Thursday, June 26, 2008

Webinar recording: Civil Rights as a basis for Public Accountability

First of all, thank you to ALL of our speakers from all 3 webinars! You have all given us so much to think about and act upon.

Well, had our last webinar presentation today and it was fabulous! We hope you can take the time to listen:

https://uthconnect.uth.tmc.edu/p57441435/

Several articles and web sites were mentioned during the presentation. These will be posted within the next day or so as will be the PowerPoints.

As a reminder of the topic and who spoke:

Topic: New Opportunities to use Civil Rights as a basis for Public Accountability in Health Care Delivery
Speakers:
Brian Smedley, Research Director of The Opportunity Agenda, and former Staff Director of the IOM Report "Unequal Treatment" and Bob Griss, Executive Director, Institute of Social Medicine and Community Health.
Moderator:
John Steen who has been on the Board of Directors of American Health Planning Association for the past 14 years and is a specialist in certificate of need and community health promotion activities, and has served in various capacities with CON and Health Systems Agencies in New York City, Westchester County, NY, New Jersey, Georgia, and Ohio, and writes the Policy Perspective column in "Health Planning Today".
Summary:
Bob Griss and Brian Smedley will focus the third webinar on opportunities to apply civil rights principles to health care regulations in order to reduce disparities in health status and health care delivery at the state, regional, and community levels.

Wednesday, June 25, 2008

“CIVIL RIGHTS STRATEGY FOR TRANSFORMING HEALTH CARE DELIVERY”

INSTITUTE OF SOCIAL MEDICINE & COMMUNITY HEALTH
Bob Griss

Originally presented at the 2007 APHA Annual Conference, Panel Discussion on Civil Rights and Health Care, Washington, DC

“CIVIL RIGHTS STRATEGY FOR TRANSFORMING HEALTH CARE DELIVERY”

Aim: Create a system of public accountability by using Title VI of the Civil Rights Act of 1964 to reduce health disparities by requiring changes in the health care delivery system that have a disparate impact on racial and ethnic minorities.

Means: Extend the protections for equal access that persons with disabilities have under the ADA to racial and ethnic minorities under Title VI.
  • Add the concept of "reasonable accommodation"
  • Broaden the concept of "public accommodation"
  • Extend the concept of "program accessibility" in Title II of the ADA to nondiscrimination standards that can be applied to the entire health care delivery system "as a system" at the community level
  • Incorporate principles of nondiscrimination as interpreted by the Courts into health care regulations such as licensing, quality assurance, accreditation, and conditions of participation
    • circumvent legal obstacles that the Courts have imposed to block a private right of action unless there is grounds for “intentional discrimination”
    • apply nondiscrimination standards to mechanisms of accountability to identify disparities in health care and in health status

Strategy: Regulate health care delivery system “as a system” at the community level

  • Address inefficiencies, ineffectiveness, and inequities in health care delivery system at the community level through a Certificate of Need (CON) type process coordinated by local health department
  • Utilize regulatory authority through licensing, quality assurance, accreditation, and conditions of participation to promote community benefit obligations and strengthen functioning of health care delivery system “as a system” at the community level
  • Coordinate through a consensus building publicly accountable process the interface of health care delivery system and social determinants of health
  • Capture surplus in health care delivery system and redirect to expand health care coverage, and/or address social determinants of health
  • Utilize funding and regulatory authority at the state and federal levels to reduce disparities in health care and health status at the community and/or regional levels in the most efficient, effective, and equitable way

Goals:

  • Overcome fragmentation in health care delivery that undermines public accountability
  • Provide health care to the total population within a geographical area in the most efficient, effective, and equitable way (universal design)

Bob Griss, Executive Director, Institute of Social Medicine and Community Health
3301 Horseman Lane, Falls Church, VA 22042
Telephone: (571) 282-3283; Email: Bgrisscdh@aol.com

Tuesday, June 24, 2008

New Opportunities to use Civil Rights as a basis for Public Accountability in Health Care Delivery

The 3rd and final webinar will be held on Thursday, June 26. The presention will be recorded and a link will be placed on the blog.

The final webinar will feature Brian Smedley and Bob Griss. Brian Smedley is the Research Director of The Opportunity Agenda, and former Staff Director of the IOM Report "Unequal Treatment". Bob Griss is the Executive Director of the Institute of Social Medicine and Community Health. Bob has served as moderator for the other two webinar presentations.

Some resources to check out:
The Opportunity Agenda Web site (Brian Smedley, Research Director): http://www.opportunityagenda.org

From the Commonwealth Fund, "Identifying and evaluating equity provisions in state health care reform": http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=679040

From the Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care: http://www.nap.edu/catalog.php?record_id=10260

Families USA, "Universal and equal: Ensuring equity in state health care reform": http://www.familiesusa.org/assets/pdfs/universal-and-equal.pdf