Transcript Federal Health Policy 2006

Hispanics & Health
Disparities Summit Series
Recommendations
National Hispanic Medical Association
U.S. Department of Health and Human
Services Office of Minority Health
2008
NHMA – Who are We?
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Established in 1994 in DC, non-profit 501c6
association representing 36,000 Hispanic
physicians in the U.S.
Mission: to improve the health of Hispanics and
other underserved
NHMA Board of Directors
Established its foundation, National Hispanic
Health Foundation, 501c3, for research and
education activities – affiliated with NYU Wagner
Graduate School of Public Service
NHMA Board of Directors
Ciro Sumaya, MD, Chair
Dean, Rural Health Public Health School,
Texas A&M
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Elena Rios, MD, Pres & CEO
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Kathy Flores, MD, Sec
Dir, UCSF-Fresno Latino Research Ctr, CA
AHEC
 Yolanda Partida, DrPH, Treas
Hablamos Juntos/RWJF
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Carol Brosgart, MD
Gilead Sciences
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Emilio Carrillo, MD
President, NY-Presbyterian Health Plan
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Rogelio Lopez, MD
VP, Presbyterian Hospital, CA
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Jaime Rivera, MD
Dir, Public Health, Delaware
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Angel Seda, MD
Treasurer, Wyeth Pharmaceuticals
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Reed Tuckson, MD
VP, United HealthCare
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Alfonso Vargas, MD
Chair, NHMA Council of Medical Societies
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Advisory Council:
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Richard Carmona, MD, 17th Surgeon
General
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Henry Cisneros, CEO, CityView
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Ivelisse Estrada, VP, UNIVISION
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Linda Griego, Pres, Griego Enterprizes
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NHMA Networks
NHMA Council of Medical Societies
 NHMA Council of Residents
 Medical Student members
 Hispanic Health Professional Leadership
Network – all national Hispanic health
professional associations
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American Latinos & Health Care
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Largest ethnic group now and in new America
 2050: America
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will be a nation >50% bicultural groups
Most uninsured (over one-third of all Hispanics)
Most problems with disparities in health care
according to US DHHS 2006 Disparities Report
Need for cultural, language, education services
System lacks Hispanic researchers, providers
and leaders in public/private agencies
Think Future: how to prepare for a
New America?
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The new America will consist of populations who
face severe lack of access to health care, lack of
trust and knowledge, and are low-income, poorly
educated with strong cultural and family values,
limited English proficiency, mainly living in urban
areas, suffering from high rates of obesity,
diabetes, infectious and chronic diseases, and
demanding health care reform.
THE FUTURE IS NOW… YOU ARE THE
ANSWER
Planning
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3 Regional Summits –
 New York Academy of Medicine,
 Sacramento, California
 Austin, Texas
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New York
November 2007 – March 2008
Planning Committee of OMH hdqts/regional
offices and NHMA
Announce Recommendations at NHMA Annual
Conference, April 18th, DC to the Health Policy
Advisors of Obama, Clinton, McCain
Stakeholder Participants
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Clinics/Community
agencies
Hospitals
Medical Schools
Foundations
Pharma Cos.
Insurance Cos.
