2012 Annual Conference Proceedings
Center on Health Disparities A D V E N T I S T H E A L T H C A R E
S U M M E R 2 0 1 3
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Authored and Designed by Staff of the Center on Health Disparities at Adventist HealthCare Tiffany Capeles, MBA Consultant Talya Frelick, MPH Project Manager Marilyn Lynk, PhD Program Manager Eme Martin, MPH Project Manager Marcos Pesquera, RPh, MPH Executive Director Deidre Washington, PhD Research Associate
To download additional copies of the proceedings or learn about the activities of the Center on Health Disparities, visit the Center’s web site at: http://www.adventisthealthcare.com/disparities
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TABLE OF CONTENTS
Acknowledgments ··················································································4 Welcome ····························································································5 Executive Summary ················································································6 Overview ·····························································································8 Agenda ····························································································· 11 Conference Planning Process ··································································· 12 Blue Ribbon Award ·············································································· 15 Morning Panel: CEO Roundtable Discussion ················································ 16 Keynote Speaker: Dr. Benjamin Carson ······················································ 22 Afternoon Panel: Where the Rubber Meets the Road ······································· 24 Conference Evaluation Summary······························································· 28 Recommendations & Conclusions ····························································· 30 Conference Attendees List······································································· 34
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ACKNOWLEDGEMENTS
Adventist HealthCare and the Center on Health Disparities (CHD) would like to thank all of the 2012 Health Disparities Conference participants, speakers, panelists, and sponsors for their continued support of the Center’s activities. We are grateful to CareFirst BlueCross BlueShield for providing financial support for the conference. Our thanks to the vendors as well who shared their services with the conference participants. We were honored to have Dr. Benjamin Carson and Lt. Gov. Anthony Brown provide comments and recommendations for solutions to achieve health equity and eliminate the health disparities plaguing our communities. Furthermore, it was a pleasure and honor to present Lt. Gov. Anthony Brown with the 2012 Blue Ribbon Award for his visionary leadership and dedication to promoting health equity in the state. In addition, we were pleased to welcome Helen Darling, President and CEO, National Business Group on Health; J. Knox Singleton, Chief Executive Officer, Inova Health System; Neil Meltzer, President of Sinai Hospital of Baltimore and Senior Vice President and Chief Operating Officer of LifeBridge Health; Martine Charles, Director of the Office of Health Equity at Inova Health System; and Danielle Marks, Program Coordinator at Sinai Hospital of Baltimore, as panel presenters. In addition, Center staff Deidre Washington (Research Associate) and Eme Martin (Project Manager) joined the panel presenters in describing activities to help achieve health equity locally. Their invaluable contributions are what helped make this conference a success. 2012 Annual Health Disparities Conference Proceedings The Adventist HealthCare Center on Health Disparities’ 6th Annual Health Disparities Conference was held on October 8, 2012. The 2012 Conference Proceedings summarizes the day’s events. The program agenda included presentations, panel sessions, and the 2012 Blue Ribbon Award presentation. A list of attendees is included here to facilitate networking and communication with colleagues dedicated to achieving health equity in Maryland. Conference Sponsors & Vendors CareFirst BlueCross BlueShield (Bronze Sponsor) Energy Federal Credit Union NIH Federal Credit Union Walden University Hunter Cleaning Services American Sign Language, Inc. National Institute of Health Federal Credit Union Washington Adventist Hospital Adventist Behavioral Health Adventist Rehabilitation Hospital of Maryland Shady Grove Adventist Hospital
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WELCOME
Marcos Pesquera, Executive Director of the Center on Health Disparities at Adventist HealthCare, welcomed participants to the conference and thanked the sponsors and vendors for their support of the conference and their commitment to meeting the needs of local communities. He also acknowledged the staff and volunteers involved in the planning, registration, support, and implementation of the conference.
Marcos Pesquera, Executive Director, Center on Health Disparities at Adventist HealthCare.
Shortly after, Mr. Pesquera introduced Lt. Governor of the State of Maryland, Anthony Brown, who made opening remarks. Following the Lt. Governor’s remarks, he was awarded the 2012 Blue Ribbon Award for his efforts on eliminating health disparities and promoting health equity.
Next, Mr. Pesquera introduced morning panel moderator Helen Darling, President and CEO of the National Business Group on Health, a national non-profit, membership organization devoted exclusively to providing practical solutions to its employer-members' most important health care problems and representing large employers' perspective on national health policy issues. Finally, he thanked the audience members for their efforts and dedication to promoting health equity for the benefit and improvement of our communities.
