Proposals Offered to Eliminate Inequality in Health Care Access

By Garret Condon, Courant Staff Writer
March 4, 2005

An expert panel made 14 specific proposals on Thursday aimed at eliminating racial and ethnic inequality in health care access, but the committee's chairman, former legislator and Aetna executive Sanford Cloud Jr., acknowledged that such a deep-seated problem will take time to uproot.

"Prejudice, racism and discrimination are at the foundation of many cultural and institutional health disparities,'' said Cloud, who just retired as president and CEO of the National Conference for Community and Justice. "While eliminating racism and discrimination cannot be accomplished overnight, the panel believes that our policy recommendations, in some small way, begin to extinguish any continuing flames of racism and discrimination in our society.'' Nonetheless, he said, the effort to end these inequalities must begin immediately.

The panel, made up of 12 educators, community leaders, business executives and public health experts, was created two years ago by the Connecticut Health Foundation, which focuses its philanthropy primarily on issues of access to oral health, child mental health services and racial and ethnic health disparities. The panel conducted public meetings in Bridgeport, Hartford and Willimantic.

The 14 proposals, grouped in four main areas, are meant to be practical and realistic goals, although some may be more politically difficult to achieve than others, according to Sen. Toni Harp, D-New Haven, a veteran of health and health care access issues at the legislature, but not a member of the report panel. "It really is not as easy as it seems,'' she warned at a public meeting marking the release of the report.

Here is a summary of the panel's recommendations, grouped by subject area:

Social and Environmental Factors -- The committee calls for at least $2.12 million from the state's Master Settlement Agreement funds for health-promotion programs that would be responsive to the needs of underserved state residents. Tobacco-control advocates long have pushed for wide use of this money for smoking cessation and other programs, but nearly all of the more than $600 million received so far has gone into the general fund, and Gov. M. Jodi Rell's budget would put every penny into the general fund. Rell spokesman Dennis Schain said the governor has proposed a budget that closes a $1.2 billion budget gap. Harp said that the current deficit makes this proposed change a long shot.

The panel also calls for particulate filters for Connecticut Transit's diesel bus fleet. More broadly, the panel called on health coverage for all -- another proposal not likely to happen quickly.

Data Collection -- The panel asks the state to better monitor progress toward creating equal access to health care and to collect, publish and provide heath data on minority populations. It also recommends that the state make each patient's primary language part of his or her health record and require HMOs, physicians and others to post signs in the languages of the people they serve.

Language Barriers -- The Department of Social Services should allow Medicaid reimbursement for medical interpretation services, according to the panel. Deputy Commissioner Michael A. Starkowski of the social services department called this a worthy recommendation, but he added that he's not sure the state can afford it this year. In addition, the panel said that the state should create a certification program for medical translators and should better monitor and enforce laws that require hospitals to provide "linguistic access'' to non-English speakers.

Workforce Diversity -- The committee recommends that the state health department track the ethnic and racial composition of the state's health care workforce and require cultural and linguistic competence training for health care professionals. In addition, the state should match all available federal dollars for loan forgiveness funds and target this money to attract historically underrepresented students to health professions. Also, the panel recommends that the Department of Higher Education ensure diversity in college programs that train students for health professions