Child Study Center Grand Rounds 02.08.2022

March 21, 2022

Information

Closing Health Equity Gaps in Healthcare: A Statewide Approach to Eliminating Racial Disparities

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00:00Accurate, but yeah, Adam is here
00:04today sharing on some of her work.
00:09Before we get started,
00:10I'm going to actually just give
00:11an update on what's coming ahead.
00:16So we will get that updated for you
00:19so you all can have the accurate
00:22title for today and then moving
00:24forward we will have next week.
00:27We're looking at the socioeconomic
00:30inequality's and children brain
00:32development by Doctor Noble and
00:33then the following week we're going
00:36to have a perseverance tells a
00:38story which is a highlight feature
00:39for our Black History Month event.
00:45So we will make sure we get all that to you.
00:47If you have questions or whatever it may be,
00:49you can use the chat.
00:50We have our grand rounds committee
00:54keeping close eye on that for you as well.
00:55So thank you for being here today.
00:58It is an absolute honor to be presenting.
01:02Our speaker for today who has been doing
01:03some really great work around the state
01:05and within our child study centers,
01:06so I will come to allow her
01:09the most ample time to share.
01:11Today I will get us started
01:13on introducing our speaker.
01:15Is that OK, ready?
01:18OK, so doctor Cecilia Frometa is
01:22a licensed clinical psychologist
01:24and assistant professor here at
01:26the Neal University School of
01:28Medicine for the past 18 years.
01:31Doctor Frometa obtained her PhD
01:33in counseling psychology from
01:35Northeastern University and completed
01:37her postdoctoral internship at Harvard
01:39Medical School with the clinical
01:41focus on trauma related disorders.
01:43In addition, Doctor Formato completed
01:46her postdoc fellowship at Yale Child
01:48Study Center and choose Core faculty
01:50member within the psychology section
01:52at the Charleston E Center as well.
01:55She also serves as a statewide
01:58icaps network training coordinator,
02:00which is our intensive in home,
02:02child and adolescent psych
02:04psychiatry program here at you.
02:06Doctor Frometa has been a mental health for
02:08over 20 years and has extensive therapy,
02:10teaching,
02:11program development and
02:12public policy experience.
02:14Her work hasn't publishes
02:16in several issue briefs.
02:18She's also been a keynote speaker
02:21and expert panelists and a
02:23presenter at several national and
02:25statewide mental health forums.
02:27Most recently she was featured
02:28on NBC Nightly News on Sigma on
02:31a segment focusing on helping
02:33parents identify depression and
02:35children during the COVID pandemic.
02:37She currently serves as a state
02:39consultant for the Connecting Children
02:41and Families to care projects.
02:43A federally awarded systems of Care
02:45grant that will focus that will be
02:47the focus of today's grand rounds.
02:49The Connect project focuses on the
02:51implementation of the Connecticut
02:53Child Behavioral Health Care plan.
02:55Following the tragic events of Sandy Hook.
02:58Doctor Mehta is part of the cultural
03:01linguistic Appropriate Services
03:02Advisory Council whose purpose is to
03:04focus on ensuring that Connecticut
03:05child and Family Agency has obtained
03:08formal training and support of
03:10addressing health disparities
03:11in the communities they serve.
03:14Last but certainly not least,
03:16Doctor Pamela is a recipient of the
03:18Merck Scholar and distinguished
03:20Presidential Scholar program, Doctor Fumetto.
03:22Thank you for sharing your time
03:23with us today,
03:24and I'm honored to have an
03:25opportunity to hear of the great
03:26work you're doing around the state.
03:29Thank you so much for that
03:31great introduction crystal.
03:32I'm I'm very appreciative and I'm
03:34really looking forward to this and
03:36sharing some of the great work that
03:39is being done across the state of
03:42Connecticut and talking a little more
03:45to you about the connect connecting
03:47children and families to care grant.
03:50So I do as just as a couple of
03:54disclaimers on housekeeping things
03:56number one I have a puppy who typically.
03:59It was very, very quiet.
04:01However, I think he has.
04:03He's gotten, you know,
04:04the word that I have grand rounds today,
04:07and so he's a little
04:09so he may be a little funky.
04:10So I just want to let you know.
04:12So my apologies in advance and I
04:15also want to introduce my colleague.
04:19My state colleague Lisa Palazzo,
04:22who will who will be talking about the
04:26Connect Grant as well. And she is.
04:30The class on chair for the connecting
04:33Children and Families to care grants,
04:35so I will be introducing her as well.
04:40So I'm going to share my screen
04:42and hopefully I will be able to.
04:48Do I have any technical
04:49difficulties in doing so?
04:51So give me one second.
04:56For those of you, I also
04:57updated the title in the chat.
05:01And Crystal, if you wouldn't mind actually.
05:06Just looking at the chat to see if there are.
05:11On any questions that come
05:13up that would be fantastic.
05:15Thank you, no problem, OK?
05:18So I am sharing hopefully my slideshow.
05:22Give me one second.
05:35One second. Sure.
05:42Apologies, I'm having some
05:44technical issues here.
05:51Which we'll figure out.
05:57There is a new
05:58technical issue every week.
06:02And I do this all the time so you
06:04know it's interesting. Alright,
06:06so let me see if I can re save it
06:09and give me one second, I apologize.
06:13Blame this on the puppy if that is useful.
06:16You know, I think that I I'm gonna go there.