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EXECUTIVE SUMMARY
Summary The Sixth Annual Health Disparities Conference, sponsored by the Adventist HealthCare Center on Health Disparities, was held on October 8, 2012 at the Hilton Garden Inn in Greenbelt, Maryland. The theme of the year’s conference, Starting at the Top: Achieving Health Equity through Executive Leadership, attracted a diverse audience of attendees including: Adventist HealthCare employees; federal, state, and county government officials; public health professionals; policymakers; professionals from community-based organizations; students; and others. We hope that executives within healthcare and other industries found the speakers and panels especially informative, particularly as related to promoting health equity within their respective institutions. The conference opened with remarks from Maryland’s Lt. Governor, Anthony G. Brown. In recognition of his efforts to promote health equity throughout the state of Maryland, including his support of the Maryland Health Improvement and Disparities Reduction Act of 2012, the Center on Health Disparities awarded the Lt. Governor the 2012 Blue Ribbon Award. The conference continued with a CEO Roundtable Discussion, featuring the chief executives from three local health systems, including Adventist HealthCare President and CEO William G. “Bill” Robertson. J. Knox Singleton, CEO of Inova Health System and Neil Meltzer, President of Sinai Hospital of Baltimore and Senior Vice President and Chief Operating Officer of LifeBridge Health (recently appointed President and CEO of LifeBridge Health) completed the panel. Helen Darling, President and CEO of the National Business Group on Health served as the moderator. All speakers participated in a lively discussion and Q&A session on how their respective organizations were implementing a health equity agenda. The morning concluded with a keynote address from Dr. Benjamin Carson, the Director of Pediatric Neurosurgery at Johns Hopkins Children’s Center and a New York Times best-selling author. Dr. Carson mesmerized the audience, masterfully weaving together a speech about his own upbringing, health disparities, health equity, social determinants, and even the War of 1812 and the composition of the Star-Spangled Banner. After lunch, Marcos Pesquera, Executive Director of the Center, provided an overview of the 2012 Adventist HealthCare Health Equity Report. The Health Equity Report presents data on patients treated at Shady Grove Adventist Hospital and Washington Adventist Hospital in 2011. In addition to describing the patient populations by race, ethnicity, and preferred language, the report also illustrates how other hospital data such as inpatient core quality measures,
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EXCUTIVE SUMMARY readmissions, and patient experience, can be further analyzed by examining whether or not disparities exist by demographic characteristics, including race and ethnicity. The Report is available on the Center’s website at: www.adventisthealthcare.com/disparities. The afternoon concluded with a panel session entitled “Where the Rubber Meets the Road.” The panelists, employees from LifeBridge Health, Inova, and AHC, highlighted ongoing projects at their respective organizations, providing specific examples of how they are striving to achieve health equity in their organizations and their communities. The 2012 Annual Health Disparities Conference Proceedings offer an overview of conference presentations and summarize the comments from all speakers and panelists. We also describe our conference planning process, including the members of our planning committee. All of the ideas, questions, and suggestions that emerged from the day are incorporated and formulated into specific recommendations and action items as we continue our efforts to achieve health equity. We hope that you will use these Proceedings as a resource when looking for information on how three major health care systems in Maryland and Virginia are approaching health equity within their organizations and communities. Audio portions of Dr. Carson’s remarks may be heard on the Center on Health Disparities website (see link above). Selected PowerPoint presentations are available on the website as well. We remain encouraged by the efforts of so many in our region dedicated to the promotion of health equity, and we invite you to continue with us on this journey in the years to come. NOTE: The opinions and thoughts expressed here are those of the speakers and do not necessarily reflect the positions of the Center on Health Disparities or Adventist HealthCare, Inc.
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OVERVIEW
Partnering Toward a Healthier Future
Cൾඇඍൾඋ ඈඇ Hൾൺඅඍඁ Dංඌඉൺඋංඍංൾඌ Aඇඇඎൺඅ Cඈඇൿൾඋൾඇർൾඌ: 2007-2011 The Center on Health Disparities has developed and disseminated six annual reports in conjunction with a health disparities conference to bring community stakeholders together and share best practices in research and community interventions to eliminate health disparities locally. The Center held its first conference in November 2007, less than a year after its inception at Adventist HealthCare, to disseminate the findings published in its inaugural report, Partnering Toward a Healthier Future: Eliminating Health Disparities in Frederick, Montgomery, and Prince George’s Counties in Maryland (Center on Health Disparities, 2007). The report provided local stakeholders with information about health disparities in the tri-county Maryland region, including compiled data on demographic characteristics and health outcomes across several health indicators for racial, ethnic, and linguistic groups, and cultural influences on health. The Center also outlined several recommendations to help health care and other organizations address health disparities by: expanding outreach and services to racial and ethnic minorities; promoting systematic data collection and research; disseminating knowledge from best practices in data collection to community members and leaders in health care; promoting innovative, linguistically and culturally -sensitive care in the community; and funding mechanisms to foster the exchange of best practices. The 2008 Center on Health Disparities report described community partners’ achievements in response to the 2007 report recommendations and identified ways the Center on Health Disparities could support their partners’ progress (Center on Health Disparities, 2008). The report recommendations called for more community collaboration to disseminate information about organizations’ activities and accomplishments; improved standardization of racial/ethnic identifying data procedures, practices, and utilization; and more cultural competency education and training for health care organizations, providers, and staff. At the conference that same year, speakers and panelists discussed how to leverage health disparities research and policy at national, state, and local levels to eliminate disparities. The speakers discussed advancing race/ethnicity and language data collection strategies and facilitating partnerships among health disparities research experts and policy leaders committed to achieving health equity. Whereas the previous report focused on community initiatives primarily, the 2009 report highlighted education, health services, and research initiatives at Adventist HealthCare to help improve cultural competency in health care and eliminate disparities (Center on Health Disparities, 2009). The 2009 report evaluated Adventist HealthCare’s progress in achieving the recommendations and initial goals set out in the 2007 Progress Report and by the founding Blue Ribbon Panel. The main goals of the 2009 conference were to identify and share strategies for implementing cultural competence standards in order to reduce barriers to quality health care for underserved populations, and foster community partnerships among
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OVERVIEW stakeholders committed to measuring and reporting cultural competency and quality of care to local residents. Speakers and participants exchanged ideas and best practices in improving health care quality during breakout sessions. The Center’s 2010 annual conference, entitled "Social Determinants of Health: The Role of Health Care in Leading Social Change in Local Communities," provided community stakeholders from different sectors the opportunity to learn from one another and explore potential collaborative partnerships by networking with participants from multiple sectors of the community. Leaders, professionals, and community members from criminal justice, education, and business as well as health care shared knowledge and began discussing ways to improve quality of life and promote health equity locally. The 2010 Center on Health Disparities Progress Report summarized the evidence on social factors that influence health disparities among racial/ethnic groups in the tri-county area, and local efforts to eliminate them. The 2011 annual conference, entitled “Achieving Health Equity through Health Care Reform” held on November 2, 2011, brought greater understanding on new legislation around health care reform and its impact on Maryland residents. The afternoon panels highlighted efforts around the promotion of equity among local efforts from external community partners, including Montgomery County Health and Human Services Minority Initiatives, and within Adventist HealthCare, including: organizational cultural competency assessments, the provision of qualified language interpreting for patients with limited English proficiency (LEP), and health information exchange (HIE). The 2011 annual report summarized the evidence on social factors that influence health disparities among racial/ethnic groups in the tri-county area, and local efforts to eliminate them.
