MASSACHUSETTS






 

MASSACHUSETTS
Office of Health Equity
Prepared by National Association of State
Offices of Minority Health (NASOMH)

Rodrigo Monterrey, MA, DPH - Director

Office of Health Equity
Massachusetts Department of Public Health
250 Washington Street, 5th Floor
Boston, MA 02108
Phone: (
617) 994-9806
Fax: (
617) 624-6062


Email:
rodrigo.monterrey@state.ma.us

Website:
www.mass.gov/dhp/healthequity
 
Organizational Structure/History
 
The Massachusetts Department of Public Health created the Office of Health Equity in 2007 The Office of Health Equity was formerly the Office of Multicultural Health and was located in the Bureau of Family and Community Health (BFCH). The Office of Health Equity is located in the Commissioner’s Office, reporting to the Medical Director. The Office of Health Equity is also strategically positioned to work collaboratively with the Executive Office of Health and Human Services on health disparities elimination efforts.
Purpose/Mission Statement
 
The Massachusetts Office of Health Equity (OHE) promotes the health and well being of racial, ethnic and linguistic minority communities statewide. In an effort to significantly decrease health disparities, MA-OHE works to ensure that MDPH’s public health frameworks and programs are inclusive of and responsive to the needs of these communities and increase the capacity to respond effectively to the critical needs within these communities. Specifically, the Office:
    Promotes health policy to improve the health status of racial, ethnic and linguistic communities.
 
    Serves as a Department-wide resource and provides technical assistance to department programs on effective strategies to reach and serve racial, ethnic and linguistic communities.
 
▪    Develops and implements uniform standards related to racial, ethnic and linguistic populations.
 
▪    Collaborates with public and private entities to ensure an infrastructure that supports responsive health systems and addresses issues of access, capacity and service delivery. 
  •  Liaison with the Executive Office of Health and Human Services to ensure synergy in health disparities elimination efforts for the Commonwealth.
  
Program Focus/Activities
 
The MA-OHE is designed to promote health equity and reduce racial, ethnic and linguistic disparities in health through efforts that ensure language access, culturally appropriate services, community mobilization and awareness of local issues as well as the social determinants of health.  It accomplishes these activities in partnership with internal programs and external public and private agencies, academic institutions and broader community initiatives.
 
Eliminating Health Disparities Statewide Initiatives
 
MA-OHE seeks to ensure that public health programs services are available at the level and need of populations that are racially, ethnically and linguistically diverse and are designed to address identified disparities.
 
Health Equity and the Social Determinants of Health
 
MDPH issued $1M in contracts throughout Massachusetts in FY09. The initiative, Reduction in Racial, Ethnic, and Linguistic Disparities in Health, is a 3 year effort initiated in FY08 and operates out of the Office of Health Equity. The projects span a wide range of populations, address a multitude of individual and system-level barriers including social determinants that contribute to disparities; strengthen the technology for detecting disparities in health care quality through quality improvement efforts; and build a pipeline for a more diverse health care workforce.
 
Language Access:
 
MA-OHE ensures quality, accessible and appropriate language interpretation and/or material translation services for persons whose first language is not English and are limited in their capacity to communicate or read in English.
 
▪     MA-OHE works with acute care settings to ensure an infrastructure for language access and, in collaboration with the Determination of Need Program (DoN) at the Center for Health Quality Management, assesses healthcare systems for quality of interpreter services. As part of the DoN process, MA-OHE meets with hospitals and attaches interpreter services conditions to the DoN approval. In FY 09 MA-OHE issued the 1st Annual Hospital Interpreter Services report, highlighting the work of Acute Care Hospitals in ensuring language access.
 
▪     MA-OHE develops and disseminates the biennial MA First Language is Not English (FLNE) report. This report utilizes Department of Education data collected at the beginning of the school year on children whose language at home is other than English. The report identifies those public school systems whose population of FLNE students is 10 percent or more of students. The most recent report is available http://www.mass.gov/dph/omh/omh.htm.
 
Culturally Appropriate Services: 
  •    Through a partnership grant with the federal OMH, MA-OHE developed the CLAS Initiative; a 5 year project to develop state specific standards consistent with the 14 DHHS CLAS standards for procurement, contracting, monitoring and evaluation processes. Although the Initiative is based at the OHE, support throughout the Department is reflected in the Initiative’s Coordinating Committee with representation from numerous Bureaus within MDPH.
 In FY09, the CLAS Initiative produced a guidance manual, “Making CLAS Happen: Six Areas for Action” which serves as a guide to providing culturally and linguistically appropriate services in a variety of public health settings. The six areas: Foster Cultural Competence, Build Community Partnerships, Collect and Share Diversity Data, Benchmark: Plan and Evaluate, Reflect and Respect Diversity, and Ensure Language Access were developed in response to concerns raised by services providers large and small. Each chapter has associated tools and additional resources referenced.  
 