06:22Let's see, let's see if
06:24this actually works here.
06:28OK, so let me try this again.
06:31I'll come back to my colleagues
06:34and for whatever reason it's not
06:36coming up here and it was coming up.
06:39Uhm, can you see my slideshow at all?
06:43Let me see. Probably not OK,
06:46let me see. It is a.
06:53Coming up.
07:05To say, I know we were playing,
07:06I know we were playing around with
07:08it before. Here we go OK, I got it.
07:12OK, thank you. OK, so hopefully
07:14you can see your screen, yes.
07:18Yeah. OK, great. OK so uhm,
07:24I am absolutely honored to be presenting
07:28on the connecting to care or what's called
07:34the connecting children and families
07:36to Care initiative, which has been.
07:39But in Connecticut since 2013,
07:42and we're going to talk a little bit
07:45about the history of how we got started,
07:48my focus today is going to be on closing
07:52HealthEquity gaps in health care.
07:55So I'm going to specifically be
07:58talking about a statewide approach
08:01that has been on again solidified.
08:06By the state in terms of assisting
08:10organizations and eliminating racial
08:12disparities and health inequities.
08:15So it's a complete. It's a.
08:18This is clearly a very, very important topic.
08:21Very timely topic.
08:22Given some of the socio political
08:26challenges that we've had.
08:28Within R and nationally as
08:30well as given some of fund,
08:32what we know has happened
08:33in this state as well.
08:39So we have 4 objectives today.
08:42The first objective is to introduce
08:44you to the connecting children and
08:46families to care statewide initiative.
08:49I do have a couple of videos that I
08:51will show you which will summarize some
08:55of what the initiative on is about.
08:59The second objective is to provide you with.
09:05Information on our on statewide free
09:09technical assistance and ways that you,
09:12if you are interested
09:15following this presentation.
09:17If you're interested in building
09:19HealthEquity strategic plans
09:21within your organization,
09:22how you can actually get involved and
09:25the types of supports that we offer.
09:30I next I'm going to subway and
09:32review some racial disparities
09:33data and HealthEquity data within
09:37both our health and mental health.
09:41Systems within the state of Connecticut,
09:44within the state of Connecticut.
09:47And finally, a call for action.
09:50I am going to leave you with some
09:52resources that I think are going
09:54to be beneficial to you and your
09:57organization in terms of understanding
10:00our connecting our excuse me,
10:03or connect Connecticut four phase change
10:07model toolkit which was published in 2019.
10:11Which I was a part of as well,
10:14with the goal of engaging you in
10:17how to become involved in in future
10:20cohort groups that are being offered
10:23across the state across the state.
10:26So I am going to actually fingers
10:29crossed show you my first video or
10:32their first video which talks a
10:34little bit more about connecting
10:36children and families to care.
10:37So with that, if I am going to go ahead and.
10:44Share my screen and can you start speaking?
10:47Can you see my screen?
10:48Can somebody tell me?
10:50You're
10:50going to need to share your desktop.
10:56OK. Give me one second.
11:05So. I am. Here.
11:13Who's this?
11:20Let me see if I can. Slideshow.
11:29You'll need to stop your
11:30share 1st and then just
11:31restart the share and click on screen
11:34instead of the PowerPoint window.
11:39I see screen OK. Thank you.
11:44OK. And hopefully now you can.
11:49You can't see it.
12:01And try that again,
12:03I apologize. Share my screen.
12:11And let me see if I can open this.
12:22Can you start seeing the?
12:25Yes.
12:28In Connecticut,
12:29up to 20% of our children experience
12:32behavioral health difficulties
12:33and would benefit from treatment.
12:35This puts them at risk for expulsions,
12:38substance use, suicide,
12:40and other everyday struggles providing
12:43behavioral health support and services
12:45to our youth and their families is
12:48an investment in our community,
12:50which is why connecting children and
12:53families to care is so critical.
12:59Since 1997, Connecticut's network of
13:02care has been evolving to improve
13:05access and the Newtown tragedy
13:07highlighted this need even more.
13:12Through a federal grant, Connecticut
13:14network of care transformation
13:16connecting to care was created.
13:22Leading the way for families to become
13:25champions by receiving training,
13:27then training their neighbors and
13:29working together with professionals
13:31to access the best care community.
13:34Conversations where families shared
13:36their experiences about the network
13:39of care helped gather information
13:40on what Connecticut was doing, well,
13:43where there was room for improvement,
13:45and a plan to get there.
13:51As a result of connecting to care
13:53families and child serving systems
13:56in Connecticut are partnering
13:58to create a network of care with
14:00collaboration from schools,
14:02pediatricians and other health professionals.
14:05Deliver care that is culturally
14:08informed with language assistance,
14:10mentor youth and family members,
14:12and share data so everyone can
14:15contribute more effectively.
14:17Within a transform system,
14:19each family based team develops
14:21a plan of care that is community
14:25based and family centered,
14:26strengths based and needs driven
14:29culturally and linguistically competent
14:31connecting to care is families
14:34and professionals working Better
14:36Together with families comprising
14:39at least 51% of the decision makers.
14:43Sensitivity to cultural diversity
14:45and support for language barriers,
14:48focusing on the child's strengths and needs,
14:51and never giving up when faced
14:54with challenges.