Cൾඇඍൾඋ ඈඇ Hൾൺඅඍඁ Dංඌඉൺඋංඍංൾඌ 2012 Aඇඇඎൺඅ Hൾൺඅඍඁ Dංඌඉൺඋංඍංൾඌ Cඈඇൿൾඋൾඇർൾ The 2012 annual conference entitled, “Starting at the Top: Achieving Health Equity through Executive Leadership” was held on October 8, 2012 at the Hilton Garden Inn in Greenbelt, Maryland. This conference sought to arm leaders and executives with the knowledge and tools necessary to promote health equity at their own organizations. The conference design allowed for richly informative presentations from start to finish. For instance, during the morning session CEOs and Presidents from INOVA, Sinai Hospital of Baltimore, and Adventist HealthCare shared their experience, successes, and challenges in managing their ever changing diverse patient populations. The keynote address was delivered by national bestselling author and surgeon, Dr. Benjamin Carson. Dr. Carson spoke about his experiences as a young man striving to achieve success in medicine as well as his dedication to ensuring equitable health outcomes for the young patients that he treats. Following lunch, the Center’s Executive Director, Marcos Pesquera, unveiled the first Health Equity Report for Adventist HealthCare to be shared with the public. The 2012 report showed how organizations can use patient demographics and quality indicators to provide meaningful reports to leadership with information that can help them understand and meet the needs of their patient population with greater precision. The afternoon panel discussion provided highlighted specific programs, initiatives, and partnerships that health care organizations have used to actively address the health inequities that plague their communities and patient populations. The 2012 Blue Ribbon Award was presented to Lt. Governor Anthony G. Brown for his visionary leadership in combating the health disparities faced in Maryland today. The conference closed on a very positive note that left participants motivated and eager to continue working toward achieving health equity.
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AGENDA AT A GLANCE AGENDA
Welcome
Marcos Pesquera Executive Director, Center on Health Disparities Adventist HealthCare
Opening Remarks
Lt. Governor Anthony G. Brown State of Maryland
2012 Blue Ribbon Award Presented to Lt. Governor Anthony G. Brown CEO ROUNDTABLE DISCUSSION Moderator:
Helen Darling President and CEO, National Business Group on Health
Panel Presenters: William G. “Bill” Robertson, President and Chief Executive Officer, Adventist HealthCare J. Knox Singleton, Chief Executive Officer, Inova Health System Neil Meltzer, President, Sinai Hospital of Baltimore and Senior Vice President and Chief Operating Officer, LifeBridge Health Audience Question and Answer Session KEYNOTE ADDRESS
Benjamin Carson, M.D. Director, Pediatric Neurosurgery Johns Hopkins Children’s Center and New York Times Best-Selling Author
Center on Health Disparities Update: Health Equity Report
Marcos Pesquera Executive Director, Center on Health Disparities Adventist HealthCare
PANEL DISCUSSION: Where the Rubber Meets the Road: Creating Health Equity at Your Organization Moderator:
Marilyn Lynk Program Manager, Center on Health Disparities Adventist HealthCare
Panel Presenters: Danielle Marks, LifeBridge Health Martine Charles, Inova Health System Eme Martin, Adventist HealthCare Deidre Washington, Adventist HealthCare Closing Remarks
Marcos Pesquera Executive Director, Center on Health Disparities Adventist HealthCare
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CONFERENCE PLANNING PROCESS
PLANNING MEETING SCHEDULE: January – September 2012 Pඁൺඌൾ Determined topics, speakers, and format Drafted preliminary conference program and agenda Chose target audience Proposed outcomes and deliverables Identified potential sponsors, funding sources Determined conference staffing needs Drafted preliminary budget Pඁൺඌൾ Identified replicable models of achieving health equity Contacted health care leaders and executives Scheduled and led speaker/topic subgroup meetings Pඁൺඌൾ Sent Invitations Nominated and Selected Blue Ribbon Award Candidates Proposed discussion questions Selected Moderators October 8, 2012: Health Disparities Conference Pඁൺඌൾ Evaluation Summary and Analysis Recommendations for Future Directions Proceedings Development and Dissemination
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CONFERENCE PLANNING PROCESS
PLANNING COMMITTEE MEMBERS
Cindy Glass Internal Communications Specialist Marketing and Communications Teresa Witt Business Partner Development Officer Adventist HealthCare Talya Frelick Project Manager Center on Health Disparities Marilyn Lynk Program Manager Center on Health Disparities Eme Martin Project Manager Center on Health Disparities Marcos Pesquera Executive Director Center on Health Disparities Deidre Washington Research Associate Center on Health Disparities
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OPENING REMARKS Maryland’s Lieutenant Governor Anthony Brown Lieutenant Governor Anthony Brown opened the 6th Annual Center on Health Disparities Conference by emphasizing the need to address the state of health equity in Maryland. Maryland is one of the wealthiest states in the country with access to a multitude of resources, yet minorities suffer from a higher rate of poor health outcomes compared with whites. The Lt. Gov. stressed that the need to address health disparities is not only a financial imperative, but a moral one as well. The three areas that must be addressed are expanding access, improving quality, and reducing the cost of health care. Lt. Gov. Brown has been at the forefront of numerous efforts being made to address these areas and expressed his enthusiasm to see so many leaders coming together to continue the push forward to improve the state of healthcare in Maryland. He noted that collaboration and strong leadership are the keys to reducing health disparities and this conference is an important step in the process. Maryland Lieutenant Governor Anthony Brown delivering opening remarks.
