Civil Rights and Health Care

PowerPoints and Presentations from June 26

2008-07-01T14:21:00.000-07:00

The recording of the third webinar has been posted already; here are the PowerPoints from the speakers.

John Steen, the moderator for the session didn't have a PowerPoint but he has given us a written copy of what he said. This is wonderful reading; take a look at it regardless of whether you've listened to the webinar or not!
John Steen: Civil Rights, HSAs, CON, and Public Health

Bob Griss: Using Civil Rights as a Countervailing Influence on Market-Driven Health Care

Brian Smedley: Universal and Equal: Ensuring Equity in State Health Care Reform

If you would like to listen to the earlier webinars, go to the blog archives and click on April for the 1st webinar (Legacy of the Civil Rights Era) and May for the 2nd webinar (Current Assessment of Civil Rights in Health Care).

Webinar recording: Civil Rights as a basis for Public Accountability

2008-06-26T11:23:00.000-07:00

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.

“CIVIL RIGHTS STRATEGY FOR TRANSFORMING HEALTH CARE DELIVERY”

2008-06-25T13:30:00.000-07:00

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

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

2008-06-24T13:02:00.000-07:00

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

What do you think? (Q#3)

2008-05-23T10:51:00.000-07:00

Can Daniel Hounchell's public utility funding model eliminate discrimination? Why/Why not? Discuss how health care funding presents barriers and opportunities to equal access.

What do you think? (Q#2)

2008-05-23T10:46:00.000-07:00

What recommendations do you have for challenging business necessity arguments for discriminatory practices such as moving hospitals from minority intensive neighborhoods?

What do you think? (Q#1)

2008-05-23T10:39:00.000-07:00

What options do States have for enforcing accountability and ensurring non-discrimination in conjunction with Title VI? Can other states implement programs similar to that in California? Why or why not?

Reading List for Second Webinar

2008-05-23T10:30:00.000-07:00

1. Health Care Divided By David Barton Smith
Buy Health Care Divided from Amazon.com
2. Dying While Black By Vernellia Randall
Buy Dying While Black from Amazon.com
3. Ensuring Linguistic Access By Doreena Wong
Buy Ensuring Linguistic Access from Amazon.com
4. Facts about patient-centered communications from The Joint Commission
a. Hospitals, Language, and Culture
b. One Size Does Not Fit All: Diverse Populations Pose Special Health Needs
c. What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety

Languages spoken in your neighborhoods

2008-05-23T07:46:00.000-07:00

During the section on language and health care, Ms. Wong mentioned the importance of knowing what languages are spoken in your communities to ensure that you have the ability to meet the needs of all. Not sure where to find the information? Try the US Census Bureau!

The 2000 Census Summary File 3 has block group data on languages spoken at home (tables P19 and P20, PCT10 through PCT14, PCT62). PCT10 provides the most thorough description of the actual languages spoken at home. The other tables generally use a broader classification (Indo-European languages, Asian and Pacific Island languages, Spanish).

Summary File 3 will also show by race (P6), place of birth by citzenship status (P21), and year of entry for foreign-born population (P22). It is important to remember that the Census Bureau does not list "Hispanic" as a separate race, but rather as an ethnicity. A person can be Hispanic but counted as White or African American. If you need to know data for Hispanics living in your communities, be sure to choose tables that indicate this such as "Hispanic or Latino by Race" (P7).

Why use a block group or Census tract to find your data rather than a zip code? The block group is a smaller geographic area than the Census tract which is generally smaller than the zip code.

Need help finding your block group or Census tract? This handout can help:
Finding Data from the Census Bureau

The 2005 & 2006 American Community Survey also have data on languages spoken at home but only down to the county level for all states. There is subcounty level and school district level data for select states as well.

If you haven't taken the time to explore the vast wealth of data at the Census Bureau, now is a good time. You might find out that you have more Laotian speakers than you realized!

Current Assessment of Civil Rights in Health Care-- 2nd webinar

2008-05-22T11:21:00.000-07:00

A big thanks goes out to our speakers for the session on Current Assessment of Civil Rights in Health Care. The presentation was timely and thought provoking.