14:55It's time for the stigma around
14:57behavioral health to disappear
14:59so we can care for our youth and
15:02families holistically understanding
15:03that both behavioral and physical
15:06health need to be addressed to
15:09ensure a healthy community.
15:11By becoming more informed about the process,
15:13everyone is a part of the transformation
15:17connecting the children and families of
15:19Connecticut to a better network of care.
15:47Cecilia, you're muted.
15:52OK so I am back on the slide show
15:54and hopefully you can see this yes.
15:59Click on the other window in
16:01the PowerPoint 'cause your
16:03PowerPoint is still running. OK.
16:09When you hover over the PowerPoint
16:11icon and then the one to the right.
16:14One to the right.
16:18See once again, let me share my screen again.
16:25OK.
16:28So. Can you see my power?
16:33Can you see the PowerPoint now? See.
16:38No.
16:48OK.
16:51Can you see my screen?
16:52I just want to somebody could tell
16:54me it says connecting to care.
16:55OK, OK great so. So again connecting to
16:59care is a federally funded initiative.
17:02Focus on improving the state's behavioral
17:04health system with care for children.
17:06The focus again today is really on
17:09the class work group. That's the part.
17:12The group that I am a part of.
17:15And again, the focus of our group.
17:19Within the integrative services that we
17:22provide to child and family service.
17:25Organizations across Connecticut is to
17:28really focus on quality and ensuring
17:31that organizations receive support to
17:34ensure that they are providing quality
17:38racially just culturally responsive and
17:40linguistically appropriate treatment
17:42to the population that they're serving.
17:47The vision of connecting with class.
17:50Our workgroup or specific workgroup.
17:54Is to develop, plan,
17:56and implement a statewide process
17:58for incorporating some of you may
18:01be familiar with this movement.
18:02Spend some time on this,
18:04incorporating the enhanced
18:05culturally and linguistically
18:07appropriate services standards.
18:09These are 15.
18:11A set of 15 class standards that are
18:16utilized across our country and we
18:19do this in Connecticut within the
18:22children's network of care and the goal.
18:24In terms of how we get there is
18:27to partner with families and
18:30with key stakeholders across the
18:33state to promote HealthEquity,
18:35racial justice and cultural and
18:38linguistic competence across
18:40all behavioral health services
18:42at multiple levels.
18:43So we're looking at this from
18:46a local perspective regionally
18:47and at the state level.
18:49So we work with all six regions
18:51across the state of Connecticut
18:54For more information.
18:55And I will leave you as I said,
18:57with multiple resources we do
19:00have a website and and we are a
19:03part of the planforchildren.org.
19:06And this gives you more information
19:08on our work group as well.
19:12So without further ado,
19:14I would like to introduce my
19:17colleague on Lisa Palazzo,
19:19who once again is the chair
19:21of our class work group,
19:24and she's going to provide you
19:26with some historical information
19:27on how we actually got started
19:29and some of the highlights of
19:31some of the work that we've done,
19:33not just within the state of
19:35Connecticut but also nationally as well.
19:38So with that Lisa,
19:39I'm going to actually turn it over to you.
19:43Sure, yeah, thank you doctor Frometa.
19:46You want to just advance the next slide.
19:48Thank you. Alright, as she mentioned,
19:52we do have a connect class work
19:54group that has been meeting since
19:562015 but just recently actually last
19:59month we created a statewide class
20:02Advisory Council and you can see the
20:04structure listed on this slide here.
20:06We really wanted to focus more on
20:08the integration of the work across
20:11multiple sectors and thinking about
20:13sustainability that this work.
20:14Would you know why past any grant and
20:17continue to to work on these system issues?
20:20We utilize a system of care philosophy so
20:23we can get feedback from multiple partners
20:25and get input to make recommendations.
20:28So the purpose of the statewide
20:30class Advisory Council and I'm
20:31going to refer to it as SCA.
20:33See because you know we we like our
20:36acronyms and it's easier to stay.
20:38So the purpose is to develop,
20:41plan and implement a statewide
20:43process for incorporating enhanced
20:45class standards within the children's
20:48network of Care in Connecticut.
20:49And we do that by partnering with families.
20:51And network of care leaders.
20:53And so as you can see in this diagram,
20:55the SCA Si falls under C back,
20:58so some more initials C back stands
21:00for the Children's Behavioral
21:02Health Advisory Committee.
21:03CBK is formally established by state
21:07legislation and began meeting in 2000.
21:09It's comprised of state agency
21:11appointments and many of the members
21:13are parents or relatives of a child
21:16with serious emotional disturbance
21:18and their mission really is to
21:20promote and enhance the provision of
21:22behavioral health services for all
21:24children in the state of Connecticut.
21:26They do submit an annual report on
21:28the local systems of care which are
21:31the community collaboratives and
21:33make recommendations concerning the
21:35provision of behavioral health services.
21:38One of their priority areas for many
21:40years has been disparities in access
21:42to culturally appropriate care.
21:44So the sea sea sea sea fit nicely
21:47within their structure.
21:49As one of their work groups.
21:51So the sea Sea will be sustained
21:53with the support of the groups that
21:55you see listed on the bottom.
21:57So the connect consultants and are
22:00supporting Grant staff a representative
22:02from the regional Learning Communities
22:05Wraparound Multicultural workgroup
22:06and families and youth.
22:08And so just to back up to the
22:10learning communities.