Lt. Gov. Brown was the recipient of the Blue Ribbon Award for being a visionary leader in promoting health equity in Maryland. For example, he has spear-headed efforts to implement the Affordable Care Act and create the Maryland Health Connection, the new marketplace being built for individuals, families, and small businesses to learn about their insurance options, compare different plans and enroll for health coverage. This program is on track to be made available in fall 2013 (for more information go to: www.marylandhealthconnection.gov). He launched the innovative Health Enterprise Zones (HEZ) to address disparities among the most underserved populations in the state. The HEZ is a pilot program modeled after the success of Economic Enterprise Zones, which incentivized businesses to create jobs in distressed neighborhoods to improve the economic status of those neighborhoods. The goal of the program is to target communities to incentivize primary care providers and community resources to make a difference in health outcomes. Lt. Gov. Brown stated that he wants the zones to be spread throughout the state in urban settings, rural settings, and in areas with barriers to care are due to cultural and linguistic challenges. This pilot program will measure results over the course of four years and through successes achieved, facilitate the expansion of the program throughout the state.
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BLUE RIBBON AWARD
Maryland Lieutenant Governor Anthony Brown Each year, the Center on Health Disparities presents a Blue Ribbon Award to a person or organization that has demonstrated efforts to remove barriers to health equity through education and/or collaboration. Maryland Lieutenant Governor Anthony Brown was awarded the 2012 Blue Ribbon Award for his commitment and dedication to achieving health equity for all Maryland citizens through promotion of supporting initiatives, strategic focus, and increased access. Some of his achievements include:
Spearheaded efforts to implement President Obama’s health care reform law and the health insurance exchange (now the Maryland Health Connection).
Expanded Medicaid to 340,000 more Marylanders, half of which are children.
Insisted on making addressing health equity and disparities a critical pillar in Maryland’s implementation plans.
Raised awareness of disparities and poor health outcomes in the most underserved and isolated communities in Maryland.
Launched the innovative Health Enterprise Zones program to address disparities.
This year’s award was presented by Marcos Pesquera, Executive Director of the Center on Health Disparities at Adventist HealthCare. Lieutenant Governor Anthony Brown accepted the award with great appreciation.
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PANELISTS
The morning roundtable discussion, moderated by Helen Darling, President and CEO of the National Business Group on Health, gave way to dynamic and engaging discussions touching upon the realistic challenges of leaders in large organizations within the tri-state area. During Ms. Darling’s introductory comments she noted “[Addressing health equity issues] is not just the moral thing to do, …[it] is the best thing to do for your business practice.” She also shared that health disparities do not affect those with health insurance exclusively. When isolating populations with insurance coverage, studies show that high blood pressure and obesity among minorities are major problems. As a way to aid employers, Ms. Darling shared that the Health Assessment Toolkit: A Road Map for Employers, which guides employers in administering effective employee health assessments, is now available online at the National Business Group website. Helen Darling, President and CEO of the National Business Group on Health
Before beginning the panel discussion, Ms. Darling introduced each panelist. Each panel speaker was asked to share the journey their organizations have taken to help achieve health equity among their patient populations and within their communities.
The salient theme that emerged across all presentations was the importance of integrating health equity into the organizational culture and daily operations, rather than making it a separate strategic pillar. Each speaker had about 20 minutes to present before the moderator led the discussion after the panel presentations.
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PANELISTS
Aൽඏൾඇඍංඌඍ HൾൺඅඍඁCൺඋൾ:
Mඋ. Wංඅඅංൺආ “Bංඅඅ” G. Rඈൻൾඋඍඌඈඇ
With a history in Montgomery County that dates back to 1906, Adventist HealthCare (AHC) has been at the forefront in addressing the health needs of its community. Since the opening of Montgomery County’s first hospital, the community has gone from a rural to a very diverse urban environment. “In Montgomery County there are over 150 languages spoken, and over 80 of those languages are spoken by our workforce,” said Bill Robertson. He continued, “About a decade ago, we put together a Blue Ribbon Panel of experts in the community to address health disparities, and they came up with three areas of focus to address disparities across the various racial/ethnic groups we serve: 1) Education and Training, 2) Research, and 3) Health Care Services.” The Center on Health Disparities was established to lead this effort. The elimination of disparities is the Center’s goal; however, it is only attainable with the “engagement of our community and its resources. Once you engage your community, then you’re William “Bill” G. Robertson, accountable to deliver,” Mr. Robertson expressed. He President and CEO of Adventist remarked that hospitals should look to partner with HealthCare organizations that have the focus and expertise in certain areas and populations of the community, such as CASA of Maryland, MobileMed, Mercy Health Clinic, and the Primary Care Coalition. “When Washington Adventist Hospital was first opened, it was all about improving lifestyle…[and still today], part of our focus is about targeting lifestyle among communities’ members rather than just on disease.” Though many organizations are searching for the reasoning behind investing in health equity, Mr. Robertson shared that “[AHC] did not initially decide to do this from a business perspective; it was how to stay relevant, which is important in order to be financially successful. Also, it directly relates to patient experience and safety where increasingly there are economic incentives.”
Panelist during the CEO Roundtable Discussion.
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PANELISTS Mr. Robertson later spoke about research being the key to understanding which disparities affect populations in a particular region. He also noted that collection of population data was one of Adventist HealthCare’s biggest challenges, “We have to be willing to collect the data, and that is not easy. Registrars cannot make assumptions about people they see. They have to ask, and that is uncomfortable.” To address this challenge, Adventist HealthCare taught hospital patient registrars how to collect race, ethnicity, and language data, as well as the importance and purpose behind data collection and how the data are used. The training has made a significant difference in standardizing and improving accuracy of the data. Lastly, Mr. Robertson discussed AHC’s commitment to addressing the pipeline deficit of health professionals. As a member of the Governor’s Workforce Investment Board for the past eleven years, he’s been assessing the nursing workforce shortage. In addition to AHC participating in local efforts to engage elementary, middle students, and high school students in what it means to have a career in health care, “we also participate with the Welcome Back Center of Suburban Maryland to create opportunities for immigrant communities [with a health professional] education, but need a license, language assistance, etc.” “You have to be willing to change, “ Mr. Robertson concluded, “and this is what ultimately improves our mission to demonstrate God’s care by improving the health of people and communities through a ministry of physical, mental and spiritual healing.”
