RHODE ISLAND






 

RHODE ISLAND
Office of Minority Health
Prepared by National Association of State
Offices of Minority Health (NASOMH)
 
Rilwan K. Feyisitan, Jr., Chief
Office of Minority Health
Rhode Island Department of Health
3 Capitol Hill, Room 304
Providence, RI 02908-5097
Phone: (401) 222-5940
Fax: (401) 222-5957
E-mail:
Rilwan.Feyisitan@health.ri.gov
Website: www.health.ri.gov/programs/minorityhealth


Organizational Structure/History

The Rhode Island Department of Health’s Office of Minority Health (RI-OMH) was created in June 1992 by the state legislature (Article 102, Title 23, and Chapter 64 of the Public Laws of Rhode Island), which allocated a portion of the revenues from a tax imposed on smokeless tobacco to the Office. The Office is currently funded through general revenue funds of the state and federal grants. It is located within the Health Disparities & Access to Care Team in the Division of Community, Family Health and Equity. As a member of the Health Disparities & Access to Care Team, the RI-OMH works across the Department of Health to provide leadership in addressing the Department priority to eliminate racial and ethnic health disparities. 
 
The RI-OMH includes the Minority Health Promotion Program, the Refugee Health Program, and Rhode Island’s Healthy People Initiative. A Minority Health Advisory Committee (MHAC), comprised of representatives from community-based organizations, health care providers, academic institutions, and racial and ethnic advocacy groups advises the RI-OMH and the Director of Health on matters related to the health of racial and ethnic minorities in Rhode Island.
 
From 1990 to 2000, Rhode Island’s minority population increased by 77% while the White (non-Hispanic) population decreased by 3%. Today, 20% of the state population is a racial or ethnic minority (Census Bureau’s 2005-2006 Current Population Survey). In general, the median age of Rhode Island’s minority population (26 years) is lower than the median age for the overall state population (38 years). Also, a larger percentage (84.4%) of the minority population is age 50 or less as compared to 70.2% of the overall state population that is age 50 or less. The health priorities specifically for racial and ethnic minority populations are obesity, heart disease and stroke, HIV/AIDS, cancer control, and diabetes.
 
Purpose/Mission Statement
 
The mission of the Rhode Island Office of Minority Health is to facilitate access for racial and ethnic minority communities to health information, education and risk reduction activities; and to develop policies, plans and tracking systems for ensuring that the needs of these communities are integrated and addressed within all department programs.
 
The RI-OMH carries out its mission through the following functions:
·         Developing policies and designing systems to improve minority health and reduce health disparities.
·         Providing funding and technical assistance to community-based organizations to perform targeted, culturally appropriate, health promotion and disease prevention activities.
·         Collaborating with other organizations in the public and private sector to amplify resources, programs, and planning to improve racial and ethnic minority health.
·         Monitoring and reporting data related to statewide public health surveillance and local health initiatives.
·         Facilitating access for racial and ethnic minority communities to HEALTH programs resources, and data.
 
Additionally, RI-OMH has adopted and promotes the National Association of State Offices of Minority Health’s Guiding Principles (NASOMH) stated below as a part of our core work.
  1. Eliminate health disparity for affected communities and nations through vigilant monitoring, regulation, and investigation of the determinants of disease and injury.
  2. Build capacity of national, state and local government to develop, implement, monitor and evaluate high quality cultural competence standards in all domains of public health, including policy, funding and programs.
  3. Engage and empower affected communities and nations in innovative ways to support individual and community efforts.
  
