Minority Fellowship Program: Challenges and Opportunities

Under Healthcare Reform

Miriam E. Delphin-Rittmon, Ph.DMFP 40th Anniversary Celebration and

Grantees MeetingApril 23-24, 2013

• Healthcare landscape quickly changing as a result of ACA

• MFP aligns well with key provisions of ACA and priorities of HHS Disparities Action Plan

• Alignment opens program to challenges and opportunities for remaining current and in step with HHS policies

• MFP-Youth Expansion creates additional opportunities

MFP and Healthcare Reform

Overview

• Disparities Related Provisions of the Affordable Care Act

• HHS Secretary’s Action Plan to Eliminate Disparities

• Challenges and Opportunities for MFP• Discussion

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Federal Efforts: Health Reform and Disparity Populations

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Selected Health Reform Provisions

Benefits of ACA

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Expanded Coverage

FamiliesUSA, 2010

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Health Reform and Disparity Populations

FamiliesUSA, 2010

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Health Reform and Disparity Populations

FamiliesUSA, 2010

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Health Reform and Disparity Populations

FamiliesUSA, 2010

ACA Provision 4302: Final Standards Published by HHS

Ethnicity Data Standard Categories Are you Hispanic, Latino/a, or Spanish origin?

(One or more categories may be selected) • ____No, not of Hispanic, Latino/a, or Spanish origin • ____Yes, Mexican, Mexican American, Chicano/a • ____Yes, Puerto Rican • ____Yes, Cuban • ____Yes, another Hispanic, Latino, or Spanish origin

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What is your race?(One or more categories may be selected)

• ____White • ____Black or African American • ____American Indian or Alaska Native

• ____Asian Indian • ____Chinese • ____Filipino • ____Japanese • ____Korean • ____Vietnamese • ____Other Asian

____Native Hawaiian • ____Guamanian or Chamorro • ____Samoan • ____Other Pacific Islander

• These categories are part of the current OMB standard

• These categories roll-up to the Asian category of the OMB standard

• These categories roll-up to the Native Hawaiian or Other Pacific Islander category of the OMB standard

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Health Reform and Disparity Populations

FamiliesUSA, 2010

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Call To Action: A Federal Policy Driver

• As a provision of the ACA Offices of Minority Health established in six HHS Agencies

• HHS agencies are required to assess the impact of policies and programs on disparities

• Improve language access in Medicaid, promote healthcare interpreting profession

• Increase diversity and cultural competence of healthcare workforce

Challenges and Opportunities

• Impact assessment - accountability– Consistent with HHS priority of assessing impact and

outcomes, will be important to track specific outcomes as they relate to goals of the program

– What percentage of fellows are working with in underserved communities post fellowship?

– What percentage are engaged in research? What do the career trajectories of fellows look like over time?

– How is outcome information used to inform implementation of MFP? **

Challenges and Opportunities

• Language Access– Given the HHS Priority of addressing language access,

how can MFP continue to address language access?– What recruitment strategies can be put in place, or

expanded, to attract bilingual and bicultural applicants?

– What data is collected regarding the language competencies of fellows?

– Findings can inform recruitment

Challenges and Opportunities

• Diversity and Cultural Competence– What strategies can MFP implement to continue

to prepare fellows to work with the changing healthcare populations?

– Newly insured individuals released from prison? Individuals who have experienced trauma? Refugee populations?

– How can fellows be assisted in their preparation for working in primary care settings?

Challenges and Opportunities

• Cross-disciplinary Grantee Planning– Six disciplines could partner to develop recommendations

for the optimizing behavioral health service delivery for underserved populations in primary care settings

– Develop and test models for involving service users in trainee and provider cultural competence education and training programs

– Develop strategies and recommendations for addressing language access in integrated care

settings

Challenges and Opportunities

• Workforce Expansion - FY 2014 MFP-Youth– Aims to increase the number of culturally competent

behavioral health providers who provide clinical services to underserved minority children, adolescents and transition-age youth (16-25)

– Working through existing MFP structure will expand the focus to Master’s level trainees in psychology, social work, professional counseling, MFT and nursing.

– Creates opportunities for mentoring of master’s level trainees

Challenges and Opportunities

• What challenges or opportunities do you anticipate as a function of the ACA or other Secretarial priorities?

• What challenges or opportunities might arise with the MFP-Y Expansion?

• Questions and Discussion