Iඇඈඏൺ Hൾൺඅඍඁ Sඒඌඍൾආ:
Mඋ. Kඇඈඑ Sංඇඅൾඍඈඇ
President and CEO of Inova Health System, Knox Singleton, was the second panelist to present. During his presentation, he highlighted some of the biggest hurdles hospitals needed to overcome in order to address health disparities. The first and biggest challenge he shared was in bringing about C-suite commitment to health equity, as it is often disconnected from the overall focus and priorities of the organization. At Inova, “we’re having to simultaneously reinvent every aspect of what we’re doing.” Mr. Singleton then took a moment to praise Adventist HealthCare for being pioneers and modeling innovative strategies and initiatives for achieving health equity, adding “Inova is building excellence across the same focus areas identified earlier by Bill, while also working on the ‘must-do-can’t-fail’ imperatives of healthcare reform.” Mr. Singleton, then identified the second hurdle by describing health disparities as being largely among populations without financial resources, “therefore, most physicians are not engaged in the issue.” The last hurdle he identified was legal Knox Singleton, President and CEO of Inova Health System issues. “Legal issues are often pushed out of the C-Suite and into the legal/regulatory compartment, and then the culture of the organization isn’t changed.” Apart from hospitals’ needing an organizational cultural shift, a cultural shift is needed within the community. At Inova they are using the human fabric of integration and support to help drive healthier behavior. “Engineering social experiences that will dramatically change behavior” is one of the ways in which to shift paradigms, such as switching from soda to water, using the stairs versus the
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PANELISTS elevator, etc.” An example of the health system’s efforts on creating a cultural shift is their focus on childhood obesity. Through targeted financial support, Inova helps to address high obesity rates among minorities by ensuring that healthy and sustainable food is available via farmers’ market accessibility programs. On the changes that health care reform brings, Mr. Singleton said, “Transition to populationbased care gives strong incentives to keep new Medicaid recipients out of the emergency room.” The use of community partnerships as well as collaboration with federally qualified health centers as well as local clinics for women and children, aid in building that first degree of care. For non-documented populations, however, expanded Medicaid coverage is not set to cover them. Mr. Singleton said, “…[for these populations], it is the top priority of the hospital to get them into a first degree care setting and [break] the frequent flyer trend of hospital use.” When asked about patient involvement in advisory groups, Mr. Singleton noted that Inova has a Patient Advisory Group that is about fifty percent minority, a representation reflective of their population. He added, “[historically], professional ethic has been dismissive of patient empowerment. [In recent times], that is the transition, to have patients speak and be heard for their own interests.” He acknowledged that at times that can be the most difficult piece because it means giving up some of the hospital’s authority and control. Nonetheless, patients provide value input and feedback and are an integral part of what propels a hospitals business. He concluded with a simple solution to how organizations as a whole can address health equity, “The way to do it is to inject health equity into each of the pillars of the organization, such as patient experience, patient safety, and quality. … Think of health equity as a piece of all your business goals. [T]his focus is a means toward every important thing that the community, the patients, and colleagues, expect.”
Sංඇൺං Hඈඌඉංඍൺඅ ඈൿ Bൺඅඍංආඈඋൾ: Sinai Hospital of Baltimore’s history dates back to 1866, with a need to address discrimination against Jewish providers, many of whom were not allowed to work in other area hospitals. Sinai Hospital’s President, Neil Meltzer, described the hospital’s current location as being surrounded by two vastly divergent economic communities in Baltimore: one of extreme poverty and the other of wealth. “The prejudice was blatant, among patients, physicians, staff, etc.”, Mr. Meltzer noted about his initial experience coming to Sinai. Upon watching the groundbreaking PBS documentary [Unnatural Causes], he felt inspired and began to refocus the hospital’s priorities. “We created a diversity committee within the organization to start to look at some of the discrimination, using ’Creating Healthier Communities Together’ as our purpose statement.” He continued that Sinai has had various waves of immigrants in the area, creating many challenges such as language and cultural barriers. Health care reform presented further demands, as an influx of new patients came to the hospital to receive care. These challenges have been met with a myriad of structural, procedural, and programmatic changes.
Mඋ. Nൾංඅ Mൾඅඍඓൾඋ
Neil Meltzer, President of Sinai Hospital of Baltimore
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PANELISTS One solution was the incorporation of a diversity module in their orientation. Another is establishing a patient-centered medical home. “We need to make use of the medical home, [either using general practitioners or primary care providers], with social workers or case managers following-up with patients in their homes after discharge. At Sinai, we’ve created a Transitions of Care unit and we provide incentives for low readmissions.” Mr. Meltzer also mentioned a shift in their patient-centered model of care to be more inclusive of family engagement, as the family is an integral part of health. “Family-centered care moves us toward a better standard of care,” he shared. Mr. Meltzer identified one of the biggest hurdles in achieving health equity as different cultural perspectives. “Until we address cultural perspectives, we’re not going to have much success on this issue, as people from various cultures may think a healthy weight looks different [from the mainstream].” In a call to action, Mr. Meltzer announced that a paradigm shift in behavior is needed in their community, “[everyone needs to] know their numbers and that’s a struggle.” He acknowledged that some degree of motivation is necessary to make this happen, but he did not have the whole answer. Mr. Meltzer mentioned that Sinai hospital provided primary care for a disproportionate number of young African American males. After conducting a study to identify why these young men were coming to the hospital, Sinai found that women and children were getting care, but young African American men were not. In response, Sinai created a Men’s Health Clinic to address and serve those men. Also, to better understand and address the needs of the community, Sinai created a Community Advisory Panel (CAP) consisting of community leaders, local and state elected officials, and business executives, as well as media and law enforcement, to serve as a voice for the community. Sinai’s CAP members are very ambitious, but what’s even better is their willingness to partner and work together with Sinai to achieve community goals that affect the social determinants of health within their community. At times, however, “we do need to work with them in order to narrow the focus to things that can happen in a feasible, appropriate way.” Nonetheless, he enjoys the challenges presented and always welcomes feedback. When asked what some essential factors were in addressing health equity, Mr. Meltzer stated, “You need a dedicated staff or individual who’s going to help you drive the agenda, as well as a commitment to educate.” This dedication and commitment to eliminate health disparities and remove barriers to access is what has led to Sinai’s success in targeting many of the issues that arise within their community. “It’s hard to provide a hard and fast business case with hard data showing that this will improve the bottom line financially, but I know it’s the right thing to do.”