Government
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Business – Corp +
 Media
 Unions
 Hispanic
Chambers of
Commerce
 Physicians
 Consultants
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Associations
K-12
Access – Recommendations
1. Financing
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Universal and affordable health insurance
coverage
eligibility for public programs –
families, undocumented, legal doc, FPL level
 Comprehensive benefits - preventive, mental
health, dental, educational services
 Individual mandates, automatic for all
 Portable, quality measures, accountable
 Expand
Access – Recommendations
1. Financing
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Public-Private partnerships with community
demonstrations for low cost care delivery
(eg. Mobile clinics)– with understanding of
poverty, social determinants of health, outcomes
for increasing health equity, preventive services
that are culturally/linguistically appropriate, midlevel providers, promotoras
Access – Recommendations
2. Health Care System
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Enforce standards for Culturally and Linguistically
Appropriate Services (JACHO)
Promote cultural competency provider training
(incentives, performance payments, Federal
clearinghouse)
Language services – interpreters, pooling of resources,
federal laws on access to services
Race/ethnicity/Language data --mandatory
Support providers in underserved communities
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Strengthen DSH payment system to private practice
Expand NHSC or similar program
Access Recommendations
2. Health Care System
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Invest in a diverse workforce
 Fully
fund HCOP, COE
 Emphasize diversity throughout the pipeline
Medical Home = CHCs for all + increase
referral systems to tertiary care
 Patient centered care
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Access – Recommendations
3. Education/Marketing
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Promote Awareness
 Standard
health education in K-12
 Use promotoras for community education
National Media Campaigns
 Incentives/reimbursement for patient
education
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Prevention – Recommendations
1. Education and Awareness
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Schools
 Standardize
K-12 wellness programs
 Provide healthy foods in schools
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Community/parents
 Support
community coalitions
 Increase green market penetration
 Cooking skills, food pyramid
 Clinics – increase diabetes and obesity focus
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Policymakers – find our champions
Prevention – Recommendations
2. Marketing
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Expand Social Marketing
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Public/private partnership to promote healthy
lifestyles
Major Hispanic marketing campaign about
public health
 Industry to ban marketing of unhealthy
foods to kids
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Prevention – Recommendations
3. Nutrition Policy
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Federal policy for healthy foods
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Strengthen nutrition education
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Provide USDA subsidies for healthier foods
Make WIC and food stamp programs healthier
Regulate unhealthy food marketing, labeling, and sales
Standardize evidence-based health education in schools
Redefine traditional Hispanic foods as healthy
Schools
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Ban vending of junk food/sodas
Report cards/incentives to good schools/state standards
Prevention – Recommendations
4. Promote Physical Activity
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Build a healthier environment to live in
 More
and safer parks, sidewalks, and gyms in
minority areas
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Increase availability of exercise programs
 in
and after school, community
 at worksites & elsewhere - supported by
employers
Prevention Recommendations
5. Health Care System
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Reimbursement/cpt codes for prevention (CMS
to increase focus on diabetes and obesity)
Redesign for obese pts
Low cost interventions (CDC, NIH)
Healthy food in hospitals
CME/cultural competence training
Research – community-based
Multidisc teams – include nutritionists, educators
Hispanics in the Health Professions
Recommendations
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BUILD POLITICAL WILL
Strengthen Educational Pipeline
 Improve K-12 education in minority communities
 Target funds to low income school districts, increase
counseling and faculty awareness
 Health career tracks in high schools –magnets, tutoring
 Provide
more Hispanic mentors & role models in
health professions at all educational levels
 Support Hispanic students in higher education
 Provide more scholarships & loan repayment options
Hispanics in Health Professions
Recommendations
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Outreach to students/parents in low
income neighborhoods about health
careers in a new program
 Develop
value of education; funding
 Link to clinics, libraries, science museums
Media/marketing about health careers
 Public-Private partnerships in regions
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 HSIs
linkage in regional efforts
Hispanics in the Health Professions
Recommendations
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Changes in Health Profession Schools
 Fund
COE and HCOP & expand focus
 Change admissions – increase focus on
background, leadership, underserved interest
vs #s
 Improve minority representation – admissions
(include community), faculty, leadership
 Link recruitment to professionals, alumni
Obama Administration
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CHIP Bill
Economic Stimulus Bill – H-IT, Medicaid,
Medicare, Cobra, Workforce, Clinics,
Comparative Effectiveness Research
Health Care Reform – Health Disparities
Title VII reauthorization
HHS Leadership & Hispanics
OMH Leadership Summit – Feb. 26th
What We Do - NHHF
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Affiliated with the Robert F. Wagner Graduate School of
Public Service, New York University
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Education Programs
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NHMA Leadership Fellowship
Childhood Obesity Education Program
Hispanic Health Portal www.hispanichealth.info
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Research and Research Training on Hispanic Health
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Hispanic Health Professional Student Scholarship
What We Do - NHMA
Advocacy – health of Hispanics
 Leadership development of Hispanic
physicians and health professionals
 Policy forums – Summit Series
 13th Annual Conference – Mar. 19-22nd
 NY Marriott at the Brooklyn Bridge
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 www.nhmamd.org