Public health leaders and community health workers gathered yesterday at the State House, in celebration of the new Department of Public Health report on community health workers (CHWs) in Massachusetts (press release). The report highlights the effectiveness of CHW’s in assisting families with obtaining and maintaining health care coverage, engaging in prevention efforts, managing chronic disease, and coordinating health and social services. The report resulted from a study commissioned in the state’s 2006 Health Reform Law.
With the devastating Haitian earthquake on the minds of all in attendance, speakers from the Legislature and Administration emphasized the significant role that CHW’s play on the front lines of public health crises; serving some of the most vulnerable and underserved populations in the nation and around the world. It was noted that Massachusetts is home to the nation’s third largest Haitian American population, many of whom are CHW’s and/or touched by the community health worker profession. DPH’s senior policy advisor Geoff Wilkinson acknowledged the important role that community health workers will play in the disaster’s rescue and recovery efforts in Haiti, as well in supporting Massachusetts’s Haitian American communities.
EOHHS Secretary Judy Bigby and Representative Gloria Fox both praised the health worker community for their expertise in understanding the unique health and social needs of Massachusetts’ diverse communities including immigrants, refugees, and many at risk populations. Alongside State Representative Harriet Stanley, they emphasized that CHW’s support prevention and wellness in all communities, and are key leaders in the state’s health care reform implementation and cost control efforts. The MA Association of Community Health Workers encouraged the packed crowd to advocate for policies that further support the community health worker profession, including H. 4130, a bill to establish a Board of Certification of Community Health Workers.
The full DPH Community Health Worker report and other CHW information is available on the DPH website, www.mass.gov/dph/communityhealthworkers. Health Care for All congratulates the Administration, Legislature and Massachusetts Association of Community Health Workers for this achievement. -Dayanne Leal
Early last week, the Commonwealth’s Health Disparities Council held its monthly meeting to continue their work on creating policies to reduce health disparities among Massachusetts residents.
Since the Senate was in the midst of addressing their version of the FY10 budget, the meeting was chaired by Rep. Rushing and Sec. Bigby in the absence of Senator Fargo. The Report Card Group provided an update to the Council on its work thus far and presented a timeline for moving forward. The indicators they presented that are schedule to be included in the first draft of the report card are based on a model from the National Women’s Law Center. A number of Council members raised concerns about the indicators chosen and offered several suggestions for additional indicators focused on the social determinants of health.
Judy Parlato, Clinical Advisor from the Division of Health Care Finance and Policy presented updated information on Hospital Race and Ethnicity Data Collection, a commission recommendation. She outlined use of the data, shared information on race and ethnicity standards as well as the process for developing the Division’s new race and ethnicity requirements, and presented details of the Division’s implementation process. Parlato reported one great improvement: no missing data from participating hospitals found data collection easier to accomplish once they better understood how it would be used. Georgia Simpson May, Director of the Department of Public Health’s Office of Health Equity also provided the Council with an update of her office’s work on Interpreter Services.
The Council recently launched their new website (mass.gov/hdc) and encourages the public to visit it for the latest information and meeting materials. Any questions should be emailed to HDC@state.ma.us. Materials from this meeting will also be posted on our website as soon as we have them. - Jessica Hamilton
The Blue Cross Blue Shield of Massachusetts Foundation is launching their new website today: BlueCrossFoundation.org. We think it’s great, we want you to take a look at it, too.
The website is user-friendly and chock-full of valuable information about the Massachusetts health care world and the Foundation’s work. The site has information about the grants the Foundation funds and helpful FAQ for organizations interested in applying for grants. The site allows viewers to watch stories of real people helped by MA health reform in the “Voices of Reform” section. Viewers can watch interviews with leading thinkers in the area of health care and health reform with the “Prescriptions for Health Reform” feature.
The Foundation’s publications and reports on access to care and health care finance and delivery are easily accessible on the new site as well as information about the three programs run by the Foundation to expand access to health care. The site also has relevant press releases and news stories. Congratulations to the Foundation, and check out the new website!
P.S. — and while we’re talking website, the Kaiser Foundation just set up a dedicated site for national health reform. The site pulls together everything health reform: healthreform.kff.org. Highly recommended. Catherine Hammons
First, please watch the video below, highlights from today’s inspirational, packed “Stop The Cuts” rally at the State House. The speakers include Harris Gruman of SEIU and the Stop the Cuts Coalition; Lisa Wong, Mayor of Fitchburg; John Bennett of Mass Senior Action; and Lynn Norris of Neighbor to Neighbor.