22:10These are part of our CONNECT grant
22:13technical assistance work that we
22:15offer their quarterly meetings with
22:18organizations that utilize class
22:19standards or that they have been
22:22building HealthEquity plans and
22:24they share their best practices
22:25of implementing class standards
22:27really support each other,
22:28share strategies of engagement
22:30and support mutual learning.
22:32Each region has an ambassador that helps
22:34lead this work from a local community
22:36organization and they provide the input.
22:39Into the sea,
22:40see the wrap around multicultural workgroup
22:42came out of community care coordination,
22:45and the mission was to develop a
22:47network of supports to empower,
22:49validate,
22:49and equip bilingual and multicultural
22:51staff to provide individualized care.
22:54So these groups will provide
22:55us CAC updates
22:57and recommendations which will
22:59be incorporated into the overall
23:01recommendations that are made by C.
23:03Back to the DCF commissioner.
23:11So to support the sea,
23:13sea and all of the technical assistance
23:15work that we offer to organizations,
23:17we do have a dynamic team of consultants,
23:20including our fabulous doctor,
23:21Frometa front and center.
23:23There you can see our other
23:25consultants that we have from seat
23:28from CT data collaborative Dr.
23:30Christo, who also is with Yale
23:33Carlos Blanco and Ellen Boynton
23:35and then at the bottom of the
23:37slide you see some of our CONNECT
23:39grant partners that help support.
23:41Work from beacon health options CHDIDCF
23:45favor and yield consultation center.
23:51Do a quick review of the
23:52timeline of our activities.
23:54We talked about some of it and
23:55you saw some of this in the video.
23:57Doctor Fairmeadow will be speaking
23:58further about how we utilize
24:00the national class standards,
24:02but to mention that so they were
24:04developed in 2000 by the US Department
24:07of Health and Human Services,
24:09Office of Minority Health as a
24:11blueprint for individuals and
24:12healthcare organizations who
24:14want to systematically advance
24:16HealthEquity by delivering culturally
24:18respectful and linguistically
24:19responsive health care services.
24:21They enhance them in 2013 and then you
24:24can see we took that a step further
24:26in 2020 and adapted them for our youth
24:29with the connecting to care grant.
24:31Adding language to include the
24:33words racially just in addition
24:34to culturally responsive,
24:36respectful and linguistically
24:38responsive care.
24:39And we thought this was important
24:41to include that language in the work
24:42that we're doing with providers to
24:44align with some of the work that DCF
24:46is doing in their racial justice initiatives.
24:49Doctor Mehta gave you an overview of the
24:52Connect Grant which was awarded by Samsa.
24:54The substance abuse Mental Health Services
24:58Administration that was granted in 2320.
25:00Thirteen you can see some of
25:02the events that preceded it,
25:04including the Newtown tragedy,
25:06which led to PA 13178,
25:08which called for a children's
25:09behavioral health plan in Connecticut
25:11and the connect work supports
25:14that children's behavioral health
25:15plan and then as mentioned,
25:17we created the class work group in 2015.
25:20Which as you know,
25:21transition most recently to the Sea
25:23sea and in between you see the work
25:25that we've done with organizations in
25:27our cohort model using the toolkit and
25:30other technical assistance that we provide.
25:33And this slide gives you an overview
25:35of the technical assistance that
25:36we offer through the grant.
25:38Multiple ways that we support and assist
25:41organizations around HealthEquity
25:42planning and the multiple tools that we have.
25:45Doctor Frometa will be spending
25:46additional time focusing on the
25:48six month cohort process using the
25:50four phase model of change that
25:51you see highlighted there.
25:53But in addition we do offer other
25:55trainings and assistance around evaluation
25:57strategies for organizations that
25:59have already developed HealthEquity
26:02plans and we can continue to provide.
26:04In support organizations,
26:05even past the six months,
26:06if they choose,
26:07you see a link provided there with
26:10and again on plan for children
26:12with our full menu of options that
26:14explains all of the technical
26:16systems in further detail.
26:23And then the next slide shows some of
26:26our connect initiatives and state and
26:28national highlights throughout the years.
26:31And again, we'll spend some further
26:34time reviewing the Connecticut Toolkit,
26:36but it's definitely worth highlighting here.
26:38You can see the image of
26:40the toolkit on the right.
26:41The full title is advancing
26:43HealthEquity and racial justice
26:45in children's behavioral health.
26:47It was published in 2019 and we're
26:49looking to make some enhancements on that.
26:52Hopefully this year.
26:54It does help.
26:55The toolkit helps organizations
26:57develop HealthEquity plans based
26:58on the class standards and really
27:00takes them through their four phase
27:02model of change and outlines a
27:03lot of the work that we're going
27:05to do that we do in our cohort.
27:07Eddie individuals have been trained
27:09on how to utilize the toolkit.
27:11We also have had 52 organizations trained
27:14in that six month cohort process,
27:16and we have five currently in process and
27:1848 of them have developed HealthEquity
27:20plans that many of them continue.
27:22To this day,
27:23we've had 266 individuals trained in and.
27:26Equity Workshop,
27:27which is really around how to implement
27:29class standards in your everyday work
27:31with clients and then 209 trained
27:34in implicit and explicit bias.
27:37We've had 149 people attend information
27:40sessions around our technical assistance
27:43and cohort process that we offer,
27:45and then the regional learning communities
27:47again continue in every region.
27:49They're quarterly.
27:50The focus is on sustainability and
27:52ongoing support and training on
27:54how to implement class standards.
