Hispanics & Health Disparities Summit Series Recommendations

1. Hispanics & Health Disparities Summit Series Recommendations National Hispanic Medical Association U.S. Department of Health and Human Services Office of Minority Health Elena Rios, MD, MSPH, President & CEO, NHMA 2008

2. NHMA – Who are We? • 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

3. American Latinos & Health Care • Largest ethnic group now and in new America • 2050: America 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

4. Pew/RWJF Survey & Reform Policy • 2009 Health Care Reform Information • Health communication channels in community: <30yo • Low literacy, bicultural, bilingual – NEW MEDIA • Internet & cable TV - social marketing • 2009 usual health care provider: health team with community linkages who can change behavior with low educated communities • Recruit Latino healthcare workforce now • National prevention curriculum - diabetes, obesity

5. NHMA & HHS Summits 2008 • To develop consensus recommendations to improve the health of the Hispanic community targeted to Federal programs and policies over the next 5 years. • 3 Regional Summits – 300 participants • NYC, Sacramento, CA, Austin, TX • Announced recommendations at NHMA Annual Conference, April 18th, DC to the health policy advisors of Obama, Clinton, McCain

6. Clinics/Community agencies Hospitals Medical Schools Foundations Pharma Cos. Insurance Cos. Government Business – Corp + Media Unions Hispanic Chambers of Commerce Physicians Consultants Associations K-12 Stakeholder Participants

7. Federal Health Policy Focus Areas • Access to HealthCare • Prevention of Diabetes and Obesity • Increasing Hispanics in the Health Professions

8. Access Recommendations1. Financing • Universal and affordable health insurance coverage • Expand 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

9. Access Recommendations1. Financing • 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, mid-level providers, promotoras

10. Access Recommendations2. Health Care System • 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 • Strengthen DSH payment system to private practice • Expand NHSC or similar program

11. Access Recommendations2. Health Care System • 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

12. Access Recommendations3. Education/Marketing • Promote Awareness • Standard health education in K-12 • Use promotoras for community education • National Media Campaigns • Incentives/reimbursement for patient education