Next, call your State Senator (not sure who that is? look it up here) and urge him or her to support expanded revenues and HCFA’s key budget amendments to restore critical health care programs. The Senate will be starting its budget debate on Tuesday.
Adult Dental Benefits (Amendment EHS 473)
Senator Chandler
Eliminating adult dental benefits from MassHealth and Commonwealth Care will affect nearly 800,000 individuals throughout the state. Oral health is a critical part of overall health - studies show that chronic oral infections are associated with complex health problems such as heart disease, stroke, diabetes, low-birth weight, and premature infant births. Approximately one-ninth of Massachusetts’ population will be affected by this cut, including more than 120,000 low-income seniors and 180,000 disabled individuals on MassHealth and 91,000 individuals on Commonwealth Care.
Commonwealth Care Coverage (Amendment EHS 656)
Senator Chang-Diaz
Some 28,000 “special status” legal immigrant adults are enrolled in Commonwealth Care. They pay sliding-scale premiums, and are enrolled in private managed care plans. Coverage for this group, whose health needs was previously covered by episodic coverage via the Uncompensated Care Pool, was a provision of health reform. Ending eligibility for special status immigrants will leave over 28,000 Massachusetts residents without the comprehensive health coverage they need, and increase costs in other programs.
Office of Oral Health (Amendment EHS 465)
Senator Chandler
Line item 4512-0500
This amendment will provide equitable funding the Department of Public Health’s Office of Oral Health to bring needed oral health education and care to children and adults in underserved parts of the state, including dental care for persons with disabilities.
Child and Adolescent Mental Health Services (Amendment EHS 500)
Senator Spilka
Line item 5042-5000
This amendment restores funding to the primary account under the Department of Mental Health that provides services to children and young people with behavioral health needs. Included in this line item is funding for the Massachusetts Child Psychiatric Access Project, a model program that provides mental health consultations to pediatricians.
Office of Health Equity (Amendments EHS 597 and EHS 690)
Senator Fargo
Line item 4000-0300
These amendments add language to maintain the Office of Health Equity in the Executive Office of Health and Human Services. The Office of Health Equity oversees comprehensive efforts to eliminate health disparities, providing leadership and coordination of all state agency efforts. The Office is developing interagency disparities initiatives, preparing an annual health disparities report card, and evaluating the effectiveness of interventions.
Children’s Medical Security Plan (Amendment EHS 621)
Senator Eldridge
Outside Section
This amendment standardizes administration of the Children’s Medical Security Plan (CMSP), to bring the program into line with other programs administered by MassHealth. Additionally, it gives EHS the option to reexamine benefits offered under CMSP and to eliminate unrealistic caps on services (such as the currently-mandated $200 annual cap on prescription drugs for children).
DEEC Consultative Mental Health Services (Amendment EHS 617)
Senator Flanagan
Line item 3000-6075
This amendment restores the line item and funding for mental health consultative services to preschools. Massachusetts ranks 9th nationally for the rate of expelling young children from early education settings. Providing behavioral health consultative services has been shown to reduce the rate of expulsions and to reduce special education costs for children the following year in kindergarten.
DPH Quality Programs (Amendment EHS 686)
Senator Fargo
Line item 4510-0710
Last year Massachusetts made huge strides in improving the quality of health care in the Commonwealth by passing Chapter 305. Among its important duties, the Division of Health Care Quality gathers information and issues reports on Serious Reportable Events and infections to help hospitals improve the delivery of health care and save lives. Proposed cuts would slash this program.
Prescription Advantage (Amendment EHS 697)
Senator Montigny
Line Item 9110-1455
This is a state sponsored prescription assistance program for the elderly and some individuals who are disabled. It currently has 64,000 enrollees and this cut will cause 14,600 enrollees to lose their prescription drug assistance that keeps our seniors healthy, independent and out of more expensive care.
FMAP Transparency (Amendment EHS 700)
Senator Montigny
The United States federal government’s economic stimulus package will give states additional money for urgent health care needs. The enhanced Federal Medical Assistance Percentage (FMAP) funds are intended to be invested in MassHealth, health care, and public health. This amendment creates an identifiable, transparent FMAP fund to: secure jobs; maintain health care reform’s achievements; protect essential safety net services; preserve funding for our hospitals and community health centers; and fund cost-effective public health initiatives.