▪     MA-OHE collaborates with the Bureau for Health Information, Statistics, Research and Evaluation (BHISRE) to implement a methodology for the collection of self-reported race, ethnicity and language across all DPH programs and healthcare settings. In FY 06, the former MA-OMH, BHISRE, the Division for Health Care Finance and Policy—the state agency responsible for regulating data reporting and setting health policy—and the Boston Public Health Commission reached consensus on a race and ethnicity data collection methodology. With the Massachusetts Hospital Association and the other identified partners, we prepared materials and trained hospital access and registration personnel for a January 2007 implementation. In FY 08 these standards were implemented through the public health program data reporting. In FY09 “Race, Ethnicity and Language Data Collection Training of Trainers” was conducted for other health and human service agencies.
 
▪     In addition to the CLAS Initiative that involves other programs in developing standards for the RFR process, MA-OHE works with programs internally to assist with designing frameworks that incorporate approaches leading to disparities reduction and that are more culturally appropriate for populations that are racially and ethnically different. 
 
Community Partnerships to Reduce Disparities:
 
MA-OHE works to increase collaboration with members of racial, ethnic and linguistic communities to become involved in efforts to eliminate health disparities and within the Department to ensure an infrastructure that supports responsive health systems and addresses issues of access, capacity and service delivery.
 
▪     MA-OMH partially funds Critical MASS, a program located at the Center for Community Health Education, Research and Services (CCHERS), to develop 2 regional coalitions to address health disparities. Critical MASS has developed a community action toolkit to help communities take action locally to address disparities. In addition, CCHERS, based at Northeastern University, works to increase the use of community based participatory research principles and practices by institutions wanting to conduct community based research. MA-OHE is collaborating with Critical MASS to pilot and disseminate the toolkit.
 
▪     MA-OHE, in collaboration with the Harvard School of Public Health sponsors the Annual Hinton Lecture. Since 1989 the DPH has observed Black History Month by highlighting a theme/issue of importance to the health of African Americans. This year’s focus was Place Matters, looking at the social determinants of health and issues related to factors that contribute to our health outcomes – where you live, level of education, socioeconomic status. 
  •  Using the documentary “Unnatural Causes, Is Inequality Making Us Sick?,”  MDPH achieved the following:
  •  provided a series of targeted screenings within our organization and at the Massachusetts State House to engage cross-cutting dialogue and action around policy and institutional changes to address the root causes of health inequities;
  •  engaged communities disproportionately impacted by inequities in health by convening neighborhood-based planning committees to prepare for neighborhood screenings and dialogues across the State; and
  •  conducted a series of regional screenings and dialogues across the State that served as a venue to connect Massachusetts residents and organizations to opportunities that advance health equity including training, funding, and advocacy. 
Starting with its existing pool of partners, a limited group of key stakeholders were invited at the first conversation to design the program, select a venue, and help market the event to the region’s selected audiences. Over time, others were identified and invited to be involved in the planning process. Embedded in each event were a number of activities to provide attendants ample opportunities for service and community empowerment through individual and corporate actions.
 
Level of Funding Sources
 
             Year                Federal             
 
FY 2005          351,000
            FY 2006          487,332            
            FY 2007          605,421
            FY 2008          529,332
            FY 2009          363,998
 
Resources
 
  • FY 05 funds reflect 4 staff positions covered by the Federal Prevention Block Grant, the Federal MCH Block Grant, and the Federal BSAS.
 
  • FY 06 funds reflect the award of the Federal OMH Partnership Grant of $127,343 and 4 staff covered by the federal block grants above. The Partnership Grant funds Critical MASS to undertake community mobilization.
 
  • FY 07 funds reflect 4 staff covered by the federal block grants mentioned previously, an  additional staff to ensure language access in MA hospitals, and an increase of the partnership grant to a base of 136,332 plus carry over funds unexpended in FY 06 due to a later than anticipated implementation of the partnership grant. The Partnership Grant funds Critical MASS to undertake community mobilization.
 
  • FY 08 funds reflect 5 staff positions covered by the above block grants and the Federal OMH Partnership grant
 
  • FY 09 funds reflect a total of 4 staff covered by the federal block grants and the federal OMH Partnership grant; as well as funding to Critical MASS to undertake community mobilization. 
The MA-Office of Health Equity staff includes - 5 FTEs: OHE Director; Coordinator of Interpreting Services; CLAS Coordinator; and 2 Contract Managers.