NEW MEXICO






 

NEW MEXICO
New Mexico Department of Health
Lou Anna Sanchez, Acting Director
Division of Policy and Performance
New Mexico Department of Health
1190 St Francis Drive
Santa Fe, NM 87502
Phone: (505) 827-2895
Fax: (505) 827-2942
Email: louann.sanchez@state.nm.us
 
 
Organizational Structure/History
 
In July 2002, the Office of Workforce Development and Health Equity (OWDHE) was established within the Department of Health (DOH), Public Health Division. The Office’s Health Equity component functioned as the point of contact for the regional and national Offices of Minority Health. Specifically, the Health Equity component addressed issues related to health disparities, developed and provided cultural competence training, and identified resources to address issues related to limited English proficiency. In July 2004, the OWDHE was moved from the Public Health Division into the newly created Office of Policy, Planning and Evaluation (OPPE). OPPE was charged with establishing health policy, tracking and coordinating legislative activity, and monitoring evaluation for DOH programs.
 
In July 2005, the New Mexico Department of Health’s Secretary, Michelle Lujan Grisham renamed OPPE and created the Office of Policy and Multicultural Health (OPMH), responsible for developing policy initiatives, coordinating the Department’s legislative strategies and bill analysis process and coordinating the Department’s efforts on reducing health disparities. In November 2007, the New Mexico Department of Health’s new Secretary, Dr. Alfredo Vigil, renamed the Office of Policy and Multicultural Health (OPMH) the Division of Policy and Performance (DPP). DPP reports directly to the Office of the Secretary, New Mexico Department of Health. Within the Division of Policy and Performance the Office of Health Equity (OHE) is responsible for managing the State Partnership Grant and related activities to reduce health disparities in the state’s minority populations.
 
Purpose/Mission Statement
 
The mission of the Division of Policy and Performance is to reduce gaps in health status and to  improve the quality of life of the state’s diverse populations. The Division will accomplish its mission by:
 
  • Developing health policies and programs that improve access and care;
  • Advocating for policies at the state and federal level that improve health;
  • Working with the state’s congressional delegation to communicate Department needs for federal programs and funding;
  • Coordinating the Department’s legislative strategy and bill analysis process;
  • Collecting and reporting data on Department priorities and programs;
  • Facilitating effective health outreach and education and promoting community participation in decision-making related to health issues;
  • Facilitating the American Indian Health Advisory Committee and the CLAS Standards Workgroup;
  • Promoting sound health policy and programs that address the needs of these       populations.
  
Program Focus/Activities
 
DPP/OHE oversees and implements the activities of a State Partnership Grant to improve minority health which was awarded by the Federal Health and Human Services Office of Minority Health in July 2005. The funding received through this grant has enabled DPP to engage in the following program activities with the goal of improving awareness of health disparities as well as the ability of the Department to address these disparities.
 
Health Disparities Report Card
The New Mexico Racial and Ethnic Health Disparities Report Card is intended to increase awareness about health disparities; it contains data from a variety of sources from within the NM Department of Health (DOH). The report card is designed to monitor the state’s progress toward eliminating the health status gap among racial and ethnic minorities. Letter grades are used to show how well the health system is doing in eliminating differences among populations by comparing each group to the population with the best rate. A copy of the 2008 report card can be found on the following website: www.health.state.nm.us/DPP/.
 
CLAS Training
One of DPP’s ongoing initiatives is to implement the four mandated Culturally and Linguistically Appropriate Services (CLAS) Standards. In September 2006, training on cultural competency and the 14 CLAS Standards was offered to 30 agency staff. Following the success of this event, DPP/OHE convened a CLAS workgroup which developed a shortened version of the training to be used for New Employee Orientation (NEO) for DOH staff. The short version includes an overview of the 14 CLAS Standards, a self assessment of cultural competence by the participants and a discussion of the importance of culturally competent health care, especially in New Mexico. Beginning in April of 2007, all new employees of the Department of Health began receiving this training. In addition, the CLAS workgroup assisted the DOH Learning Center in developing a CLAS Training that is available to all DOH employees as part of the menu of trainings available through the DOH intranet. DPP also has a link on their website to the National OMH website for the cultural competence training, “A Physician’s Practical Guide to Culturally Competent Care.” The DPP link is available to anyone accessing the DOH web page.
 