27:56And mutual learning and integration of
27:59efforts across the child serving system.
28:02Doctor Frometa and Doctor Kusto
28:04conducted a meta analysis of the class
28:07health health HealthEquity plans.
28:08Excuse me to identify themes.
28:11Which was really helpful in our
28:13continuing working with organizations
28:15to meet their needs.
28:16And then we've presented at
28:18several national conferences.
28:20A couple of them included here and
28:22we more most recently submitted
28:25a proposal to present at nomicon.
28:28In Georgia.
28:31So I'm going to hand it back
28:32to Doctor Frometa and she can give you
28:34further information about the work
28:35we do with organizations. Thank you,
28:38Lisa. Thank you so much.
28:39That was a wonderful overview
28:40of some of the work that we've
28:43been doing on and so thank you.
28:46We're very appreciative,
28:47so I'm going to talk a little bit
28:50about some of the nitty gritty of
28:52how we actually support organizations
28:55in terms of building a HealthEquity
28:57plan before we get there.
29:00But again, by way of review,
29:03I just want to highlight that
29:06the national class standards,
29:08the purpose of the national class standards,
29:09again as Lisa.
29:13Reviewed is to provide organizations
29:16and individual a blueprint a
29:20foundation to implement culturally and
29:24linguistically appropriate services
29:25that will advance HealthEquity,
29:27improve quality and again to
29:30mitigate health disparities.
29:31Health care disparities.
29:35There are 15 standards and there's
29:37four areas that are beyond the scope
29:40of what we actually can dive into.
29:42Today, however,
29:43that part of the technical assistance
29:46that we offer is providing a lot
29:49of support and education around
29:52what the class standards are,
29:54which is a part of our model and
29:57ensure that all individuals within
29:59organizations are trained to understand
30:02what the class standards are.
30:04As well as.
30:07Clients who may be served by
30:10organizations on that they
30:12know that these are areas that
30:15organizations are really focused on.
30:17And in general, or in some.
30:21The four areas really cover kind
30:23of again a foundational standard,
30:25ensuring that organizations are committed
30:29to HealthEquity and racial justice.
30:34And sometimes I work with organizations
30:36that have a mission statement that
30:40highlights that on sometimes agencies
30:42we write their mission statement or
30:46create a HealthEquity statement in addition.
30:49There's also a focus on governance,
30:53leadership,
30:53and workforce.
30:54Really looking at standards 2 and four
30:57and within that particular area we
31:01focus on promotional opportunities,
31:04retention and looking at data to
31:08help us really help organizations
31:11focus on their internal structure
31:14and are there areas you know?
31:15What are areas that they're doing very
31:17well in as well as areas that they need to?
31:19From a workforce perspective,
31:22highlight.
31:24And shift we also focus on
31:27communication and language assistance.
31:29I find that this is an area that
31:32many organizations focus on and,
31:35and this is ensuring that I'm written.
31:38Materials are actually translated on
31:41in languages that actually match the
31:45population of that specific region
31:48actually serves as one example.
31:51At times it may also mean some
31:54training and support,
31:55formal training and support around
31:58ensuring that there are translators
32:00in order to help support clients or
32:05patients who are in need with the
32:09goal of again providing quality health care.
32:14And then from a from a more long term
32:16perspective, really thinking about this,
32:18we know that this is the lifetime
32:20work and we work with agencies
32:23for a specific period of time,
32:25but we do provide them with
32:27more additional support.
32:29And so how do we do that?
32:30We provide them with ongoing resources
32:33and support across the state through
32:35the learning communities as Lisa
32:38mentioned on on ways of continuing
32:41to keep that HealthEquity plan.
32:43And the HealthEquity goals and
32:47objectives alive within the organization.
32:51So that's a little bit about what we do.
32:54By way of definition,
32:55I just want to just briefly highlight
32:58and I'm aware of time and I'd like to
33:01leave about 5 to 10 minutes for for
33:04Q&amp;A as well behavioral HealthEquity on.
33:08Is the right to access quality health
33:12care for all populations regardless of.
33:16What they identify with from a
33:19intersectionality perspective,
33:20really thinking about race, ethnicity,
33:22gender, socioeconomic status,
33:25sexual orientation and geographical
33:29location and and this is the SAMHSA
33:33definition of behavioral HealthEquity
33:35and this includes access to prevention,
33:39treatment and recovery services for both
33:42mental health and substance use disorders.
33:47And again, as mentioned on,
33:51we have also, along with DCF,
33:55really focused on racial justice.
33:57Given some of the shifts and given
34:00some of the challenges that that
34:03have been much more from associate
34:07political perspective on a part of
34:10what we have been talking about here
34:13in the state and at the national level.
34:16So racial justice is a systematic,
34:19fair treatment of individuals of all races,
34:22resulting in equitable opportunities
34:24and outcomes for all.
34:27And I I do want to add, you know,
34:30the definition of what we mean by
34:32racial equity because racial equity
34:35is 1 component of racial justice.
34:39And it includes work to address
34:42the not just the effects,
34:44but the root causes of inequities.
34:46What causes inequities and again a
34:48part of what we do is really work with
34:52organizations to really dive into.
34:54You know why this is happening in ways
34:57that they can actually shift practice
35:00in order to mitigate this from happening.
35:04So this is very in a,
35:06you know very specifically,
35:08and includes eliminating policies or
35:11shifting policies or practices or attitudes,
35:14cultural messages that reinforce
35:17unequal outcomes by race.