Program Focus/Activities
 
 
Health Planning and Policy Development
 
In calendar year 2009, the Minority Health Advisory Committee recommended the following priorities for the RI-OMH:
  1. Continue to focus on the elimination of health disparities. As we approach 2010, continue to integrate elimination of racial and ethnic health disparities across all HEALTH programs. Reaffirm commitment to this goal even beyond 2010.
  2. Continue facilitating implementation of the CLAS Standards in health care settings across Rhode Island.
  3. Health disparities database to track health indicators and progress toward elimination for minority populations. Commit department-wide resources to this initiative of the Office of Minority Health. Commit to identifying baselines and monitoring progress.
  4. Provide training and capacity-building services to community-based organizations statewide to improve capacity for evaluation, planning, and research.
  5. Implement a system to link RI agencies doing racial/ethnic disparities work. Identify effective mechanisms of linking community-based organizations, academia, research, and administrative/policy agencies based on common programmatic or goal areas. 
  6. Advise and participate in the development or revision of Community Benefits regulations (including Charity Care regulations).
  7. Promote community-based participatory research and the translation of research into practice. Direct attention to research on health seeking behaviors among Rhode Island’s racial/ethnic minority populations.
  8. Establish a Men’s Health Program to target the health conditions linked to disproportionately higher rates of morbidity and mortality in racial and ethnic minority populations. Changed: Work with the RI Department of Health to look at feasibility of an Office of Gender Equity
 
In partnership with the Minority Health Advisory Committee, RI-OMH is strategically responding to these recommended priorities.
 
Health Initiatives/Programs/Services
 
Since FY 1994, the RI-OMH Minority Health Promotion Program has awarded nearly 3 million dollars in grants to community-based agencies serving minority populations to develop Minority Health Promotion Centers (MHPC). MHPC are funded to implement community-based interventions that address health priorities specific to the racial and ethnic minority populations by:
1.      Conducting individual and community health risk assessments;
2.      Conducting community outreach;
3.      Performing health education and health promotion with community members about health conditions, health behaviors, and resources related to conditions for which minority populations experience a disproportionate burden.
4.      Promoting consumer empowerment by educating clients regarding consumers’ rights and responsibilities within the health care system;
5.      Working with public and private health care providers and community clinics to promote minority access to health screenings by making client referrals and tracking needed follow-up care; and
6.      Developing a health information resource area at their agency.
 
The MHPC grants are awarded through a request-for-proposal process for up to $30,000 a year
for a period of three consecutive years. More than 10% of Rhode Island’s minority residents receive services at MHPC each year. MHPC organizational capacity is enhanced through training for MHPC Coordinators on topics ranging from developing coalitions to conducting community assessments and planning and evaluating community interventions. MHPC staff also receive training on managing chronic diseases and other health disparities topics. MHPC clients have increased access to health care and health promotion services through health screenings, referrals and wellness programming. In addition, mini-grants (grants less than $5,000)
are made available to community-based organizations to provide smaller scale culturally and
linguistically appropriate community-based outreach and education services to racial and ethnic
minority populations. To date, more than 30 community-based organizations have received
funding from the RI-OMH.
 
The Refugee Health Program (RHP) serves approximately 150 newly arriving refugees and asylees who are resettled in the state each year and provides assistance with adjustment of status applications for refugees who have resided in the country for at least one year. The RHP ensures that refugees and asylees enter into a comprehensive system of care that adequately responds to their unique health care needs by performing three core functions- coordination of care, education & training for refugees and service providers, and surveillance & epidemiology. To achieve this, the RHP works with the DHHS Office of Refugee Resettlement, State Coordinator of Refugee Resettlement at the R.I. Department of Human Services, refugee resettlement agencies, and health care and social service providers to promote medical homes and the delivery of culturally and linguistically appropriate services.
 
Healthy Rhode Islanders 2010 (HRI 2010), modeled after Healthy People 2010, is an initiative to a guide to public health improvement efforts in Rhode Island and tracks progress toward the two overarching goals- the elimination of health disparities and increasing the quality and years of healthy life. HRI 2010 tracks annual progress on ten leading health indicators and 27 public health objectives. The RI-OMH Healthy People Initiative is engaged in national efforts to design Healthy People 2020 and is committed to maintaining the goal to eliminate health disparities through monitoring and reporting on key public health indicators.
 
RI-OMH also leads state efforts to implement the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards). RI-OMH currently supports three committees representing service providers serving linguistic, racial, and ethnic minorities. RI-OMH works closely with health care providers, academic institutions, insurers, state agencies, and community-based organizations to implement the CLAS Standards with particular emphasis on the four language access mandates. Strategies to meet the CLAS Standards include developing policies, procedures and tools; sharing data and strategies; and promoting patient/client and agency rights and responsibilities.
 