Evidence-based outreach and education program (Amendment EHS 702)
Senator Montigny
Line item 4510-0716
The evidence-based outreach and education program, also referred to as “Academic Detailing” would provide doctors with unbiased evidence to guide them in their prescribing decisions. Such programs have demonstrated to provide immediate savings that far exceed the cost of the program. This amendment restores this cost-saving program.
A detailed list of HCFA-supported amendments are here.
As we celebrate three years of healthcare reform this week and applaud the great work that has brought insurance coverage to hundreds of thousands of individuals across the Commonwealth, we should also recognize efforts in the law to improve health care quality and eliminate health disparities.
Chapter 58 created the Massachusetts Health Care Quality and Cost Council with the mandate of creating a consumer-oriented website with quality and cost data and also setting cost containment and quality improvement goals for the Commonwealth. The website went live in December and now consumers have access to vital information that can help them make health care choices. The website will be expanded in the future with more hospital-focused measures as well as measures focused on the outpatient setting. The Quality and Cost Council is also now deeply involved in cost control conversations and has a goal of bringing the annual increase in health care costs down to the rate of increase of GDP by 2012. The Quality and Cost Council’s patient safety goals include reducing infections in both inpatient and outpatient settings. In concert with this is the Department of Public Health’s infection control and surveillance program, also created under Chapter 58. DPH, along with the Betsy Lehman Center for Patient Safety and Medical Error Reduction, has been working to track and reduce infections in hospitals. This week, DPH is issuing its first public report on healthcare-associated infections. A hospital-specific report will come out in the fall. Again, consumers can use this information to make choices and hospitals can use this information to further reduce infections. Chapter 58 set the path for huge changes in the quality improvement landscape in Massachusetts.
The Massachusetts Health Disparities Council was also born in Chapter 58. Convened in December of 2007, the legislatively appointed Council brings together health equity experts to analyze state progress and challenges on a host of racial and ethnic health disparities issues. With the leadership of Senator Susan Fargo, Representative Byron Rushing and Secretary JudyAnn Bigby, the Council has been actively working on a comprehensive set of recommendations that address the state’s gaps in health status by race and ethnicity. Using 2005’s Legislative Commission on Health Disparities Final Report as a guide, the Council is evaluating the state’s progress on collecting race and language data, expanding healthcare access, and addressing social factors that influence health. Challenged with a complex and difficult issue, the Disparities Council is progressing with determination, and keeping disparities on the healthcare reform agenda.
The progress of these quality and disparities initiatives over the past three years is significant, and should be recognized alongside the expansion of healthcare insurance. Ensuring that all Massachusetts residents have quality, affordable and equitable healthcare is the next phase of healthcare reform, and essential to achieving the ultimate vision of Chapter 58.
Yesterday Attorney General Martha Coakley released updated Community Benefit Guidelines for Non Profit Acute Care Hospitals and Health Maintenance Organizations (Links: the guidelines and the press release). The AG and her staff led a thoughtful guideline revision process including convening an Advisory Task Force that worked via consensus to advise the AG (HCFA was honored to serve on the Task Force) and a public comment period.
These new community-focused guidelines prioritize transparency and accountability. Community Benefits programs must include pre-planning that engages the community to set goals and measurements. We are specifically pleased by the elevation of health care disparities to a statewide priority and the special attention to fair medical debt collection practices.
The real work is ahead as these guidelines go into effect in 2010. Now that the AG has provided a meaningful tool for collaboration between communities, providers and insurers, communities and consumers must engage in the Community Benefits pre-planning process to maximize the potential of the guidelines. Stay tuned to this blog for more information on community rollout events for the guidelines and how you can get involved. Fawn Phelps
The Council on Racial and Ethnic Health Disparities met on Monday, September 15th. Chaired by Representative Byron Rushing, the September meeting focused on a presentation on the Council’s prioritization process and the working groups’ priorities of the former Special Legislative Commission on Health Disparities.
Council members discussed the most appropriate role for the council in a variety of areas, particularly areas that are currently underway including hospital race and ethnicity data collection. The group also debated the addition of new priorities and topics that were not recommended by the Commission nearly two years ago.
The next Council meeting will include a vote on the working group recommendations and any new proposals that members contribute as a result of Monday’s meeting.
Nearly 25,000 experts, advocates, and impacted populations converged on Mexico City last week for the International AIDS Conference. The 17th meeting was as much political as scientific, with contentious issues around stigma, antiretroviral drug access, and research funding shaping the dialogue and debate. While the international meeting drew much needed attention to the epidemic raging in Africa, Latin America, and Eastern Europe, Black American leaders shed light on the U.S’s failure to address the epidemic within its very own borders. During a press conference, leaders from the Black AIDS Institute, CARE, and the Ford Foundation called for a new domestic strategy and increased funding to address HIV/AIDS in America, particularly in black communities.