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KEYNOTE ADDRESS
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KEYNOTE ADDRESS
Speaker Dr. Ben Carson, Director of Pediatric Neurosurgery at the Johns Hopkins Children’s Center
Dr. Benjamin Carson, Director of Pediatric Neurosurgery at the Johns Hopkins Children’s Center and recipient of many awards and recognitions, including the Presidential Medal of Freedom and thirty-eight honorary doctorate degrees, delivered the keynote speech at the Health Disparities Conference. He began by explaining that a person’s health is more important than all the possessions they can own. As a physician, Dr. Carson stressed the importance of being empathetic and understanding patients’ points of view in order to address health disparities. He went on to explain that individuals tend to react based on their expectations and experiences, and understanding this is key to addressing cultural differences. Dr. Carson provided a few examples of health (and healthcare) disparities and stressed the need to examine their root causes. Some disparities stem from the organizational structure of hospital systems, while others stem from the lack of trust among minorities of the health care system. He linked lack of trust to poor development of relationships between patients and their providers, and encouraged medical professionals to gain patients’ trust by spending some time getting to know patients rather than simply addressing their medical needs. He discussed other key issues such as physicians’ unwillingness to assist patients with matters outside their areas of expertise and becoming weary of patients due to the proliferation of malpractice lawsuits. Dr. Carson also expressed his opinion about the high cost of healthcare stemming from defensive medicine and physicians’ tendencies to order more exams than needed to avoid potential future lawsuits. Dr. Carson explained further the societal changes needed to address the root causes of disparities. Based on his experience, he believes that disparities in healthcare are largely financial-based. He explained how he witnessed well-educated and wealthy patients being treated better than others. He stressed the importance of teaching individuals early in their careers to overcome this human tendency. In Dr. Carson’s opinion, the primary issue in healthcare that needs to be addressed is access to care. As a cancer survivor, Dr. Carson believes that his access to care was largely to thank for his survival. However, finding primary care can be a difficult process. Dr. Carson challenged healthcare professionals to take the lead in health reform and not to leave it solely to politicians.
2012 Annual Conference Proceedings Page 23
KEYNOTE ADDRESS In this light, he offered some solutions to certain challenges in healthcare, such as billing reform to standardize the process of charging for a procedure and leveraging electronic medical records. He also suggested the use of electronic medical cards based on the food stamps methodology to allow those in need to take control of their healthcare and encourage them to seek treatment at clinics rather than more costly emergency rooms. Visiting clinics would lead to preventative care and a greater chance for developing trusting patient-doctor relationships. He further proposed that at birth, everybody should receive a birth certificate, electronic medical record, and health savings plan. Beyond healthcare, Dr. Carson asserted that we need to take an active role in the life of minority children to make sure they are aware of the historical importance of their cultures and link it back to their ability to make a positive impact on society. Dr. Carson closed by encouraging everyone to keep working on addressing disparities and staying determined through the hurdles they would inevitably face. “Healthcare is our responsibility and the sooner we recognize that, the sooner we have one nation under God with liberty and justice for all.�
Center on Health Disparities interns.
Dr. Carson with Carson Scholar, Alfredo Colina.
2012 Annual Conference Proceedings Page 24
PANELISTS
Where the
R
Meets the
R
The afternoon panel included dynamic discussions with representatives from within the three health systems highlighted in the morning’s CEO panel. The afternoon panelists shared examples of how their respective organizations work to achieve health equity on the front lines every day. Their journeys are all vastly different, yet one common theme emerged: the unification of a community is the only way that many of the issues contributing to health disparities can be addressed. Martine Charles, Director of the Office of Health Equity at Inova Health System, presented efforts underway in Northern Virginia to achieve their vision of a “community where all residents have access to resources that promote and sustain optimal health and well-being.” To achieve this vision, Inova has been very purposeful in linking health equity with Inova’s three strategic focus areas: (1) Community-based/Coordinated Care, (2) Destination Clinical Services, and (3) Hospital-Based Care.
Martine Charles, Director of the Office of Health Equity at Inova Health
Some innovative ways in which Inova integrates health equity with its strategies is through community surveys, collaboration with physician partners to expand access to language services, cultural competence class offerings, targeting underserved populations in community programs, and providing language services for wellness and prevention initiatives in the community. Inova is currently in the process of transitioning to an electronic medical record system, which will enable them to monitor data by race, ethnicity, and language. Once the transition is complete, the health system will evaluate and report data in a Health Equity Report Card.
