Office of Sen.

Mike Johnston
Colorado General Assembly | 200 E. Colfax Avenue | Denver, CO 80203 | 303.866.4864

FACT SHEET MEMORANDUM

HB 13-1088 Office of Health Equity CDPHE Rep. Fields & Sen. Giron Staff Name: Amanda Levin What the Bill Does: The current law establishes an office of health disparities, which is dedicated to eliminating racial, ethnic, and rural health disparities in Colorado. Its duties include: coordinating and providing advice to the department, providing education to the public on racial and ethnic health disparities, improving the interpretation and translation services within the public health systems, and coordinating and supporting the interagency health disparities leadership council. The current law also establishes the office of minority health advisory commission, whose purpose is to provide a formal mechanism for community members to raise awareness of minority health needs, issues and resources, as well as to give input on health programming. It includes ten members who represent Colorados ethnic, racial and geographic diversity. There must be at least one member who represents African Americans and Blacks in Colorado, one member who represents Asian Americans and Pacific Islanders, one who represents native American Indians, and one who represents Latinos and Hispanics. This bill will change the current law in five primary ways. First, it changes the name of the department from the office of health disparities to the office of health equity, in order to represent the recent advancements in the field of health by broadening the scope of the office to include the economic, physical, and social environment. It will offer a more inclusive and collaborative approach to eliminating health disparities for all Coloradans. Second, the bill defines health disparities as the differences in health status, access to care, and quality of care as determined by race, ethnicity, sexual orientation, gender identity, disability status, aging population, socioeconomic status, and other factors. Third, the bill defines health equity as achieving the highest level of health for all people, focusing its efforts to address avoidable inequalities by equalizing those conditions for health for all groups, especially for who have experienced socioeconomic disadvantages or historical injustices. Fourth, the purpose of the commission will be to serve as an advisor to the office on health equity issues, specifically on alignment, education, and capacity-building for state and local health programs and community-based organizations. The make up of the commission will change as well. There must be 10 members who represent, as practically as possible, Colorados diverse ethnic, racial, sexual orientation, gender identity, disability, aging population, socioeconomic, and geographic backgrounds. DRAFT 3/5/2013 1:19 PM For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.

Each person appointed must have demonstrated expertise in at least one of the following areas: African American, Black, Asian-American, Pacific Islander, Native American, Hispanic, Latino, aging population, lesbian, gay bisexual, transgender, disabled, low socioeconomic status, and geographic community health issues; data collection, aggregation, or dissemination; education; housing; healthy community design; community engagement; local public health; nonprofits, foundation or grant-making; environmental health; behavior health; or the provision of health care services. Finally, the bill codifies the commissions existing, informal practice of having a subcommittee first review grant applications and then make grant recommendations for the Health Disparities Grant Program. Colorado Context: Individuals who have distinct cultural needs are affected by health care provider bias. Such bias may be tied to race or ethnicity, national origin, sexual orientation, gender, socioeconomic status, or geographical differences.1 In Colorado, the cost of Medicaid and emergency Medicaid has grown significantly, with costs for emergency Medicaid going up 57 percent between 2002-2008.2 Emergency Medicaid costs rose from $39.4 million in 2001-2002 to $61.9 million in 2006.3 National Context: States are trending towards the idea of health equity instead of health disparities in order to put a more positive spin on addressing health care, with the ultimate goal of eliminating racial and ethnic disparities in health.4 The federal government has an Office of Minority Health & Health Equity.5 Massachusetts attempted to pass a similar bill that adopted a broad definition of people included in health disparities and that would create an Office of Health Equity, but it failed and has been adjourned.6 It was the only state in 2012 to do so. Floridas Office of Minority Health7, Arkansas Office of Minority Health & Health Disparities8, Connecticuts Department of Public Health9, Minnesotas Office of Minority and Multicultural Health10,

Colorado Interagency Health Disparities Leadership Council, Eliminating Health Disparities, A Cornerstone for Solving Colorados Health Crisis, Aug. 2008, at 5, http://www.cdphe.state.co.us/ohd/. 2 Id. at 9. 3 Id. 4 National Conference on State Legislators, State Profiles: Minority Health and Health Equity Offices, updated Sept. 2010, http://www.ncsl.org/issues-research/health/disparities-state-profiles.aspx. 5 CDC, About CDCs Office of Minority Health & Health Equity (OMHHE), last reviewed March 26, 2012, http://www.cdc.gov/minorityhealth/omhhe.html. 6 National Conference on State Legislators, 2012 Health Disparities Legislation, http://www.ncsl.org/issuesresearch/health/2012-health-disparities-legislation.aspx. 7 Florida Department of Health, Welcome to the Office of Minority Health (OMH), 2012, http://www.doh.state.fl.us/minority/. 8 Arkansas Department of Health, Minority Health and Health Disparities, 2011, http://www.healthy.arkansas.gov/programsServices/minorityhealth/Pages/default.aspx. 9 Department of Public Health, Health Disparities, last modified Sept. 28, 2012, http://www.ct.gov/dph/cwp/view.asp?a=3132&q=388116.

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For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.

among others, include a broad definition of people included in health disparities, including groups impacted by disabilities, gender, age, and sexual orientation. Bill Provisions: Changes the name of the office of health disparities (in the department of public health and environment) to the office of health equity. Adds duties of the office of health equity, such as: promoting health equity and including more diverse groups that might be affected by health equity and health disparity issues. Replaces the minority health advisory commission with the health equity commission, which will serve as an advisor to the office on health equity issues. The commission representation is changed from 13 to 15 members, and includes the executive directors of the department of human services and department of health care policy and financing. Members must represent diverse populations in Colorado whose health equity may be affected due to ethnicity, sexual orientation, gender identity, disability, and socioeconomic status. Moreover, each member must have expertise in at least one specified area. The commissions new duties include: coordination of the departments health equity efforts and health disparities grant program, and strengthening partnerships with communities impacted by health disparities. Changes the sunset review date of the commission from 2017 to 2023. Fiscal Impact: There is no fiscal impact associated with this legislation.

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Health Reform Minnesota, Health Disparities, http://mn.gov/health-reform/topics/prevention/healthdisparities/index.jsp.

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For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.