Minnesota Department of Human Services (DHS) Health Equity

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Overcoming Racism Conference
Metropolitan State University
Cultural and Ethnic Communities
Leadership Council (CECLC)
Achieving Equity in Access and Outcomes in Human
Services
November 14, 2014
•A Collaboration: Community and the Minnesota Department of Human Services
(DHS) Disparities Reduction Strategy
•Vision: Across all department programs,
recipients from all racial and ethnic
communities have an equal opportunity to
achieve successful outcomes.
•Mission: DHS working with community, will
reduce disparities in access and outcomes
for cultural and ethnic communities served by
the agency.
•Collaborative Guidelines
•Have Principles &
Values
•Leverage
Technology &
Information
•Have Shared
Mission & Purpose
•Commit to Action &
Outcomes
•Have a Group
Identity
•2011 – 2012 Priorities
•Percentage of eligible Minnesotans
who experience improved access to
health services.
•Definition of culturally competent
health care organization.
•Ensuring DHS request for proposal
process is accessible to smaller culturallyspecific organizations.
•Strategic Lenses for Framing Implementation of Priorities
•Research &
Evaluation:
•What is it that
we need to know
about disparities
at DHS? What
are nationwide
best practices?
•Partner to
Educate About
Disparities:
•Learn together
foundational topics issues of historical
trauma, discrimination,
identify audience,
outreach to staff,
partners, community.
•Reform Policies that
Perpetuate
Disparities:
•History of
policymaking; analysis
of specific policy,
recommendations for
change.
•Fund Reform and
Transparency:
•Ensure
Accountability:
•Focus on
prevention,
intervention and cost
effectiveness;
annual public “state
of human services”
by commissioner.
•Examine current
policies &
procedures; track
findings; increase
participation of
others.
From left: Community
Relations
Antonia Wilcoxon;
Disparities
Reduction Advisory Committee member
•From
left:Director
Community
Relations
Director
Elizabeth Anderson, director of cross-cultural services for HealthEast Care System; and Deputy Commissioner fo
Direct Care
and Treatment
Anne Barry. Disparities Reduction Advisory
•Antonia
Wilcoxon,
From left: Community
Relations
Antonia Wilcoxon,
Disparities Reduction
Advisory Committee member Ruthie
•From
left:Director
Community
Relations
Director
Dallas and Deputy Commissioner for Direct Care and Treatment Anne Barry.
•Antonia Wilcoxon, Disparities Reduction Advisory
Committee member Ruthie Dallas and Deputy
Commissioner for Direct Care and Treatment
•Anne Barry.
Committee member Elizabeth Anderson, Director of
Cross-Cultural Services for HealthEast Care System,
and Deputy Commissioner for Direct Care and
Treatment Anne Barry.
•From left: Community
Relations Director
•Antonia Wilcoxon,
Disparities Reduction
Advisory Committee
member Sai Her,
Executive Director of the
State Council on Asian
Pacific Minnesotans, and
Deputy Commissioner for
Direct Care and Treatment
•Anne Barry.
Updates, 2012

Diversifying the workforce at DHS

Anti-Racism Training, Actionable Items

Establishment of an Equity Stewardship
Work Group – strategic
planning/implementation

Establishment of the CECLC: advises the
commissioner of human services on
disparities reduction
•Legislation
Legislation
Effective August 1, 2013.
Laws of Minnesota 2013, chapter 107, article 2, section 1
ARTICLE 2
CULTURAL AND ETHNIC COMMUNITIES
LEADERSHIP COUNCIL
Section 1. CULTURAL AND ETHNIC COMMUNITIES
LEADERSHIP COUNCIL.
Subdivision 1. Establishment; purpose. There is hereby
established the Cultural and Ethnic Communities Leadership Council
for the Department of Human Services. The purpose of the council is to
advise the commissioner of human services on reducing disparities
that affect racial and ethnic groups.
Council Members
Back row, left to right: Brian Ambuel, DHS intern; David Haley, Ramsey County Community Human
Services; Kamaludin Hassan, Hennepin County; DHS Commissioner Lucinda Jesson; Mitchell Davis Jr.,
Minneapolis Urban League; DHS Health Care Assistant Commissioner Nathan Moracco; State Sen. Tony
Lourey; Paula Haywood, Continuous Practice Improvement manager, Department of Community
Corrections; Maria Sarabia, DHS Health Care Administration.
Front row, left to right : Denise Flock, DHS; Antonia Wilcoxon, DHS community relations director; Vayong
Moua, Blue Cross Blue Shield; Mee Cheng, DHS intern; Pam Cosby, Minnesota Urban Area Health Ed
Center and council chair; Titilayo Bediako, WE WIN Institute Inc.; Pahoua Yang, Amherst Wilder
Foundation; Bauz Nengchu, Office of the Ombudsperson for Families.
Not pictured: Rep. Jim Abeler, Legislature – Representative; Rep. Tom Huntley, Legislature –
Representative; Rep. Tina Liebling, Legislature – Representative; Sen. Michelle Benson, Legislature –
Senate; Rep. Tara Mack, Legislature – Representative; Sen. Julie Rosen, Legislature – Senate; Sen. Kathy
Sheran, Legislature – Senate; Annamarie Hill, Minnesota Indian Affairs Council; Hector Garcia Chicano
Latino Affairs Council; Edward McDonald, Council on Black Minnesotans; Yende Anderson, Council on
Black Minnesotans); Sia Her, Council on Asian Pacific Minnesotans; Ann Hill, Office of the Ombudsperson
for Families; Muriel Gubasta, Office of the Ombudsperson for Families; Jill Kehaulani Esch, Office of the
Ombudsperson for Families; Anna Mazig, DHS Compliance Office;
Hassan Samantar, PACER; Jose Gonzalez, Minnesota Department of Health, Office of Multicultural and
Minority Health; Kamala Puram, SEWA-AIFW; LaJuana Whitmore, Target Corp.; LaRone Greer, DHS
Chemical and Mental Health Services Administration; Pa Lor, St. Catherine University; the Rev. Janet
Johnson, Wayman African Methodist Episcopal Church; Saciido Shaie, Parent Leader/Prevent Child Abuse
Minnesota; Sarita Ennis, Fernbrook Family Center Inc.
What do you wish to see as a result
of the work of the council?