Wilson noted, “We’re not here to wring our hands about the situation. We are calling today for a National AIDS Strategy…a clear, aggressive plan of action to provide HIV education, prevention and treatment to all who need it. This National AIDS Strategy would be the equivalent of a `U.S. PEPFAR,´ incorporating many of the same approaches the U.S. recommends for other countries with serious HIV epidemics.” Wilson’s call alludes to a criticism included in the new report, that the U.S. has invested more resources into the epidemic in Africa than within African American communities. The report notes that there are more HIV-positive African Americans within the United States, than in 7 of the 15 countries included in the President’s Emergency Plan for AIDS Relief. Camille Watson
The Health Disparities Council held its monthly meeting yesterday, reviewing recommendations of the Special Legislative Commission on Health Disparities, and developing a work group to develop priorities for the Council to implement. Materials from the meeting are available here.
Dr. Alice Coombs (Massachusetts Medical Society) , Dr. Paul Mendis (Neighborhood Health Plan), Dr. Joseph Betancourt (Massachusetts General Hospital) and DPH Commissioner John Auerbach, presented on behalf of the original Commision’s working groups, addressing workforce diversity, health care access and quality, and social determinants issues. The presenters all pointed to the success of health care access expansion in Massachusetts as an important step in disparities elimination efforts, but also noted the need to continue working to address quality, cultural competence, and social context problems.
Council Chair Representative Rushing developed a small work group that will identify priorities in these areas for the Council to begin addressing in the August meeting. Camille Watson
The largest professional association for American physicians, the American Medical Association (AMA), issued an apology today for a history of racial bias and exclusion against black physicians (news report here). Past practices of the AMA that were acknowledged in the apology included the exclusions of blacks from AMA membership, and the Association’s silence during Congressional decisions on federal funding for segregated hospitals and other civil rights issues.
Past President Ronald Davies said, “”The medical profession, which is based on a boundless respect for human life, had an obligation to lead society away from disrespect of so many lives. The AMA failed to do so and has apologized for that failure. Our goal is to identify and study racial and ethnic health care disparities in order to eradicate them.”
The AMA apology underscores the legacy of racism, exclusion and structural injustice that contribute to the health disparities that we continue to see in the United States.
The black physician group, the National Medical Association, accepted today’s apology. NMA’s Chair of the Board of Trustees noted, “These persistent, race-based health disparities have led to a precipitous decline in the health of African-Americans when compared to their white counterparts and the population as a whole.” She added, “In accepting this apology for past wrongs, it is important we seize this opportunity to move forward to correct these injustices.” Camille Watson
The Council on Racial and Ethnic Health Disparities will next convene on Monday, July 21st (1 Ashburton Place, 21st floor). Chaired by Senator Dianne Wilkerson and Representative Byron Rushing, the July meeting will begin a three-month process for the Council to establish priorities and develop long-term goals. Click on the links for the meeting agenda, proposed workplan, presentation and minutes from the last meeting. Stay tuned to the HCFA disparities website in the coming days, as we launch a new web page to track the Council developments.
For additional information on the Council, contact John Samuelian of EOHHS, at John.Samuelian@state.ma.us.
The Cambridge Public Health Department released a new report today, documenting the often-overlooked issue of gender-based health disparities. Both nationally and in Massachusetts, men have poorer health outcomes for heart disease, cancer, stroke, homicide and injury. Men of color fare not only worse than their white peers for these indicators, but worse than women of color as well.
The key findings include:
The overall death rate (all mortality rates are age-adjusted) for Cambridge males is 34% higher than for Cambridge females.
Cambridge males have higher death rates than females for heart disease and cancer, and higher infection rates for HIV/AIDS.
While both sexes experience a similar rate of death from stroke and diabetes, Cambridge males are hospitalized for these diseases at a higher rate than Cambridge females.
Within the city’s male population, the death rate for black males is 9% higher than for white males, 78% higher than for Hispanic males, and 327% higher than for Asian males.
This new report provides specific data for men of Cambridge, as well as a review of initiatives and policies aimed at improving men’s health in the community. For example, a Cambridge program called The Men’s League: A Community Health Partnership for Men engages participants in wellness activities and connects them to health care services.
