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					         Matrix of Key Minority-related Health Reform Provisions by Council Workgroups

                                                 Exchange and Markets

Data             Collect Racial and Ethnic data on those insured in the exchange

Workforce        Hire Racially and Ethnically diverse employees throughout health systems
Diversity        Hire, train, supervise and integrate Lay individuals (Navigators, Outreach Workers)

Cultural         Train navigators in cultural competency, in working with low health literacy
Competence       populations, and assure that translated materials and translation services are available

Health
Disparities
Research

Addressing       Assure that preventive services are covered in plans included in the exchange, since
Disparities in   users of exchange plans may be predominantly minority persons.
Prevention

Addressing       Establish procedures to ensure inclusion and input from target populations who
Disparities in   experience health disparities; gather input from target groups and local communities
Insurance        early in the planning process, empower local communities and groups to take
Reform           ownership and partner in health reform transformation in Maryland.

Health           Have informational outreach to minority communities, with persons and materials
Insurance        appropriate for the culture, language, and health literacy levels of those communities

Access to        Reimbursement levels should incentivize providers to move to or remain in
Care             underserved areas.

Quality          Exchange Plans should collect and analyze their quality data by race and ethnicity

Cost             Co-payments must be small enough not to inhibit appropriate utilization by members of
                 low income communities.

Public           Establish partnerships with public health professionals to ensure that factors related to
Health           program effectiveness and consumer acceptance are incorporated

Social       Establish communication and obtain input from state and private agencies whose
Determinants mission impact the health status of minorities and all Marylanders (education, criminal
             justice, housing)




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          Matrix of Key Minority-related Health Reform Provisions by Council Workgroups

                                                      Entry into Care

Data             Collect Racial and Ethnic data on those entering care and those currently in care.

Workforce        Establish short and long range plans to transform the health workforce to represent the
Diversity        diversity of populations served, and/or contain persons whose experience enable them to
                 demonstrate cultural, linguistic and other competencies to patients who are diverse.
Cultural         Retrain intake and related-workers to increase their cultural and linguistic competency
Competence       when enrolling individuals into health care coverage and systems.

Health           Engage academic institutions to partner with the State to search for reasons why
Disparities      minorities do not enter care, do not keep maintenance appointments and drop out of
Research         coverage.

Addressing       Conduct a statewide health prevention and awareness program that is linked to Entry into
Disparities in   Care opportunities.
Prevention

Addressing       Provide insurance information in "Plain Language" using principles of health literacy to
Disparities in   ensure understanding.
Insurance
Reform

Health           Facilitate simple and seamless entry to coverage and transition between types of
Insurance        coverage.

Access to        Provide incentives for health care providers to offer services in underserved areas, so that
Care             insurance leads to appropriate utilization.

Quality          Collect racial and ethnic enrollment and utilization data and analyze to track quality.

Cost         Seek new available Medicaid funding opportunities that will maximize coverage and care
             quality for new enrollees.
Public       Establish partnership between the insurance enrollment and management professionals
Health       and the public health program professionals to ensure that quality practices and
             standardized protocols are provided in coverage plans.
Social       Establish communication and obtain input from state and private agencies whose mission
Determinants impact the health status of minorities and all Marylanders (education, employment).




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          Matrix of Key Minority-related Health Reform Provisions by Council Workgroups

                                                Education and Outreach

Data             Establish a system to track the dissemination of Health Reform information to both
                 health care providers, the public and individuals by race and ethnicity.
Workforce        Engage a diverse workforce to provide health reform information throughout the
Diversity        different communities and geographic areas of the State.

Cultural         Mount a statewide awareness and education program that utilizes cultural and linguistic
Competence       competencies and health literacy principles.

Health           Promote community-based research projects that explore effective health messaging and
Disparities      health behavior change.
Research

Addressing       Increase disease prevention messages that reflect an integration and balance between
Disparities in   medical care (disease orientation) and public health (prevention orientation).
Prevention

Addressing       Provide insurance information in "Plain Language" using principles of health literacy to
Disparities in   ensure understanding.
Insurance
Reform

Health           Inform communities about new opportunities for entry into coverage and develop
Insurance        measures to reduce frequent dropout and transition between different plans. Develop
                 simplified measures to move between plans.
Access to        Inform providers and new health care licensees of incentives for serving in underserved
Care             areas.

Quality          Promote recruitment, training and supervision for lay health outreach workers who can
                 inform the public about health reform insurance and delivery system changes.
Cost             Seek new available funding to support outreach and education to population groups.

Public           Establish partnership between public health and state and local media outlets to increase
Health           effective health messaging.

Social       Establish communication and obtain input from state and private agencies whose
Determinants missions impact the health status of minorities and all Marylander (education, etc.).