Ms. Charles spoke of the burden of obesity in her community, ranking 30th in the nation for adult obesity and 23rd for childhood obesity. To decrease current childhood obesity rates of 15.2 percent, Inova has embarked on a campaign to address this issue in collaboration with programs such as the Northern Virginia Healthy Kids Coalition, Let’s Move the Needle on Childhood Obesity, Buy Fresh, Buy Local Double Dollar Program, and their own program called iPATH (Inova Partnering Actively Toward Health). The success of these programs have led to the
2012 Annual Conference Proceedings Page 25
PANELISTS launch of other programs at local schools to keep children active y changing policies, systems and/ and healthy. Ms. Charles shared that five public school systems or environments, communities can went as far as changing their help tackle health issues like obesity, wellness policy to embrace the 9-5 -2-1-0 wellness and nutrition heart disease and stroke, and other initiative. She concluded, “By chronic diseases.” changing policies, systems and/or environments, communities can help tackle health issues like obesity, heart disease and stroke, and other chronic diseases.” Danielle Marks, Heath Equity Program Coordinator, at Sinai Hospital of Baltimore, discussed the importance of social justice and community engagement in achieving health equity. Dating as far back as 1989, Sinai Hospital decided to shift their approach to health care from inside the hospital’s walls to the outside community, in order to address needs that extended beyond the care patients receive in hospital. Ms. Marks commented, “[Fifteen years later, Sinai’s model still] reflects the same social health model and continues to be used to respond to social forces that work to impair access to care or contribute to poor health.” Ms. Marks spoke about possible causes of health disparities, for example: (1) unhealthy environments; (2) risky behaviors and lifestyle, such as drug abuse, poor nutrition, and violence; (3) daily stressors of living in poverty, compounding physical and mental health issues; (4) lack of health insurance; (5) poor system of transportation; (6) competing priorities, such as the Danielle Marks, Health Equity Program Coordinator at Sinai need for food and/or shelter; (7) unequal access and inability to Hospital utilize resources; (8) unstable domestic environments for children; (9) higher economic burden resulting from increased demand for expensive health care services; and (10) depletion of resources from social investments that promote health, such as education, employment, and housing, due to increased expenditures in health care. As a result, she emphasized, “Because these effects work at an individual and system level, responses must also operate at both levels.” In efforts to bridge the health equity gap, Sinai has implemented many initiatives to improve access to care for all populations. One intervention involves the use of paraprofessionals to ensure a continuum of care for patients and to help address unhealthy conditions at patients’ homes. Another is Sinai’s Family Violence Program, which educates providers on how to screen for domestic violence with their patients. The program also incorporates elements where social workers and outreach workers conduct immediate follow-up, serve as advocates, and leverage resources within the community to get patients the help they need. 'Program staff, including social workers and outreach workers, also provide direct services to victims of domestic violence to include immediate crisis intervention, individual and group counseling, services coordination, legal referrals and court advocacy.
2012 Annual Conference Proceedings Page 26
PANELISTS Sinai’s commitment to health equity has gone as far as integrating the community into its operating structure. Understanding the importance of community engagement is what led to the development of the Community Advisory Panel (CAP) of the Health Equity Initiative. The CAP includes the following types of individuals: community activists, leaders, elected officials and representatives from housing, education, schools, law enforcement, media, etc. The unique structure of the CAP creates a collaborative environment in which innovation and partnering can occur. Together members innovatively begin to address the social factors influencing health disparities. Sinai Hospital of Baltimore’s commitment is evident and encourages hospitals to unite all community bodies to fight the forces contributing to health inequalities. Deidre Washington and Eme Martin both presented on Adventist HealthCare’s newest initiative to achieve health equity in their community called, BEAT IT!, Becoming Empowered Africans Through Improved Treatment, which is funded by the Office of Minority Health Resource Center’s National African Immigrant Project (NAIP), U.S. Department of Health and Human Services. Dr. Washington explained, “There’s a sizeable African immigrant population in the area that Deidre Washington and Eme Martin, Adventist HealthCare serves, and many of their needs Adventist HealthCare are not being met, particularly when it comes to HIV/ AIDS.” However, BEAT IT!’s distinctive design not only targets those with HIV/AIDS, it also aims to support African-born residents with type 2 diabetes and hepatitis B as well. “When it comes to data collection, Africans are often aggregated and lumped in with U.S. born and other blacks, but they have their own unique set of cultural barriers,” shared Ms. Martin. BEAT IT! was developed to directly target barriers that make healthcare inaccessible to African-born residents, such as insufficient or lack of information and healthcare resources, immigration status/fear of deportation, fear or distrust of the healthcare system, linguistic and cultural barriers and lifestyles/habits, and lack of community healthcare resource coordination. Montgomery County has more than 38,000 African-born residents and without proper resources providers are often uncertain of how to care for this population in a culturally appropriate way. Therefore, the scope of BEAT IT! was set to include a separate individualized curriculum that offers health care providers tools and strategies for effective communication. This 20-month long initiative has stimulated community engagement from across health care organizations, private practice physicians, nutritionists, health educators, pharmacists, population-specific community groups, patients and their families, and community leaders. The development of this aggregate body working towards a common goal is what drives BEAT IT’s success so far. The Center on Health Disparities aims to facilitate a link between communitybased organizations and state departments also, so data collection is more feasible and targeted interventions can continue long after BEAT IT! concludes its project term.
Page 27
2012 BLUE RIBBON AWARD
2012 Annual Conference Proceedings Page 28
SUMMARY
Conference Evaluation
With over 225 attendees, the Center on Health Disparities’ (CHD) Sixth Annual Conference was a success, bringing together Dr. Marilyn Lynk, Program Manager at the executives, subject matter experts, government Center on Health Disparities officials, healthcare professionals, and multiple other stakeholders to discuss health equity and executive leadership. This year’s conference welcomed Maryland’s Lt. Governor Anthony G. Brown and Dr. Benjamin Carson, as conference Highlights speakers, as well as two panel presentations from hospital executives in the Mid-Atlantic area and program experts. More than 220 people atThe conference objectives were to discuss leadership tended commitment to (1) promoting health equity in all aspects Approximately 40% of the of the healthcare, 2) creating health equity reports at healthcare organizations, and 3) implementing effective conference attendees repstrategies to reduce health disparities in healthcare resented non-health related settings. fields.
This year, about 30 percent of the attendees completed an extensive online survey providing valuable feedback on the objectives and quality of the conference and presentations. The majority of survey respondents indicated that the objectives were met very well. An overwhelming majority (92%) found the conference to be an effective way to learn: almost all of them (91% of all responses) agreed that the discussion topics were relevant to their work and conference materials were useful. Also, the survey respondents found all the speakers to be knowledgeable of the discussion topic and 98 percent agreed that the panels were well moderated.
