Recently, the Human Rights Campaign (HRC) Foundation, in partnership with the LGBTQ+ elder-advocacy organization SAGE, released the 2025 Long-Term Care Equality Index (LEI), which focuses on LGBTQ+ inclusion in residential long-term care and senior housing communities.
The report includes responses from 274 communities covering 33 states and D.C. (States were divided into different categories, with Illinois being in the one including four to nine communities.)
The survey revealed reasons for hope. Ninety-nine percent of the communities that participated in the LEI 2025 showed that they have updated their resident and employee non-discrimination policies to include protections based on sexual orientation and gender identity. In addition, 27% of participating communities earned either the High Performer or Leader designation, indicating that they are going beyond the basics and have adopted at least some of the policies and practices outlined in each criteria section.
However, individual scores for the respondents were not released. The LEI stated, “The hard work and dedication needed to ensure inclusive senior housing communities pushes forward in a sobering political climate. Increased, baseless attacks on diversity, equity, and inclusion efforts have resulted in a greater need to protect participating communities from being unfairly targeted. Therefore, the HRC Foundation and SAGE decided not to release individual scorecards in this year’s report.”
Windy City Times talked with One Roof Chicago Executive Director Jim Harvey about the report and long-term care. (According to its website, “One Roof Chicago is a transformative initiative to build an LGBTQ+-centered intergenerational community for older adults and young people most in need of affirming housing, meaningful connection, and career development.”) And Harvey had his own statistics—as well as a sobering story—regarding long-term care. “More than 75% of LGBTQ+ seniors entering long-term care facilities express apprehension about neglect, abuse—and they’re often denied services. I had a childhood friend, but we lost touch by high school although we reconnected many years later. She came out and was in a happy relationship until her spouse died; it was prior to [marriage equality] and people taking the time to make certain that the partner would be in a good position. So the spouse’s family swooped in, did a number on her—although a couple insurance policies helped her a little bit. But as she looked for places to live that she could a) afford and b) she would find affirming, she couldn’t find anything. So she moved into this facility and was still grieving; unfortunately, she was the subject of a lot of ridicule and abuse, on a daily basis. She took her life.
“When I found out about it, it broke my heart. I had known her since fourth grade,” added Harvey, 80. “So enter One Roof Chicago. There’s the whole idea of creating a welcoming, safe community. That’s where we’re headed today.”
When asked what some of the biggest problems LGBTQ+ elders face regarding housing, Harvey immediately named discrimination and finding culturally competent care. [Regarding] care, regarding African-American people and for [Latinos], it becomes a huge issue. Retirement communities are in the business to make money. What they’re going to do is gravitate toward those who can afford the high cost—and that tends to not be communities of color. You find instances where people have to spend down so they can become Medicaid-eligible so they can live in nursing homes and retirement communities. The other side of it is that, more often than not, you have people staffing these communities—and they’re not trained properly. Even if they’re from the community, there’s a lot missing from the training.
“It’s a huge part of the problem we face. And coming back to One Roof Chicago, why we’re building this residential community on the South Side is that we want to make certain that Black and Brown people, in particular, have a better shot of living in a community that looks like them. Hopefully, they’ll be supported by people who identify with us. That should be a goal for everybody.
“We’re introducing a program where we’re looking to recruit and train certified nursing assistants from our own community, so they’ll be sensitized and equipped to provide the kinds of assistance that’s necessary.”
And Harvey spoke about the transgender community, adding, “I’m happy to say that one of the first organizations we reached out to was [the trans-led] Life Is Work. We’re going to be intentional in recruiting transgender individuals with the programs we’re producing. People from the transgender community will be bringing their own life experiences to the table.”
Regarding the report, Harvey said that “some of the statistics were spot-on, if alarming. It’s information that we live with, on a regular basis.”
One of the aspects that stuck out in Harvey’s mind was that “there’s a slow and steady build of creating welcoming and diverse communities. As we talk about welcome and diversity, we’re talking about lived experiences,” he added.
However, the report also expressed results that indicated just how far things have to go regarding LGBTQ+ elder care—such as the fact that only 274 communities responded. “A lot of communities still don’t know what to do,” Harvey stated. “One of the things we talk about with One Roof Chicago is how we memorialize the lessons we’ve learned and how we institutionalize a lot of the steps we’re taking toward what we’re doing. The interesting thing is that none of the communities that exists so far is as holistic as we’re talking about being. We want to share ideas that we don’t see elsewhere; hopefully, the number will increase from the 274 cited in that report.”
And the report didn’t delve into race, Harvey noticed. “That’s unfortunate because, whether we’d like to admit it or not, even in the LGBTQ+ community, there are lots of incidents of racism that still exist. The Rainbow History Project, which is based in D.C., captured a lot of the old history of racism in that area, like when African-Americans tried to go to clubs back in the day. If too many of us showed up, certain roadblocks went up, like unofficial quotas. So when you talk about residential communities now, there are still some of them where you’re going to continue to run into racism. That’s a part of the work that still has to be done.”
In conclusion, Harvey said of his organization, “It’s a slow and steady march to getting [our] building up, and there are so many moving parts to this intergenerational community. We’re going to start by taking care of LGBTQ+ seniors; then, we’ll bring in residential services for young adults. But we want to make certain that young adults, in particular, have the opportunity to train in some of the critical issues that seniors face. There are many issues that need to be addressed.”
The LEI report and One Roof Chicago both underscore the fact that there are many welcoming places for LGBTQ+ seniors—and that there are many more that are needed.