The RI-OMH provides staff support to a Department of Health workgroup that provides planning for special/vulnerable populations in the event of pandemic flu or another public health emergency. The Special Populations Working Group is a venue that exists to assist in the development of emergency planning. The working group contains subject-matter experts on special populations. Group members also know key contacts within their own programs and outside agencies. In addition, the RI-OMH helps to coordinate special/vulnerable population activities during state health emergencies and participates in the state incident command structure. RI-OMH also works with the Department’s Center for Emergency Preparedness and Response to conduct emergency preparedness assessments in minority communities. By maintaining a high level of engagement with community-based organizations and special/vulnerable populations in preparedness planning, RI-OMH contributes to the development of effective plans that address the unique needs of special/vulnerable populations. For groups identified as special/vulnerablepopulations, planning is occurring in advance of any public health emergency in order to reduce the risk of preventable hardship and address existing institutional barriers to the equitable distribution of services.
 
Data Collection
 
The Rhode Island Department of Health adopted a policy for maintaining, collecting and presenting data by race and ethnicity in 2000. RI-OMH and the Department’s Minority Health Data Workgroup are revising the data policy to include guidance on data collection by language spoken. The RI-OMH also prepares and disseminates biannual Minority Health Fact Sheets that provide socio-demographic data and health status profiles on all major racial and ethnic groups identified in the US Census that reside in Rhode Island. RI-OMH funded Minority Health Promotion Centers have also collected data on the demographics of their clients since 1994; these data are aggregated and reported annually by RI-OMH. Data are used to plan Department of Health programs, allocate scarce resources, drive policy development and provide justification for Minority Health/Health Disparities funding requests. Data are also shared among other state agencies, private and non-profit organizations, state legislators, community groups and potential funders.
 
Program Evaluation
 
The RI-OMH and Health Disparities & Access to Care Team are working with other units in the Department of Health and across Health and Human Services Departments to establish and monitor strategic plans and performance measures for the elimination of health disparities. Within the Department of Health, effectiveness will be measured and monitored through performance measures for disparities elimination that are currently being established and will be updated annually. Outcomes will be measured by reductions in disparities in health status, health outcomes, access to care, and healthy behaviors.
 
The RI-OMH works with an Evaluator to develop systems to evaluate Office activities and the impact of its funded programs on communities. To contribute to monitoring and evaluation efforts, the RI-OMH collaborated with the Office of Health Statistics to produce an updated Department of Health Policy on Maintaining, Collecting, and Presenting Data on Race and Ethnicity in 2000. Based on that policy, the RI-OMH was able to work with the Office of Health Statistics to review and advise the use of race and ethnicity data by all Department programs.
 
The RI-OMH also updates its series of “Minority Health Fact Sheets” every two years with the latest edition released in the Fall of 2009. The Minority Health Fact Sheets contain population demographics, socio-economic data, behavioral risk factors, leading causes of death, incidence rates of infectious diseases, and maternal and child health indicators for Native Americans, African Americans, Asians & Pacific Islanders, Hispanics/Latinos, White Non-Hispanics, and the State Overall. 
 
RI-OMH is in the process of developing a Minority Health Surveillance System that will track refugee health data and health outcomes for minority and emerging populations’ leading health indicators. This data will be publicly accessible and provide an analysis of minority health data from multiple sources. From this database and other sources, RI-OMH intends to produce an annual report on the health status of minorities in Rhode Island.
 
Technical Assistance and Training
 
The RI-OMH provides ongoing training and technical assistance to funded community-based agencies through monthly meetings. Training provided at those meetings includes capacity building topics (e.g. conducting community assessments, program evaluation) as well as health topics (e.g. breast and cervical cancer screening, diabetes prevention and control). Training is provided to Department of Health staff and community partners as requested throughout the year. Videoconferences and other educational sessions on minority health offered by foundations or national agencies are also broadcast as available.
 