The report is a much needed addition to the literature and analysis of this important health equity issue. The full report is available here. Camille Watson
What are the causes of racial and ethnic health disparities? Harvard Medical School researchers recently documented disparities in the outcomes of diabetes patients with the same physician. Despite the assumed equal treatment provided, blacks showed worse outcomes than their white counterparts for standard measures of diabetes control.
The study looked at 6,800 patients being treated by at least one of 90 primary care physicians at Harvard Vanguard Medical Associates sites in eastern Massachusetts.
Lack of attention to cultural issues may explain some of the differences. The study authors (Sequist et al) offer this as the explanation: “Racial differences in outcomes were not related to black patients differentially receiving care from physicians who provide a lower quality of care, but rather that black patients experienced less ideal or even adequate outcomes than white patients within the same physician panel. … Physician-level variation in disparities was not associated with either individual physicians’ overall performance or their number of black patients with [diabetes].”
In a New York Times interview, Dr. Sequist explains how a lack of tailored culturally competent care may lead to disparities:
“It isn’t that providers are doing different things for different patients,” Dr. Sequist said. “It’s that we’re doing the same thing for every patient and not accounting for individual needs. Our one-size-fits-all approach may leave minority patients with needs that aren’t being met.”
For instance, he said, counseling black or Latino patients with diabetes to lower their carbohydrate intake by cutting rice from their diets may not be a realistic strategy if rice is a family staple.
“We may be listing fruits and vegetables that are part of one person’s culture but not another,” Dr. Sequist said. “We’re not really giving them information they can use.”
Recommendations to remedy this disparity include greater attention to cultural and socioeconomic differences that impact patient behavior, such as diet. The abstract and complete article are available in the current issue of the Archives of Internal Medicine. Camille Watson
Unnatural Causes … is inequality making us sick is a groundbreaking new documentary series exploring how the social conditions in which Americans are born, live and work profoundly affect health and longevity, even more than medical care, behaviors and genes. The film goes beyond popular conceptions linking health to medical care, lifestyles and genes to explore evidence of other more powerful determinants: the social conditions in which we are born, live and work. Watch clips, get the toolkit and discussion guide, and more, here.
Please join us for the free Springfield/Holyoke local premiere of the film and a panel discussion about creating a unified health equity agenda and how we can all take action!
When: Wednesday, June 18th, 2008
Time: 5:30 – 6:00 p.m. Reception and entertainment; 6:00 – 8:45 p.m. Screening and Program
Location: City Stage, One Columbus Center, Springfield, MA 01103
Please RSVP by June 16th, 2008. Call 413-540-0600 ext. 106 or email: laura.hurley@bhs.org
Here’s a good news story from Mass. General Hospital worthy of note:
MGH is sponsoring an event on Tuesday, June 3rd from 12 to 1:30 under the Bulfinch Tent at its downtown campus to celebrate a change in its mission which now includes “…improving the health and well-being of the diverse communities we serve.” Dr. David Satcher, the former US Surgeon General who invented the term “racial and ethnic health disparities,” will give the keynote. MGH will also announce the renaming of their Community Benefit Program as the “MGH Center for Community Health Improvement” to signify its broader, new role.
The Center has partnerships with 35 local leaders, churches, residents, schools, police and others to improve community health. To implement the new mission, MGH President Dr. Peter Slavin will hold the chiefs of 19 clinical departments accountable for partnering with CCHI to develop community-oriented initiatives of significant scope and impact. These are big and noteworthy changes to strengthen a commitment to community health.
For more info, here’s the link for the June Third Event. Let’s give recognition to an institution making a stepped up commitment to improving community health.
The Council on Racial and Ethnic Health Disparities will convene its second meeting at 10am on Monday, May 19th (1 Ashburton Pl, 21st Fl). Chaired by Senator Dianne Wilkerson and Representative Byron Rushing, the council will build on its initial meeting of December 2007, to outline a plan of action for the diverse group of disparities experts. This meeting will be the first of a regularly scheduled gathering to take place on the 3rd Monday of every month. Stay tuned to the HCFA website and blog for updates.
To RSVP for the council meeting, contact John Samuelian of EOHHS, at John.Samuelian@state.ma.us. Camille Watson
Thanks to Representative Ruth Balser, chair of the Mental Health and Substance Abuse Committee, yesterday the House restored funding to the Massachusetts Children’s Psychiatric Access Project (MCPAP). MCPAP helps address the shortage of child psychiatrists in Massachusetts by providing phone consultations to pediatricians’ offices. MCPAP has been overwhelmingly successful since its creation. Currently, more than 96% of all pediatricians participate in the program. Representative Balser has been a tireless leader on children’s mental health issues and is the lead sponsor of S. 2518, An Act Relative to Children’s Mental Health.
