HARTFORD, Conn. (Dec. 21, 2018) – Health disparities begin early in life. The infant mortality rate for black babies is nearly four times higher than for white infants, and Latino and black children are significantly more likely than their white counterparts to be overweight or obese. Disparities in childhood can lay the groundwork for even deeper gaps in adulthood. Can these disparities be prevented?
Finding a way to do so is among the goals of a partnership of experts and philanthropic organizations led by the Child Health and Development Institute of Connecticut (CHDI), the Children’s Fund of Connecticut, and the Connecticut Health Foundation. Their work centers on transforming pediatric primary care – which all children receive – to allow providers to better meet the needs of children and families and prevent health disparities that begin early in life.
This month, the Connecticut Health Foundation awarded CHDI a $83,250 grant for the next phase of this work, which is also being funded by the Children’s Fund of Connecticut.
The idea is to ensure that pediatric primary care can serve families’ needs more holistically. While families would still turn to pediatricians for guidance on development and care when children are sick, their pediatricians – or other primary care providers – could also connect them to services that address other needs, such as accessing behavioral health care, help affording food, dealing with school challenges, or addressing maternal depression. Part of the goal is to ensure that pediatric primary care providers have the tools and support – and funding – to address children’s health in a broader way, ensuring that children are not just healthy but ready to learn and develop optimally.
“Nearly all children regularly see a pediatric primary care provider, who is often a trusted resource for the family,” said Lisa Honigfeld, CHDI’s vice president for health initiatives. “This positions pediatric primary care as a logical centerpiece of a comprehensive system to support the well-being of children and families. Ultimately, transforming the care and support children receive early in life could result in better learners, a healthier adult population, and a stronger workforce.”
CHDI has brought together a team of experts in health care, children’s health, policy, and insurance, to develop models for redesigning pediatric primary care. Key to this work will be identifying ways to fund practices that take on a broader role in children’s health, targeting outcomes beyond what have traditionally been part of health care, including ensuring children enter kindergarten ready to learn.
“This partnership has brought together care providers, payers, consumers, and child development experts to design systems that put the needs of children’s health first, recognizing that if we expect a broader set of outcomes, we have to find a new way of paying for health care,” said Patricia Baker, president and CEO of the Connecticut Health Foundation.
The grant awarded this month will support continued work on payment reform as well as two demonstrations of pediatric primary care innovations that would not be possible in the existing fee-for-service payment system.
The grant is one of 16 awarded this quarter by the Connecticut Health Foundation, totaling $1.06 million. The others are:
Center for Children’s Advocacy, Hartford: $120,000 (18 months)
The Center for Children’s Advocacy plans to use this funding to work on two separate health issues facing children and teens. One involves minors’ access to PrEP, a pre-exposure prophylaxis that significantly reduces a person’s likelihood of contracting HIV. Connecticut law allows minors to consent to examination and treatment for sexually transmitted infections, but does not allow them to consent to receiving PrEP if they do not have HIV. The Center for Children’s Advocacy will seek changes in state policy to allow youth at risk of contracting HIV to receive preventive treatments. Separately, the organization will work to ensure that undocumented children and teens can access health care coverage.
Center for Medicare Advocacy, Willimantic: $50,000 (18 months)
This funding will allow the Center for Medicare Advocacy to examine potential disparities in access to home health care for state residents who are dually covered by Medicare and Medicaid – a group that includes more than 100,000 low-income seniors and people with disabilities. The work will include analysis of data on access to home health services and is expected to result in recommendations for interventions to ensure equitable access to coverage of home health care for people covered by both Medicare and Medicaid.
Connecticut Association of School Based Health Centers, North Haven: $50,000 (9 months)
This funding will support the Connecticut Association of School Based Health Centers during a transitional period, including the retirement of its longtime executive director and a planning process to strengthen the organization and ensure the viability of school-based health centers.
Connecticut Office of Health Strategy, Hartford: $50,000
This funding will support work by the state’s Office of Health Strategy and the Office of the State Comptroller to develop a standard measure for health care affordability that can serve as a benchmark for evaluating whether policy options under consideration will create better health outcomes and care delivery that is affordable for all residents. Such a standard could provide valuable information to policymakers as they try to determine what policies to pursue with limited resources.
Green & Healthy Homes Initiative, Baltimore, Maryland: $75,000
Housing conditions can affect a person’s risk of health problems including asthma, lead poisoning, or injuries. While many services exist to address both health and housing, they are largely uncoordinated. This project, led by Green & Healthy Homes Initiative in conjunction with the Connecticut Green Bank and the state Department of Public Health, aims to develop models to better coordinate and deliver services to address housing-related health issues and to identify financing models for health-related housing interventions.