Eliminating Health Disparities Statewide Initiatives
 
The Rhode Island Department of Health’s Director has designated the elimination of racial and ethnic health disparities as one of the overarching goals of the Department. Internally, the RI-OMH provides leadership to the Department by working closely with all Divisions and Centers to ensure that work plans, performance measures, and resource allocations advance this priority. The RI-OMH and Health Disparities & Access to Care Team offer guidance and technical assistance to all programs in order to achieve the elimination of racial and ethnic health disparities. RI-OMH and Health Disparities & Access to Care Team are part the largest division in the RI Department of Health. We are part of the Division for Community, Family Health and Equity (DCFHE). The leadership of the division has determined that all program and initiative factor in the social and environmental determinates of health in planning and policy. RI-OMH and Health Disparities & Access to Care Team will play a key role in this work.
 
The RI-OMH is working toward five goals to contribute to the elimination of racial and ethnic health disparities:
1.      Enhance the state’s infrastructure to coordinate disparities elimination initiatives between state agencies.
2.      Strengthen its infrastructure of the RI-OMH in order to (1) coordinate with HEALTH programs around elimination of health disparities initiatives, (2) monitor and track data related to the elimination of racial and ethnic health disparities for evaluation purposes (3) implement the policy for the uniform collection and analysis of race and ethnicity data with our grantees and key collaborators, and (4) disseminate consumer friendly, up-to-date health disparities related information.
3.      Plan and implement culturally and linguistically appropriate programs and work to increase the numbers of racial and ethnic minorities employed at HEALTH to more closely reflect the diversity of the R.I. population of employment age. 
4.      Support information dissemination and capacity development within community-based agencies.
  1. The Office of Minority Health will build a multi-cultural “coalition of coalitions” using the recently released Community Guide- Building Coalitions among Communities of Color, A Multicultural Approach.
 
Inaddition, the RI-OMH is an active participant on the New England Regional Minority Health Committee. After hosting the first New England Regional Minority Health Conference in 1999, Rhode Island will again host the bi-annual conference in 2009, just shy of the 2010 target to eliminate health disparities. The Team Lead for Health Disparities and Access to Care is a Co-Chair of the 2009 conference along with the Director of the Division of Community, Family Health and Equity at the Rhode Island Department of Health. RI-OMH Chief chairs one of the program committees, and supports the overall conference. Each conference includes state breakout sessions to identify issues that are impacting the health of Rhode Islanders and develop strategies and recommendations to address them.
 
Level of Funding Sources
 
    
Year                     Federal                                    State                            Private
 
FY 2005                           --                                  422,695                                               --
FY 2006               159,250                                   429,304                                               --
FY 2007               159,250                                   436,928                                               --
FY 2008               159,250                                   409,509                                               --         
FY 2009               154,812                                   461,613                                               --
 
Resources
 
 
The RI-OMH is comprised of three full time staff, a part time Epidemiologist & Evaluator, and an Administrative Assistant. The full time staff includes the Chief of the Office, a Minority Health Promotion Specialist, and the Refugee Health Coordinator. To support its work and train future public health professionals, RI-OMH consistently supervises interns from local undergraduate and graduate programs. Within the Health Disparities Team, the RI-OMH works very closely with the Office of Women’s Health and Healthy Rhode Island 2010 Program to leverage resources and amplify its impact on the elimination of racial and ethnic health disparities.
 
Recent Publications
 
 
            Statewide Minority Health Speaker Directory (2009)
Minority Health Fact Sheets (2007) Updated 2009
            Refugee Health Providers Manual (2007) Updated 2009
            A Healthier Rhode Island by 2010, Mid-Course Review (2006)
            Health Disparities and People with Disabilities, Mid-Course Review (2006)
            Refugee Health Patient Guide (2005)
            A Healthier Rhode Island by 2010: A Plan for Action (2004)
            Minority Health Plan for Action (2003)
            Healthy Rhode Islanders 2010: Leading Health Indicators by Race and Ethnicity (2003)