relax and feel comfortable with something that is already uncomfortable."

Wert said that socially-acceptable outlets are not always available for young people. As a result, they self-medicate, which leads to substance abuse and increases their risk for other risky behaviors.

"I know a lot of primary care doctors don't discuss things like sexual orientation and gender identity. They aren't asking the right questions or doing the right tests. It starts with making people feel comfortable so they can have those intimate conversations and discuss their health more freely," he said.

"Studies out of New York, for example, show that lesbians don't get required pap screenings because they don't want to express their sexuality. Their perception is that they are low risk because they aren't having sex with men, but in fact their risk of HPV and cancer goes up without this exam," said Wert.

Other Michigan Health Resources

Only a couple other medical homes are focused on serving the LGBTQ community in Michigan including the Ruth Ellis Health and Wellness Center in Highland Park, specifically for at-risk LGBTQ youth who have runaway from home or are experiencing homelessness. Much like the new Corktown Health Center which opens this summer in Detroit, the ICHC model similar programs like Fenway in Boston and Howard Brown in Chicago.

"We have had the continued support of the administration and the board of directors who hired me to provide this care without interference," said Wert. "It makes this job so much easier."

Jon Villasurda, Community Health Center Board President since 2014, said, "Dr. Wert does a great job. We have a good collaborative relationship and we are intentional about making sure patients feel welcome at our health centers."

Villasurda notes that some members of the board identify as LGBTQ and is 50 percent patient-based, a requirement for federally-based health centers.

"So it really is the community driving the needs, assessment and operations of the organization to accommodate the LGBTQ population," he said, adding that the board easily gave Wert and his team authorization to participate in the HRC HEI survey. "He worked really hard on that. We are really proud of it."

See the HRC HEI results online. Find an Ingham County Community Health Center in Lansing online.
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