Braving the Grey Area with the Class of 2013 Health Leadership Fellows
Today’s post was written by Brianna Moody, communications & policy intern at the Connecticut Health Foundation.
It’s June, one of our favorite times of the year here at the Connecticut Health Foundation. On June 12, 2013 the Class of 2013 (CT Health) Leadership Fellows presented their coalition projects to proud faculty and staff.
If you have been keeping up with our Fellows over the years, you know that the Health Leadership Fellows Program brings together a diverse group of individuals who share a passion for and are highly dedicated to achieving health equity. Participants form coalitions with shared leadership goals and choose real-world projects that address pressing health equity issues.
This year, program participants committed themselves to the following areas:
- Children’s Mental Health: Early Identification and Intervention
- Improving Access to School-Based Health Centers
- Veteran’s Health Equity
- Medical Interpretation Services in Healthcare Settings
- Influencing the Legislative Process to Promote Health Equity
Relying on the unique leadership skills that each fellow brought to the table, participants committed ten months of their time to addressing a pressing health equity issue with the ultimate goal of creating lasting system-wide changes.
As fellow Natalie Achong stated, “Not everything is black and white…so much of health care delivery and access is grey.” Fellows braved the gray area and here we present an overview of their hard work.
CHILDREN’S MENTAL HEALTH: EARLY IDENTIFICATION AND INTERVENTION
Problem: 14 million children in the United States are dealing with mental health issues. Contributing factors range from the biological, to the environmental, to the physiological. With little being done to increase the identification and referral of children with mental health issues to the appropriate service providers, children are suffering much longer than necessary.
The reality is that families, child health care, early care and education, and human services providers struggle to connect at-risk children with the services they need.
Solution: Recognizing that early intervention is key, the coalition came up with a plan to strengthen the early identification process. Targeting children under eight years of age who attend daycare centers in the New Haven area, the plan included the following:
- Train early care and education providers to further the education of staff members about mental health issues and their effects on children and families.
- Refer them to Help Me Grow (HMG), a prevention program of the Connecticut Children’s Trust Fund. HMG is designed to identify children at risk for developmental or behavioral problems and connect them to existing community resources.
Outcome: Early intervention is a collaborative effort. Even when a child’s needs are identified, finding the appropriate programs designed to address those needs can be challenging. Using HMG allowed the coalition to streamline the process of connecting at-risk children with the services they need. You can read more about the HMG core components here.
Early identification is important, but the coalition knew that this issue does not stand alone. Bringing early detection AND connection to appropriate services will lead to the best outcomes for children facing developmental or behavioral challenges.
IMPROVING ACCESS TO SCHOOL BASED HEALTH CENTERS
True or false? The quality of care in School Based Health Centers (SBHCs) is comparable to other health care delivery facilities.
The answer is true.
Problem: People are unaware of the important role that SBHCs play in communities and because of that funding and other resources are limited. SBHCs provide primary care services to students right on a school campus. Students can receive physical, mental, and oral care services right in one convenient location. SBHCs offer a high quality of care, develop trusting relationships with patients, and most importantly, they are successful in engaging students of color.
Solution: In order to educate policymakers and others about the benefits of SBHCs and to advocate for increased funding, the coalition proposed the development of a Connecticut (CT)-specific informational booklet. This booklet showcases youth experiences with SBHCs and links the stories with data on key health services and outcomes. The booklet will be posted online, distributed to school-based health professionals using email marketing and sent to SBHCs in the state to spread these important messages and stories.
Outcome: SBHCs offer quality care and are a necessary tool in improving access to quality and affordable services for CT’s children and adolescents. With the support of the Connecticut Association of School Based Health Centers (CASBHC) the coalition continues working to educate policymakers about the benefits of SBHCs. CASBHC plans to use the booklet for advocacy in the CT 2014 legislative session. It will be available at the end of August.