35:20So that's something that our again,
35:23difficult conversations with.
35:24Certainly a part of what we do.
35:27I knocked now on a Segway in terms
35:30of making sure that we're all,
35:31and I'm sure that you're aware of this,
35:33but just I want to emphasize that
35:36a lot of the work that we do in our
35:39work group in our class work group is
35:42really looking at data collection and
35:46helping organizations really identify
35:48on lot of organizations have lots of
35:51data that are are all over the place,
35:55and so how do we really help them?
35:57Really streamline that data in order
36:00to build the HealthEquity plan,
36:02so one of the ways that we do that is we
36:05work closely with one of our partners,
36:07which is.
36:10See T.
36:12Data.org and you can find a lot of the
36:15data that I'm about to share with you
36:18with CT data collaborativeexcuseme.org.
36:23And they have wonderful data.
36:26They also provide lots of training
36:28and support to our cohorts who
36:31are become a part of our process.
36:34So just in brief,
36:35I won't review every single
36:37one in detail here,
36:39but we know that in the state of
36:42Connecticut from 2000 to 2920,
36:45ten that our population has
36:48increased on by 4.9 and there's been.
36:51There's been some increase from
36:542010 to 2020 twenty.
36:59By zero point 9%.
37:01So there you know there have been
37:04some cities that have actually
37:06lost populations and some cities
37:09have that have gained populations
37:11in terms of what we know about
37:14individuals who identify as black
37:17indigenous and individuals of color,
37:19the population continues
37:20as we know to increase.
37:23So here you can see some of
37:25the trends in terms of looking
37:28at 2000 data versus 2010 data.
37:31And as you can see here in 2020 data.
37:36The population has increased by 37%.
37:40Towns with the largest black,
37:42Hispanic and Asian populations
37:44are as follows, and again,
37:46this data on is from the US Census data
37:49and again from City Data Collaborative.
37:53Here we have on Black and African
37:56American populations in Bloomfield.
37:59Excuse me, make up 53% of the population.
38:05We have 4444% of the population
38:09in Hartford and New Britain who
38:12identify as Hispanic or Latino.
38:15And we have in Rocky Hill 19% of the
38:18population that identify as Asian.
38:20And again, this is based on
38:23census data of twenty 2020.
38:27I thought this was a really important slide
38:30to include here and what I really want to
38:33highlight for you is that these three bars
38:35here and as you can see in this graph.
38:37And again, this is from the US Census
38:41Bureau American Community Survey,
38:432010, 29 and 2019.
38:46What we do see is again,
38:49even the financial disparities the
38:53income disparities on based on
38:55medium household income. And again,
38:58this is across the state and what you see.
39:02Obviously it is on those individuals
39:04who identify with as two or more races,
39:08African American or latino's.
39:10Once again, who actually?
39:14Make up on less.
39:16Less of the income here.
39:19Make significantly less.
39:23Something that is also interesting is
39:26that we have in the state of Connecticut
39:30experience a 9% decrease in our
39:32population or are under 18 population.
39:36So these are the numbers.
39:38What is really interesting about this,
39:40however, is that while we have
39:42experienced a decrease in the numbers,
39:45the reason why this work is important in
39:47terms of really looking at HealthEquity
39:50and language barriers and so forth
39:52is because there's been a some poor.
39:54Percent increase in individuals who
39:58identify with in. Under 18 population.
40:012 or more races.
40:0320% increase in in the Latino population.
40:0727% decline in the white population
40:09again in this age group and it's
40:1212% increase in Asian population.
40:15So this really is a call for action.
40:16It's really, you know,
40:18highlights the need to really look
40:21at our programs and think about
40:23what it is that we're offering.
40:26So now I wanna segue to the last
40:28part of today's presentation,
40:30which is really,
40:31I'm talking about our six month
40:33process in terms of from a
40:35technical assistance perspective.
40:36What we offer.
40:37So one of the first things that I want
40:41to highlight and I'll I will keep
40:43this brief is our four phase change
40:47model to help organizations across
40:50Connecticut establish and develop
40:52HealthEquity plans and to address racial.
40:55Cost us and health disparities so
40:58there are four phases to what we do.
41:00The first phase is the initiation
41:02and engagement phase and this is
41:04the phase where we actually work
41:07with leadership to ensure that
41:08they're committed to understanding.
41:10Class standards are committed to
41:13looking at health inequities and racial
41:16injustices for some organizations,
41:18and every organization is slightly different.
41:21Some of them have DI teams on.
41:24They call them DI teams.
41:26Some of them call them class teams.
41:29Some organizations do not,
41:31so we really work with organizations
41:34to help them develop.
41:35Leadership team that is specifically
41:38focused on health disparities.
41:41We then provide them with training
41:43and support around developing a
41:46HealthEquity plan within six months,
41:48and what that process will look like.
41:51We work on bringing lots of trainers
41:55on to to the cohorts so that they're
41:59not actually they have a schedule
42:02of of trainings that they attend
42:05and the end result.
42:06It is within six months that they
42:09actually have a completed HealthEquity
42:11plan that's ready to be implemented,
42:14and certainly continued from a
42:16sustainability perspective to be looked at.
42:19The second phase is the again,
42:22the assessment phase really,
42:24really diving into once again
42:27looking at the organization,
42:29evaluating how well the organization has done
42:33in terms of HealthEquity data we provide.