Hartford Knights Youth Organization, Hartford: $25,000
Hartford Knights is a nonprofit organization that provides mentoring, education, and job training to youth in the Hartford area who are referred from the Department of Children and Families, the court system, and school expulsion programs. This funding will support Hartford Knights as it transitions from focusing strictly on providing services to also engaging in grassroots advocacy related to health disparities that affect people of color. Through advocacy work, the organization will help to ensure that state leaders hear from more people of color who are affected by health disparities.
This grant was awarded as part of the Sanford Cloud Awards for Diverse Advocacy and Policy, which are awarded to individuals who have graduated from the foundation’s Academy for Health Equity Advocacy & Leadership. The funding is provided to advance these individuals’ health equity policy projects through the organizations they lead. These grants are awarded in recognition of Sanford Cloud Jr., former foundation board chair and current board member, for his numerous personal and professional contributions to advancing social justice and equity.
Health Equity Solutions, Hartford: $300,000
This funding will support Health Equity Solutions in its work to advance policies that promote health equity for people of color in Connecticut. In particular, the organization plans to work to advance sustainable funding and payment for community health workers; improved and standardized collection of data on race, ethnicity, and language preference; and ensuring equity in health care delivery and payment reform.
NAMI of Connecticut, Hartford: $25,000
This funding will support NAMI of Connecticut’s advocacy work on issues related to health care coverage, mental health care, and the treatment of mental health issues in schools. NAMI plans to focus on advocacy to ensure that Medicaid clients maintain coverage and access to care; educational policies that ensure young children with behavioral health challenges are treated appropriately in schools; initiatives to require mental health curriculum in public schools and training on mental health issues for teachers; and efforts to strengthen the state’s mental health parity law.
Yale New Haven Health Center for Outcomes Research and Evaluation, New Haven: $74,990
Unequal access to high-quality health care is a key contributor to health disparities. Data is a critical piece of eliminating these inequities; it can allow providers to recognize gaps that exist, identify where improvements are needed, and enable payers to reward providers that can reduce or eliminate disparities. Under a previous grant from the foundation, Yale’s Center for Outcomes Research and Evaluation (CORE) developed an approach to measuring health care quality disparities based on race and ethnicity. This funding will support the next phase of this work, including additional validation to ensure providers have faith in the methodology, and work to strengthen the case for incorporating health equity quality metrics into health care delivery to reduce racial and ethnic health disparities.
Media grants
The Connecticut Health Foundation provides grants to nonprofit media organizations because news reporting on health care provides insights, informs debates, and ensures that critical topics reach broad audiences. The funding is awarded with an understanding that the journalism will be independent, and the grant will play no role in editorial decisions about health coverage.
Connecticut Health I-Team, New Haven: $40,000
The Connecticut Health I-Team is a nonpartisan news outlet focused on health and safety issues. This grant will support in-depth reporting and multimedia projects on health equity, health disparities, and social determinants of health.
Connecticut News Project, Hartford: $75,000
The Connecticut News Project is the parent organization of The Connecticut Mirror, a nonpartisan news outlet that provides in-depth reporting on state government and the implementation of public policy. This grant will support The Mirror’s coverage of health care issues and reporting on the ways policy decisions and implementation affect people and organizations in the state.
Connecticut Public Broadcasting, Hartford: $50,000
Connecticut Public Broadcasting is the parent company of Connecticut Public Radio. This grant will support WNPR’s coverage of health policy issues, including the addition of a new health reporter.
Discretionary grants
President’s Discretionary Grants are awarded to organizations and institutions that respond to the foundation’s overall mission or priority areas.
Connecticut Public Health Association, Hartford: $5,990.88
This funding will support the 2019 Connecticut Public Health Association advocacy training, during which public health students and professionals will build their knowledge of legislative advocacy and policymaking and the skills needed to be successful advocates. The training will include components about health equity to help participants advocate for policies that address racial and ethnic health disparities.
Lawrence + Memorial Hospital, New London: $13,056
This funding will support Lawrence + Memorial Hospital in developing the infrastructure and capacity to deploy community health workers to engage people with complex health needs, with the goal of improving their health outcomes.
The Village for Families & Children, Hartford: $25,000
This funding will support The Village’s work to raise awareness of a trauma treatment known as eye movement desensitization and reprocessing, or EMDR. The treatment is generally available among private practitioners, but is not as recognized or available among community mental health providers, who represent a major source of behavioral health care for children covered by Medicaid. The Village will work to raise awareness of EMDR, document the outcomes for children who have received EMDR treatment at The Village, and seek to have it recognized by the state as an evidence-based treatment, which could lead to its wider adoption.
For more information, please contact Arielle Levin Becker at arielle@cthealth.org or 860-724-1580 x 16.