In July 2009 OHE/DPP launched the state’s first online CLAS Training class available to anyone with internet access. In web-site also provides additional resources and implementation strategies to implement the CLAS Standards. The training is free, the site is www.nmdohcc.org, the training is aimed at assisting community based health care providers throughout the state without the means to train their health care staff. 
 
Medical Interpreter Training
DPP/OHE provides Spanish and Navajo bilingual medical interpreter training for DOH staff, contractors and community-based service providers. The training includes instruction on the role of the interpreter and the process of interpreting, correct medical terminology and vocabulary, and role-playing.   The training is ongoing and has been provided regularly since November 2006. In addition, DPP/OHE, in cooperation with the Behavioral Health Collaborative of the NM Human Services Department, provided the first Behavioral Health Spanish interpreter training in December 2007 to DOH staff and community-based behavioral health providers. In addition, DPP/OHE continued to provide Behavioral Health Spanish interpreter training for Behavioral Health providers throughout 2008 and 2009. In state Fiscal Year 2009 DPP/OHE provided training to 55 health care providers in Spanish medical interpretation and 11 staff were trained in Navajo medical interpretation.
 
Translation services
New Mexico has a high percentage of Hispanics, 43.6% of the total population, with a substantial number of Hispanics who speak only Spanish. Translation of documents is essential to address the four CLAS Standards, to improve access to health care, and to improve the ability of DOH programs and clinics to serve Limited English Proficiency clients. DPP has hired a Spanish Translator/Interpreter who is providing essential translation services for DOH programs and is also providing advice on how to make program materials more culturally appropriate. The DPP/OHE Spanish Translator/Interpreter has provided limited translation services to other state/local agency programs.
 
Standard Data Categories
Previously, a variety of data categories were used to piece together a picture of health disparities.   In order to improve data collection and reporting, DPP convened a workgroup to develop standardized data categories, to increase efficiency of data gathering, and to improve the analysis of health disparities. DPP staff is working with the Information Technology Division, as well as with individual programs, to implement these categories as data systems are updated and/or replaced.
 
Mini Grants
DPP provides mini-grants to local community-based, minority-serving organizations to address health care services needs in their local communities. To date, DPP has awarded 33 grants to local communities. Some of the topics grantees are addressing include teenage pregnancy prevention, diabetes, obesity, youth physical fitness maternal and child health, alcohol-related deaths, oral health, and access to care. In state Fiscal Year 2009 DPP/OHE provided mini-grants to 6 youth serving programs to develop and produce teen pregnancy prevention videos across the state. The mini-grants required that youth be involved (with adult supervision) from the development of the scripts to the acting and final production of the video. Once the videos were completed they were copied and distributed to youth serving organizations and viewed by over 205 youth who provided written evaluations on the quality of the videos. The results were tallied and the winning video team received a pizza party and certificate of award signed by the Secretary of the NM Department of Health.
 
Health Disparities Track
In June 2008 DPP sponsored a strategic planning summit entitled Awareness to Action Summit. The purpose of the Summit was to generate actionable strategies to reduce four specific health disparities in New Mexico. Data provided in the New Mexico Department of Health’s 2008 Racial and Ethnic Health Disparities Report Card pointed to four health indicators showing significant disparity rations. The four key focus areas chosen for the Summit were: 1) Diabetes in Native Americans; 2) Obesity among African Americans; 3) Hepatitis B in Asian/Pacific Islanders and 4) Drug-induced deaths among Hispanics. Professionally and regionally diverse individuals worked over two day to develop realistic strategies to reduce disparities in New Mexico. Actionable strategies chosen in each disparity are scheduled to be funded through the mini-grant process.
 