The House added $34.5 million to the budget in elder affairs and Medicaid consolidated amendments. The Disparities Action Network achieved a major victory when the House agreed to add language creating an Office of Health Equity within the Executive Office of Health and Human Services. The language details that “the office may prepare an annual health disparities report card with regional disparities data, evaluate effectiveness of interventions, and replicate successful programs across the state; provided, further, the office shall work with a disparities reduction program with a focus on supporting efforts by community-based health agencies and community health workers to eliminate racial and ethnic health disparities, including efforts addressing social factors integral to such disparities.” The DAN would like to thank the 47 co-sponsors for their support of this office and in particular, Representatives Rushing, Fox, St. Fluer and Sanchez.
The House also continued its support of health reform by continuing $3.5 million for the outreach and enrollment grants. These health reform outreach grants go to community organizations and are critical to enrolling people and helping them maintain their coverage.
And for Wednesday, consolidated amendments on public health, veterans and health and human services are being debated. Read yesterday’s blog post for the Oral Health Task Force’s priorities. Caucus at 10 am. Roll calls begin at 12:30 pm.
The Commonwealth Fund, the Opportunity Agenda and Families USA have released a new report, Identifying and Evaluating Equity Provisions in State Health Care Reform. The report identifies state-level policies that promote equitable health care access and quality for all populations, evaluates existing laws, regulations, and reform proposals in five states-Massachusetts, Washington, California, Illinois, and Pennsylvania.
Good overview and discussion of Massachusetts initiatives.
Last year, Massachusetts hospitals provided over $271 million in community benefits programs to Massachusetts residents as part of this voluntary program. All non-profit acute care hospitals are asked to submit their community benefits reports to the Attorney General’s Office annually by February 28th. …
Of the 62 acute care non-profit hospitals and health systems, 52 have filed one or more reports. Eight hospitals are working on revisions to their reports and 2 hospitals have yet to file. All together, hospital Community Benefits programs and initiatives represent a total investment of $515 million in Massachusetts communities, including $262 million in programs and services, such as those described above, and $252 million in charity care. Health plans are due to file their Community Benefits Plan Reports with the Attorney General’s Office by May 31.
Hospitals yet to file reports, according to the AG’s site, include:
Athol Memorial Hospital
Brockton Hospital
Caritas Carney Hospital
Caritas Good Samaritan Medical Center
Fairview Hospital
Franklin Medical Center
Holyoke Hospital
Hubbard Regional Hospital
Mercy Medical Center
Milton Hospital
Nashoba Valley Medical Center
Noble Hospital
Quincy Medical Center
Saint Vincent Hospital
In his FY09 budget plan, Gov. Patrick proposed creation of an Office of Health Equity to be located in the Executive Office of Health & Human Services. The House budget plan released last week did not include this item. We hope the House will reconsider this omission and approve establishment of the Office. Why is this so important?
The purpose of the Office is to establish a badly-needed focal point for state efforts to eliminate racial and ethnic health disparities. Disparities elimination is recognized as one the major challenges facing our health system. The most prominent recognition of disparities is by the esteemed Institute of Medicine in its 2002 report: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care .
The Legislature has recognized the importance of addressing disparities. A special legislative commission chaired by Sen. Dianne Wilkerson and Rep. Peter Koutoujian issued a final report in the summer of 2007 recommending the establishment of such an office as a key way to create a better statewide program to eliminate disparities. Chapter 58, the health reform law, also was praised for its elements aimed at disparities elimination, most prominently the creation of a permanent Council to eliminate disparities.
It’s fair to say that, among Chapter 58’s many successes, the disparities initiatives have achieved the least success. While other bodies such as the Connector Authority and the Quality/Cost Council have been well underway for nearly two years, the Disparities Council was only appointed at the end of 2007 and has only met once, this past January, and no future meeting has been scheduled.
We think the answer why is pretty simple. The Council reports to no one and has no administrative support. An Office of Health Equity, as proposed by EOHHS Sect. Judy Ann Bigby, has the potential to be the vital center of a dynamic state initiative to eliminate disparities. It can also serve as the home to the Disparities Council, providing a base and structure sorely lacking now.
We know House members, and particularly Speaker DiMasi, are committed to addressing racial and ethnic disparities, and we know this is a tough budget year. We hope they will consider Rep. Byron Rushing’s amendment to restore the Office of Health Equity.