42:37Lots of different templates in terms
42:39of how do you look at your data?
42:42How do you survey internal staff
42:47as well as how do you actually?
42:51Provide focus groups within the community,
42:53for example,
42:54so we spent a lot of time helping
42:57organizations organize their data
43:00collection plan in order to analyze it.
43:04Based on that analysis.
43:06Then phase two is really about
43:10helping organizations select and identify
43:14priority areas or priority class areas.
43:18There are 15 class standards as mentioned,
43:20so really helping them identify one.
43:23Two at times 3.
43:24Class standards in order to build that
43:27HealthEquity plan and to begin that
43:30HealthEquity plan is where we where we start.
43:33Phase three is really to help organizations
43:38implement some of some of the some of
43:43the goals that they have and really
43:45present their HealthEquity plan to us.
43:47We offer a graduation ceremony.
43:51Where organizations have an opportunity
43:54to invite clients and staff leadership
43:58and board of directors to present on
44:02a HealthEquity plan biology and then
44:06the final phase of our sustainability
44:09portion of our of our model is
44:12really to connect individuals with
44:15ongoing support through the loan
44:18communities across the state.
44:20So that's a little bit of
44:22what we do in terms of this.
44:24Our model that was published in 2019
44:27and then Lisa mentioned we're looking
44:30to tweak the model a bit as as we
44:34progressed and and and we learn.
44:37So that's a little bit about what
44:39we do and just briefly on.
44:41This gives you an overview of what
44:43our six month process looks like in
44:46terms of moving from the initiation
44:48and commitment fees in terms of
44:50helping organization and providing
44:51them with lots of information.
44:53And what HealthEquity planning is is for
44:57and like to helping individuals conduct
45:01organizational assessments on that time on.
45:04We are a part of a facilitating focus groups.
45:08Uh,
45:09we provide them with some templates
45:11in terms of surveys,
45:12we integrate some of the surveys
45:14that are already being done within
45:16organizations to really highlight some
45:18of the HealthEquity and racial justice
45:21components in terms of client satisfaction,
45:24for example.
45:26And then one,
45:27three.
45:28We look at outcomes review the
45:30outcomes month four we select we
45:32help organizations select two
45:34class priority areas.
45:36And when I say we help,
45:38that means that as a technical assistant,
45:41what we do is we meet with the the
45:45DEI team or the class team and help
45:49them review their data and they're
45:51the ones who really prioritize based
45:53on those results. What the two.
45:56123 priority class areas are.
45:59In the 5th month we have the formal
46:02presentation in the kickoff and then
46:04finally we transition and invite.
46:08Every organization has been a part
46:10of this process to actually take
46:12part in the learning community
46:14for sustainability efforts and
46:16for ongoing support.
46:18So what we offer again is the way
46:20that this is done is we have five
46:23monthly virtual meetings that
46:25are typically 60 to 90 minutes
46:27long and we do that on purpose.
46:29We have one in at least one individual
46:32from each organization has been
46:34a part of this process attend.
46:36Typically it's the DEI team and
46:38the class team.
46:39Whatever the organization calls it,
46:41who attends and who shares that
46:45information back to the organization.
46:48We offer a formal toolkit training which
46:50is very important in foundational,
46:52and it is our road map our framework
46:55to helping organizations actually.
46:59We bring in HealthEquity
47:03trainers on family and youth.
47:07Data collection and really importantly,
47:11quality assurance, which is something that.
47:16Becomes a part of the sustainability
47:19efforts for organizations.
47:22We also provide individualized
47:24organizational support,
47:26so one example of that is I meet
47:29with the DEI team, for example,
47:32or the Chair to provide them
47:35with further support in terms of
47:39direction of what the next steps are,
47:42and they may have some questions in terms
47:44of how to organize some of their data,
47:47and then again provide templates
47:50on building HealthEquity plans.
47:52Some organizations have internal
47:53standards that they have to follow.
47:56We also have some templates and
47:58sometimes it's integrated and then
48:00from a sustainability perspective.
48:02Again, we connect them with the community.
48:06We have two slides left on.
48:08There are some upcoming opportunities
48:09if you wish to be involved,
48:11you can certainly take a picture of this.
48:15I know that this is also being taped,
48:17but if you if this sounds interesting
48:20to you and hopefully it does if
48:23your organization is interesting,
48:24interested in developing a HealthEquity
48:27plan within that six month period.
48:31There are informational or introductory
48:33sessions that actually dive deeper
48:35into some of the information that
48:37I have provided to you today,
48:39and these are the dates and times
48:42on when they will occur in.
48:45In this month,
48:46we typically try to do this
48:48on a on a monthly basis and.
48:53And then my contact information is here.
48:57Before we go to questions,
48:59I do want to say thank you too.
49:02I want to thank you for taking
49:05time out of your busy schedule to
49:07be here today and also I would
49:10like to thank our graduating.
49:14Racial justice and HealthEquity
49:16champions across the state
49:18and all six regions who have
49:21participated in this initiative.
49:25As you can see, could probably.
49:27I'm sure that you will
49:29recognize some of these names.
49:33And lastly, I do want to say that we do
49:37have on a Facebook page in addition to
49:40the website and we have an Instagram
49:43account as well For more information.
49:46And there are lots of training opportunities
49:49and information that we do provide.
49:52Now I just want to go back here
49:55and I want to stop talking.