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       Matrix of Key Minority-related Health Reform Provisions by Council Workgroups

                                 Public Health, Safety Net, and Special Populations

Data             Collect Racial and Ethnic data on those persons not covered under new insurance
                 options and track disease incidence and mortality.
Workforce        Promote workforce diversity throughout health care systems and ensure that Safety
Diversity        Net Providers have access to resources needed to serve their populations.

Cultural         Promote cultural and linguistic competency and health literacy among Safety Net
Competence       providers.

Health           Engage research institutions to partner with the State to study the movement of
Disparities      individuals and families from insurance coverage to non-coverage status.
Research

Addressing       Increase the focus on disease prevention for Special Populations to balance the
Disparities in   attention to presenting disease states.
Prevention

Addressing       Establish procedures to ensure inclusion and input from target populations who
Disparities in   experience health disparities; gather input from target groups and local communities
Insurance        early in the planning process, empower local communities and groups to take
Reform           ownership and partner in health reform transformation in Maryland.

Health           Target Special Populations for individuals eligible for entry into care.
Insurance

Access to        Develop incentives for providers to serve in public health and in safety-net settings
Care             and to serve Special Populations.

Quality          Collect Racial and Ethnic data on disease incidence and mortality among Special
                 Populations.
Cost

Public           Establish greater partnership between Safety Network providers and private section
Health           health system providers.

Social       Establish communication and obtain input from state and private agencies whose
Determinants mission impact the health status of minorities and all Marylanders (social services).




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         Matrix of Key Minority-related Health Reform Provisions by Council Workgroups

                                                 Health Care Workforce

Data             Collect Racial and Ethnic data on individuals entering, working in and leaving the
                 State's health workforce. Analyze to identify adverse trends that can be reversed.
Workforce        Establish short and long range plans to transform the health workforce to represent the
Diversity        diversity of populations served, and or contain persons whose experience enables them
                 to demonstrate cultural, linguistic and other competencies to patients who are diverse.
Cultural         Promote the establishment of cultural and linguistic competency programs throughout
Competence       health care systems and facilities, and in health professional education institutions.

Health           Engage institutions to partner with the State to evaluate ways to develop a robust
Disparities      health workforce pipeline that engages a cross-section of Marylanders.
Research

Addressing       Increase the focus on prevention in the education of health professionals at all levels of
Disparities in   the educational program.
Prevention

Addressing
Disparities in
Insurance
Reform

Health           Ensure that reimbursements for health care services are adequate to retain providers in
Insurance        the State. Ensure adequate provider participation with all insurers.

Access to        Provide incentives for providers to work in underserved areas of the State.
Care

Quality

Cost             Investigate ways to reduce the financial disincentives for individuals to enter the health
                 professions in Maryland.
Public           Promote the integration of public health principles into health professional educational
Health           programs to bring balance between the ‘Preventive Model’ and the ‘Treatment Model’.

Social       Establish communication and obtain input from state and private agencies whose
Determinants mission impact the health status of minorities and all Marylanders (K-12 education).




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       Matrix of Key Minority-related Health Reform Provisions by Council Workgroups

                                             Health Care Delivery System

Data             Collect Racial and Ethnic data on persons reached with Health Reform, the quality of
                 their services and the outcomes on selected performance measures.
Workforce        Establish short and long range plans to transform the health workforce to represent
Diversity        the diversity of populations served, and/or contain persons whose experience enables
                 them to demonstrate cultural, linguistic and other competencies to diverse persons.
Cultural         Promote the establishment of cultural and linguistic competency programs
Competence       throughout health care systems and facilities.

Health           Engage academic and other institutions to partner with the State to search for
Disparities      innovative "Out-of-The-Box" methods to transform Maryland's health care system by
Research         building on existing strengths (Single-Payer, CMS Waivers, engaged administration).

Addressing       Increase the focus on disease prevention in the transformation of the existing health
Disparities in   system.
Prevention

Addressing       . Establish procedures to ensure inclusion and input from target populations who
Disparities in   experience health disparities; gather input from target groups and local communities
Insurance        early in the planning process, empower local communities and groups to take
Reform           ownership and partner in health reform transformation in Maryland.

Health           Monitor and publish actions to implement new insurance coverage and the progress
Insurance        on coverage of the population.

Access to        Research the barriers to access to care and implement initiatives to reduce barriers
Care             that ensure more individuals receive quality, timely and respectful care.

Quality      Collect, analyze and publish information on quality performance measures; highlight
             those systems and providers whose trends are moving toward the highest quality.
Cost         Seek new and available Health Reform funds that support reform initiatives that
             supplement State resources and investments and gain economies-of-scale.
Public       Establish collaboration and a balanced partnership between health finance
Health       professionals and public health professionals to ensure that the business of health and
             the right to health are both well-served.
Social       Establish communication and obtain input from state and private agencies whose
Determinants mission impact the health status of minorities and all Marylanders (employers, etc.).




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