VETERAN’S HEALTH EQUITY
Problem: American veterans have disparate mental health outcomes compared to those of non-veteran populations. Veterans are at high risk of suicide, depression, substance abuse, and post-traumatic stress disorder (PTSD). Up to 90% of veterans seek community-based care rather than VA services. Community-based care is often perceived as less socially stigmatized, more accessible and available, and of a higher quality than the VA mental health services.
The big problem? Veterans have become invisible. Community-based providers do not consistently identify veterans in their care. They also do not consistently identify families of veterans, train staff on veterans’ issues, coordinate care for veterans, or evaluate veterans’ health and psychosocial outcomes following treatment.
Solution: Establishing a community awareness campaign directed toward community-based health and human services agencies, the coalition developed the Veteran’s Health Equity Standards of Connecticut (VHEC). The VHEC Standards include a commitment to:
- IDENTIFY veterans among patients and their families
- TRAIN staff in culturally responsive, trauma-informed care for returning veterans
- COORDINATE care and community services for patients who are veterans
- EVALUATE outcomes for veterans
- PROMOTE the social determinants of health
As a first step in implementing the community awareness campaign, the Health Leadership Fellows Class of 2013 is disseminating the VHEC Standards in their organizations and provider networks.
Outcome: By promoting the integration of systems of care and the infusion of best practices into community-based care, the coalition began the process of raising community awareness, and advanced efforts to improve mental health outcomes for returning veterans and their families. Veterans are a disparate population whose experiences often make it difficult to reintegrate into a civilian life upon returning home. The coalition brought veterans’ unique experiences to the light and continues working to make veterans’ needs visible.
MEDICAL INTERPRETATION SERVICES IN HEALTHCARE SETTINGS
Problem: Recently, CT systems have identified the need for more funding regarding language and interpretive services in different health care settings. Opening their presentation with an influenza authorization form written in Creole, we got an idea right from the start of how limited interpretation services can lead to intimidation and frustration. Specifically, the coalition looked at Spanish language services in community health center (CHC) settings. Trying to access, understand and implement services in CHCs for patients with Limited English Proficiency (LEP) that are both culturally and linguistically appropriate, can be trying.
- The coalition conducted a survey at the Norwalk Community Health Center (NCHC) to better understand staff perspectives on language services.
- These surveys led to the development of standards that were used to hold a teaching workshop at the health center.
- Finally, the Snapshot. The coalition developed the Snapshot—a tool to serve as a “one-stop-shopping” experience for anyone seeking information about the most updated federal and local mandates, the training and certification process for interpreters, and what educational guidelines inform healthcare professionals’ instruction.
Outcome: Still in the implementation phase, the coalition is working to disseminate the data within NCHC and encourage providers and staff to use the Snapshot as a tool to better navigate the system. As coalition member Patrick Corbett stated, “language services go beyond the provider” and the group continues working to promote LEP services as being a collaborative effort. The Snapshot can be used to get everyone in CT on the same page.
INFLUENCING THE LEGISLATIVE PROCESS TO PROMOTE HEALTH EQUITY
Problem: The CT general assembly considers hundreds of bills and while both the financial and environmental impacts are often given much consideration, the impact of the bills on our health in our state is sometimes left out. CT needs a stronger method of measuring the outcomes of these decisions.
Solution: The coalition developed a roadmap for the creation and implementation of health equity impact statements and analysis as part of our state’s legislative process. The group set out to establish connections with useful contacts in order to build up experiences and relationships to get legislators to start thinking about how to make health equity impact statements an ongoing part of the legislative process.
Outcome: The coalition worked to encourage legislators, advocates, and the broader community to become more aware of health equity impacts of their decisions during the 2013 legislative session. Faced with many challenges, time being a big one, the group definitely got things rolling and sparked a conversation around the health equity legislative process. An ambitious endeavor beyond the scope of the coalition projects, the group is certainly on their way towards systems change.
You can read more about the project here.
Not long after their presentations, the fellows went on to graduate from the program. We have no doubts that they will carry forth their efforts and continue leading health equity efforts in the state of CT. Congrats class of 2013!