Governance (process and implementation)
Pursuit of better data
Inclusion and engagement
Creation of an equity cabinet in
collaboration with other agencies, entities
Equity integrated into vision, project, plans
and policies.
Key Issues






DHS leadership demographics that match
broader community demographics
Increase the number of minority providers
Increase the cultural relevance of policies
and the broader system so it is more attuned
to the needs of diverse people
Engage the broader community
Add oversight and accountability through a
culturally competent lens to the system
Review administrative policies and practices
to ensure they allow equal access
Cultural and Ethnic Communities
Leadership Council (CECLC)
Fundamental NPA Goals
DRAC Strategic Lens

Awareness


Leadership


Health system and life
experience
Cultural and linguistic
competency
Data, research and
evaluation



Partner to educate about
disparities
Reform policies that
perpetuate disparities
Fund reform and
transparency,
accountability
Ensure accountability

Research and Evaluation

National Stakeholder Strategy (NSS)
http://tinyurl.com/NationalStakeholderStrategy

Developed with input from
thousands of individuals and
organizations at the grassroots
level

Establishes a common set of
national goals and strategies

Encourages partners and
stakeholders to identify and
implement community-based
strategies
12
Fundamental Principles




Community engagement and leadership
Partnerships – critical to multiple and
complex issues
Cultural and linguistic competency
Non-discrimination – mandated by federal
civil rights, moral imperative and practical
necessity to achieve health equity.
Action Plan’s Main Objectives
Awareness – increase awareness in
community about disparities.
Leadership – develop the leadership of
diverse work force.
Community Health and Health System
Experience – focus on the Triple Aim.
Cultural and linguistic competency –
certification of interpreters
Research and Evaluation – improve
community-defined data collection
Recommendations to DHS
Awareness:
Invest in consciousness raising efforts on
significance of inequities and its harm to
populations in the state.(historical trauma,
improve capacity to use racial lenses)
Recommendations, cont’d
Leadership
Strengthen the dialogue among CECLC,
cultural communities and the governmental
structure.(equity analysis and an equity
note, embed equity criteria in all relations
with cultural communities, diverse new
leadership, hiring and retention, contracting)
Recommendations, cont’d
Community Health and Health Systems
Promote culturally appropriate care and reduce
barriers to receiving care (providers are
capable to deliver services that address
complex needs, cultural beliefs and practices
are embedded in healing; require MCO’s to
increase network to include more culturally
competent providers; redefine access:
affordability, geo accessibility, accommodation,
acceptability (Penchansky and Thomas, 1981).
Recommendations, cont’d
Culturally and Linguistically Competent
Services
Careful vendor selection (interpreters)
Clarity in eligibility determination
Audit Minnesota Statute 16c (procurements
from small businesses, targeted groups, Vet
owned small businesses, economically
disadvantaged areas, etc.
Grant making more transparent with key
outcomes on Equity
Recommendations, cont’d
Research and Evaluation
Data driven decision making on communitydefined cultural and linguistic groups
Promote translation of evidence-based
research into practice
Engage communities in this effort so they
are better users of publicly funded care
Change/update DHS Equity dashboard to
more fully reflect the status on disparities
reduction for target populations.
Contact
Antonia Wilcoxon
Community Relations Director
Office of the Deputy Commissioner
Policy and Operations
651-431-3301
antonia.wilcoxon@state.mn.us
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