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? 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 Elena Rios, MD, Pres & CEO Kathy Flores, MD, Sec Dir, UCSF-Fresno Latino Research Ctr, CA AHEC Yolanda Partida, DrPH, Treas Hablamos Juntos/RWJF Carol Brosgart, MD Gilead Sciences Emilio Carrillo, MD President, NY-Presbyterian Health Plan Rogelio Lopez, MD VP, Presbyterian Hospital, CA Jaime Rivera, MD Dir, Public Health, Delaware Angel Seda, MD Treasurer, Wyeth Pharmaceuticals Reed Tuckson, MD VP, United HealthCare Alfonso Vargas, MD Chair, NHMA Council of Medical Societies Advisory Council: Richard Carmona, MD, 17 th Surgeon General Henry Cisneros, CEO, CityView Ivelisse Estrada, VP, UNIVISION Linda Griego, Pres, Griego Enterprizes

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

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

Think Future: how to prepare for a New America? 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 3 Regional Summits –  New York Academy of Medicine, New York  Sacramento, California  Austin, Texas November 2007 – March 2008 Planning Committee of OMH hdqts/regional offices and NHMA Announce Recommendations at NHMA Annual Conference, April 18 th, DC to the Health Policy Advisors of Obama, Clinton, McCain

Stakeholder Participants 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

Access – Recommendations 1. 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

Access – Recommendations 1. 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

Access – Recommendations 2. 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

Access Recommendations 2. 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

Access – Recommendations 3. Education/Marketing Promote Awareness  Standard health education in K-12  Use promotoras for community education National Media Campaigns Incentives/reimbursement for patient education

Prevention – Recommendations 1. Education and Awareness Schools  Standardize K-12 wellness programs  Provide healthy foods in schools Community/parents  Support community coalitions  Increase green market penetration  Cooking skills, food pyramid  Clinics – increase diabetes and obesity focus Policymakers – find our champions

Prevention – Recommendations 2. Marketing Expand Social Marketing Public/private partnership to promote healthy lifestyles Major Hispanic marketing campaign about public health Industry to ban marketing of unhealthy foods to kids

Prevention – Recommendations 3. Nutrition Policy Federal policy for healthy foods  Provide USDA subsidies for healthier foods  Make WIC and food stamp programs healthier  Regulate unhealthy food marketing, labeling, and sales Strengthen nutrition education  Standardize evidence-based health education in schools  Redefine traditional Hispanic foods as healthy Schools  Ban vending of junk food/sodas  Report cards/incentives to good schools/state standards

Prevention – Recommendations 4. Promote Physical Activity Build a healthier environment to live in  More and safer parks, sidewalks, and gyms in minority areas Increase availability of exercise programs  in and after school, community  at worksites & elsewhere - supported by employers

Prevention Recommendations 5. Health Care System 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 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 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  HSIs linkage in regional efforts

Hispanics in the Health Professions Recommendations 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 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

Affiliated with the Robert F. Wagner Graduate School of Public Service, New York University Education Programs  NHMA Leadership Fellowship  Childhood Obesity Education Program  Hispanic Health Portal Research and Research Training on Hispanic Health Hispanic Health Professional Student Scholarship What We Do - NHHF

What We Do - NHMA Advocacy – health of Hispanics Leadership development of Hispanic physicians and health professionals Policy forums – Summit Series 13 th Annual Conference – Mar nd NY Marriott at the Brooklyn Bridge 