Legislative Advocacy
The 2007-2009 Legislative Session required DOH staff to address implications of the proposed legislation with a consideration of health disparities that were sent to the Governor’s Office, the Department of Finance and Administration and the Legislative Finance Committee. DPP staff was successful in adding a section on health disparities to the bill analysis template used by the Department. 

DPP was also actively involved in the passage of key legislation in 2007 that directly addressed health disparities for underserved communities. This legislation included: 1) House Bill 721, enabling tribes to place representatives on Maternal and Child Health (MCH) Planning Councils. These councils serve to provide guidance and recommendations to DOH regarding maternal and child health services. 2) Senate Bill 23, assisting medically underserved communities by providing tort coverage for certain health care providers. This legislation enables health professionals to provide critical health care services without the barriers of costly tort insurance, and it increases access to healthcare for rural and minority populations, and 3) House Bill 638, establishing a Rural Health Care Practitioner Tax Credit, giving eligible health care practitioners a credit against the tax liability imposed by the Income Tax Act. This bill will help with the retention of rural health care providers and will increase access to healthcare for rural and minority populations.
In 2008, HB 236 established the Off Reservation Native American Health Commission to address the health care needs of the urban Indian population. The Commission was modestly funded to access the health care needs of the off-reservation population, provide a report on findings and recommendations to address the identified needs. In 2009, SB 196 the State-Tribal Collaboration Act requires all state agencies to provide training for staff around the protocol for tribal consultation including cultural competence when dealing with all issues relating to the states American Indians. 
 
American Indian Health Advisory Council
In June 2006, the Department of Health (DOH) established the American Indian Health Advisory Committee (AIHAC) to address health disparities among American Indians in New Mexico and to provide guidance to DOH regarding health disparities issues impacting tribal communities. The AIHAC continues to meet quarterly in 2007-2008 and provide guidance to the Department on addressing health disparities among the American Indian Populations in New Mexico.
 
Eliminating Health Disparities Statewide Initiatives
 
The Health Disparities Plan is the lead chapter in the State of New Mexico’s 2006 Comprehensive Strategic Health Plan (CSHP) released on August 31, 2006. The State 2008 Comprehensive Health Plan is required by state law and is designed to be a roadmap, providing direction and guidance for medical practitioners, health planners, educators, elected officials, businesses, and consumers of healthcare.
 
The 2008 Health Disparities Plan has one goal: To decrease Health Inequities: The Goal identifies several strategies for different health care stakeholders to address health disparities including: 1) state government; 2) tribal governments; 3) local governments and communities; 4) the educational systems and 4) health care providers/organizations.  
 
Through its inclusion in the Comprehensive Strategic Health Plan, the Health Disparities Plan emphasizes New Mexico’s commitment to reduce health disparities beyond the Department of Health to include all entities involved in health promotion and health care. 
 
 
Level of Funding Sources
(as of January 2008)
 

Year
Federal
State
FY 2005
 
$390,000
FY 2006                       
$146,484
$684,000
FY 2007
$159,212
FY 2008
$159,212
$706,000

 
 
Resources
 
The Division of Policy Performance has a staff of eleven:
1 Division Director
1 Deputy Director
1 Director of Health Equity
3 Epidemiologists
1 Minority Health Educator)
1 Native American Liaison
1 Management Analyst
1 Spanish Translator
1 Administrative Assistant
 
Recent Publications
 
·         2007 and 2008 Racial and Ethnic Health Disparities Report Card
·         2008 Two American Indian Report Cards
·         2008 Comprehensive Strategic Health Plan
·         2008 Prenatal Care in New Mexico a Epidemiology Report
·         2008 American Indian Health Services Report