49:57And I want to thank you and
50:00I want to take questions.
50:01I'm gonna stop sharing my screen.
50:03Doctor Frometa we do have a
50:05question from Judy Eisenberg.
50:06She's asking if you can say a
50:08little bit more about the individual
50:10training for those who may not be
50:12able to engage organizationally is
50:14was called access plan and improve.
50:18Sure, so that's a part of and I
50:20don't know if Lisa is still here,
50:23because that's OK. She had to log off.
50:25OK, so that's a part of what one
50:27of our partners seat would do.
50:29So if Judy you're interested in
50:32doing more individualized training,
50:34I would connect you with our partners.
50:39Michelle Marie, you know Judy,
50:42they're wonderful. They're great.
50:43Thank you so much for this presentation.
50:45It really filled in a lot of gaps for me.
50:47I've been introduced to the class,
50:49work through the Regional Advisory
50:51Council and Citizens Review Panel,
50:53but didn't have this background and I
50:54sure could have used it a year ago.
50:56So thank you so much.
50:58Thank you Judy. I appreciate it.
51:02Questions, comments.
51:08I was going to show you more videos,
51:09but I thought given some of the challenges
51:12that would be better to help me do that. I
51:15have a question, Cecilia,
51:16thank you for this wonderful overview.
51:20A very very systematic,
51:22methodical way to help organizations.
51:25And so if the organizations
51:28are small. For example,
51:30let's say there's an inpatient psychiatric
51:32unit at Yale, New Haven Hospital that
51:34might wanna look it's.
51:38HealthEquity practices it.
51:40Is there a limitation to how
51:42small the organization is or
51:44how large the organization is?
51:47And also is is there
51:49is this free?
51:50Is there cost
51:51for enrolling in the program practicalities?
51:56Thank you so much Lori for that
51:58question and you know first
52:00of all, this is a it's free.
52:03This is free Technical
52:04Support and we know that free doesn't
52:07always mean free because it does.
52:10You know, we do ask for a commitment which
52:13means time which again does not equal free.
52:17But the support that we do offer is free.
52:18I certainly have worked with organizations
52:21that are very small that have one
52:24individual that that one individual wants
52:26to start focusing on HealthEquity and just
52:29needs to need the foundation needs the
52:32words the nuclear to really talk about.
52:35You know what HealthEquity is so that they
52:38can bring it back to their organization
52:41and they do that as kind of phase one.
52:45And so I certainly have worked with.
52:47You know I've worked with.
52:49Large organizations that are
52:51expanding but they just have,
52:54like you know that they're in the
52:55process of just having like one
52:57team and they're like, well.
52:58How do we expand?
52:59We're not sure, so we need to, you know,
53:02have you know a better foundation of what the
53:05class standards are in a HealthEquity plan?
53:07And then we need to try to scale up.
53:12Our efforts and we need to ensure that.
53:16That the different types of programs
53:19are also aware of what we're doing
53:22and be respectful of.
53:23Perhaps, you know some of the the
53:25different challenges that they may have,
53:27or different populations
53:28that they're serving.
53:30So in short, yes,
53:31we definitely work with
53:32organizations I've worked with.
53:34You know,
53:35an organization who did wonderful work and
53:37had one individual actually doing the work,
53:40and by the time that they were done,
53:42they actually had commitment
53:44from their board of directors.
53:46They had a HealthEquity plan.
53:47At which grew to a number of different.
53:52Programs within organization.
53:54So thank you.
54:00Thank you I I actually have a
54:02question you had shared about.
54:03You know within six months is there sort
54:06of a long term plan in terms of checking
54:08in with agencies and individuals to see
54:10about more around that sustainability.
54:12You know, I think it's it's easy when
54:14events arise to have this momentum and
54:16but then it sort of fizzles out sometimes.
54:18Is there a sort of active work and effort
54:21to address sort of the sustainability
54:23of the implementation of plans?
54:25Yes, yes, and that is
54:28phase four of our model,
54:30and that's when we connect individuals
54:33to learn communities and again seat.
54:35As Judy talked about Michelle
54:38and and Marie Spivey,
54:41Michelle Reardon Mills, and I'm sorry,
54:43I think I forgot her last name and correct,
54:47it's Michelle Stewart copes.
54:48Michelle Stewart copes.
54:49I work with two Michelle's
54:51that are hyphenated.
54:51So thank you a lot and so they actually.
54:55You know we'll continue to work
54:58and help organizations look
55:00at their HealthEquity plans.
55:03And part of the work that I do is you know,
55:06although it's just six months apart of
55:09the plan is to ensure that there are
55:13parameters in place so that they're
55:17looking at and reporting out on
55:20progress on a yearly basis every six months.
55:25Who's responsible for it?
55:26What is that going to look like?
55:28And then my colleagues are part of the
55:31class team will typically take that over.
55:35Uhm, so there's ongoing support.
55:37That's a great question.
55:38Thank you,
55:38Crystal,
55:39thank you. Thank you.
55:40We are just about at the two o'clock mark.
55:43You have the well.
55:45It was recorded and you also have the
55:49email that Doctor for Meta had put.
55:51If you have any questions,
55:52we truly appreciate your
55:53time and sharing some of the
55:55work that you're doing around
55:56HealthEquity across the state.
55:58So thank you so much and thank
55:59you everyone for attending.
56:02Thank you. Thank you everyone.