Human Rights Campaign and SAGE Team Up to Produce Long-Term Care Equality Index

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The Human Rights Campaign (HRC) Foundation, the educational arm of the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization, and SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBTQ older adults, announced a historic partnership to fundamentally improve the experiences of LGBTQ older adults as they seek long-term care and services.

A centerpiece of the effort will be the Long-Term Care Equality Index (LEI), the first-ever nationwide assessment of how long-term care facilities are treating their LGBTQ residents. The new survey will build on the decade-plus success of the HRC Foundation’s Healthcare Equality Index (HEI), which scores healthcare facilities on policies and practices ensuring the equitable treatment and inclusion of their LGBTQ patients, visitors and employees.

As work begins to develop the specific evaluation tools for the LEI, facilities are being asked today to take the first step by signing onto the HRC Foundation and SAGE’s “Commitment to Caring” pledge. Leaders from HRC and SAGE made the announcement today in New Orleans at the annual American Society on Aging Conference — the nation’s largest multidisciplinary conference covering issues of aging and quality of life for older adults. The American Society on Aging is the first signatory to the pledge.

“All too often, LGBTQ elders do not receive the care and support they deserve,” said HRC President Chad Griffin. “With experts predicting that as many as 4.7 million LGBTQ elders will be seeking care and services by the year 2030, the time to act is now. It is incumbent on us to ensure that all LGBTQ elders are treated with dignity and respect, and HRC is proud to join with SAGE in this historic effort to fundamentally improve the experiences of LGBTQ older adults as they seek long-term care and services.”

“It’s time to end the tragedy of LGBTQ elders being forced back into the closet because of discrimination and mistreatment in care settings,” said SAGE CEO Michael Adams. “That’s what the Long-Term Care Equality Index is all about and why SAGE is excited to join forces with HRC on this critically important effort. It will be an essential complement to the cultural competency training that SAGE provides across the country.” 

The invisibility of LGBTQ elders, many of whom remain closeted or return to the closet when they enter residential care, has perpetuated the false perception that there isn’t a pressing need to make policy or practice changes ensuring that care facilities are welcoming and inclusive of LGBTQ elders. And for LGBTQ Black and Latinx community members, there is compounded fear of discrimination and inadequate care based not only on sexual orientation and gender identity but also bias and health disparities rooted in race and ethnic identity.

national survey of LGBTQ older adults in long-term care facilities found that:

  • Only 22 percent of respondents felt they could be open about their LGBTQ identities with facility staff;
  • Eighty-nine percent predicted that staff would discriminate based on their sexual orientations and/or gender identities, and;
  • Forty-three percent reported instances of mistreatment.

This joint effort, generously supported by Ted Snowdon and Duffy Violante, will also include a nationwide campaign to raise awareness of the specific needs of LGBTQ elders. A Pfizer-funded 2015 study commissioned by HRC and SAGE of long-term care providers and association-level aging services organizations found that a tool to assess practices and help build capacity within the aging services field is a timely and much-needed initiative.


The Human Rights Campaign Foundation is the educational arm of America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer people. HRC envisions a world where LGBTQ people are embraced as full members of society at home, at work and in every community.

SAGE is the country’s largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual, and transgender (LGBT) older people. Founded in 1978 and headquartered in New York City, SAGE is a national organization that offers supportive services and consumer resources to LGBT older people and their caregivers. SAGE also advocates for public policy changes that address the needs of LGBT elders, provides education and technical assistance for aging providers and LGBT community organizations through its National Resource Center on LGBT Aging, and cultural competency training through SAGECare. With staff located across the country, SAGE also coordinates SAGENet, a growing network of affiliates in the United States.