Here's the link if you couldn't attend the session or you would like to listen to the session again:
Current Assessment of Health Care Webinar Recording

Dr. Randall and Ms. Wong have both agreed to allow me to post the links to their presentations as well.
Dr. Randall's PowerPoint presentation:
Current Assessment of Health Care and Civil Rights

Ms. Wong's PowerPoint presentation:
Language Access and Health Care

Please feel free to post comments, questions, or suggestions for follow-up presentations.

What do you think? (Q. #3)

2008-04-29T08:20:00.002-07:00

3. Why were doctors exempt from compliance with nondiscrimination laws under Title VI that hospitals were required to follow in order to be eligible for Medicare funding?

Use the Post Comment link and share your thoughts.

Reading list for first webinar

2008-04-29T08:04:00.000-07:00

Eliminating Disparities in Treatment and the Struggle to End Segregation (PDF) David Barton Smith. Fox School of Business and Management, Temple University. August 2005

The following contains a brief description of the longer document above: Health disparities as a civil rights issue http://academic.udayton.edu/health/Disparities/disparities02.htm David Barton Smith

Smith, D.B. (2005). The politics of racial disparities: Desegrating the hospitals in Jackson, Mississippi. Milbank Quarterly, 83(2): 247-249. (subscription required)
http://dx.doi.org/10.1111/j.1468-0009.2005.00346.x

Smith, D.B. (2005). Racial and ethnic disparities and the unfinished civil rights agenda. Health Affairs, 24(2): 317-324. (subscription required)
http://dx.doi.org/10.1377/hlthaff.24.2.317

Smith, D.B., Feng, Z., Fennell, M.L., Zinn, J.S. , and Mor, V. (2007). Separate and unequal: Racial segregation and disparities in quality across U.S. nursing homes. Health Affairs, 26(5): 1448-1458. (subscription required)
http://dx.doi.org/10.1377/hlthaff.26.5.1448

Sessions recorded for the Legacy of the Civil Rights Era

2008-04-29T07:50:00.000-07:00

Due to some technical difficulties, the recording of our 1st session held on Thursday, April 24 did not work properly. Don't worry- we've resolved our problems!

But, we had promised to record each session and the first one provided the foundation for all of the others that will follow. As a result, we decided to go back a re-record the sessions. Darrell Montgomery provides the welcome statements, Bob Griss had the job of laying the groundwork for the civil rights and health care sessions and introducing the first speaker, and David Barton Smith gives an excellent overview of the history of civil rights and health care. Our last speaker, Vernallia Randall, will incorporate her remarks into the next session in which she is a lead speaker.

Darrel Montgomery's Welcome remarks

Bob Griss's Introduction to to the topic and the speaker

Dr. David Barton Smith: The Legacy of the Civil Rights Era

The Legacy of the Civil Rights Era (Part 1)

2008-04-24T12:07:00.000-07:00

Our thanks go to David Barton Smith and Vernellia Randall for their excellent presentation today. Darrell Montgomery got us started; Bob Griss served as the moderator and tracked participant questions to ask at the end.

We had around 15 participants who logged in (not counting those of us who were working to make this happen). There could have been more since I know of one institution who set up a room where a group of people could watch the webinar. Of course, one of the benefits of the webinar is you don't have to leave your desk!

We will have a recording of David Barton Smith's presentation in the near future. As soon as it is ready, a link will be posted on the blog.

Welcome to Civil Rights and Health Care!

2008-04-21T12:19:00.000-07:00

Thank you for visiting this blog. We will host our first in a series of 3 webinars on health care and civil rights on Thursday, April 24. David Barton Smith will be our first presenter; Vernellia Randall will be the discussant and Bob Griss will moderate. After the presentation, we will post the link to the recording as well as links to articles that are related to this topic.

If you are interested in registering for this or any of the other presentations, please visit the CHPPD (APHA) web site: http://www.chppd.org/.

Again, thanks for visiting this blog!