Nearly 30% of the confer-
ence attendees completed an extensive online survey tool
Nearly 90% of the survey
respondents found that the executive panel effectively shared their expertise
Nearly 94 percent of respondents believed Dr. Carson demonstrated expertise and knowledge of health disparities. One respondent commented specifically on one of Dr. Carson’s key points, indicating “Poverty is at the heart of health disparities, and if we are to reduce the latter, we
2012 Annual Conference Proceedings Page 29
SUMMARY must address the former. Reducing disparities means patients must be involved in their own care and they must be empowered to do so instead of simply keeping them informed.” Another said, “we need to focus on access particularly around increasing the number of primary care physicians.” Over 90 percent of respondents agreed that the executive panel shared their expertise in health equity and executive leadership effectively. One respondent shared, “Leadership must buy in to health equity initiatives in order to meet organizational goals. [The panelist shared insight on] how to make a business case for health equity.”
eadership must buy-in to health equity initiatives in order to meet organizational goals.
The second panel received equally favorable reviews: at least 86 percent of respondents agreed that the panelists shared their knowledge on best practices and challenges of implementing health equity initiatives well. In regards to improving next year’s conference, most qualitative comments were favorable: “I thought this was well organized. Meal was excellent. The servers were polite and pleasant. Just more of this in the future.” “I love this conference every year but this one was just about perfect!” “Success means you will need a bigger room!” Several survey participants did offer suggestions for improvement: “Invite nursing executive leadership [as speakers]” and “add more diversity, both racial and ethnic, among the speakers” were two of the most common requests provided by conference attendees. Overall, the Center on Health Disparities is pleased with the sixth annual meeting and looks forward to exceeding expectations at next year’s conference.
Thank you to all our interns helping to ensure yet another successful conference.
2012 Annual Conference Proceedings Page 30
RECOMMENDATIONS AND CONCLUSION
Recommendations
Conclusion The purpose of the 2012 Adventist HealthCare Health Equity Report is to help inform quality executives and other leaders at Adventist HealthCare hospitals about the racially and ethnically diverse populations we serve and the quality of care they receive at our hospitals. We also hope to use this information to monitor and improve quality of care by identifying any disparities that may exist in the care provided to our patients. In doing so, we can develop targeted interventions to eliminate disparities and provide the highest quality of care to all of Adventist HealthCare’s patients. Specifically, the report describes self-reported demographic characteristics of the patient populations treated at Shady Grove Adventist Hospital and Washington Adventist Hospital in 2011 (namely race, ethnicity and preferred language) and the settings in which they were treated (inpatient, outpatient, and emergency department). In addition, the report has sections on cancer patients by type of cancer; quality indicators for four core measures; hospital readmission rates; and inpatient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey, all stratified by race, ethnicity, and language. The health equity report provided four recommended approaches to improve healthcare quality and outcomes:
t is essential to make] use of the medical home, by using a general practitioner or primary care provider, as well as social workers or case managers to follow-up with patient in-home, after they’ve left.”
Improve patient demographic data collection and increase transparency by reporting hospital performance data by race, ethnicity, and language preference data.
Monitor differences in quality of care and healthcare
outcomes to inform hospitals’ strategic goals, develop community outreach programs, and target quality improvement efforts.
Implement data-driven interventions to improve health-care quality and outcomes.
Promote the provision of culturally competent, patient-centered care.
2012 Annual Conference Proceedings Page 31
RECOMMENDATIONS AND CONCLUSION
ach of us who are involved in some way in health care have to begin to use our collective experience and our knowledge to come up with real solutions that really work.” Dr. Ben Carson
The 2012 AHC Health Equity Report demonstrates how internal data can be used to identify community trends in health and the type of care that patients receive at Washington Adventist Hospital and Shady Grove Adventist Hospital. Health care organizations can better understand their patient population and their care experiences by collecting and analyzing data on quality of care and outcomes by race, ethnicity, age, language and gender (REAL-G). Monitoring demographic patient data and health disparities in outcomes may lead to innovative solutions to achieve health equity both internally and with community partners, and most importantly, promote high quality, costeffective care.
The 2012 Center on Health Disparities conference was an opportunity for attendees to hear directly from the executives of three local health systems on how they strive to achieve health equity in their institutions and within their communities while navigating changes in healthcare delivery as a result of health care reform. Below are responses from the CEO panelists, when asked how hospitals are meeting the influx of new patients due to health care reform: Neil Meltzer, Sinai Hospital of Baltimore Baltimore: “[It is essential to make] use of the medical home, by using a general practitioner or primary care provider, as well as social workers or case managers to follow-up with patient in-home, after they’ve left. It does help. We’ve created a “Transitions of Care” unit – where there are incentives to keep people from being readmitted. We also work very closely with the Baltimore City Health Department and their Healthy 2015 plan and we try aligning with their initiatives.” Knox Singleton, Inova Health System: “Transition to population-based care gives strong incentives to keep new Medicaid recipients out of the ER. We’re using community partnerships, and they have large federally qualified health centers and clinics especially for women and children; building first degree care. However, folks who are not documented are not part of th e expanded Medicaid coverage, so it’s a top priority of the hospital to get them into a first degree care setting and breaking the frequent flyer trend of hospital use.” Bill Robertson, Adventist HealthCare HealthCare: “Focus on those that won’t be covered. We have a very substantial undocumented population that won’t be covered so that’s a great note that we too should especially focus on them. We won’t know how dramatic the change is going to be until we see it happen—[we are] trying to survive in the current world of ‘fee-forConference attendees during CEO Roundtable discussion.
2012 Annual Conference Proceedings Page 32
RECOMMENDATIONS AND CONCLUSION service’ while getting ready to do well with incentives for managing care and keeping people well.” During the keynote address, Dr. Benjamin Carson shared his opinions on how to face challenges to addressing disparities and some possible solutions: “We don’t have enough primary care providers. And until we solve that problem, the access problem will continue to be horrible for minorities. It will be horrible for everybody, but it will be more horrible particularly for people who don't have good insurance, who don’t have money.” He continued that health care reform also has “...another 30 million [entering] into the system on Medicare and Medicaid and then on top of that [it is scheduled to] decrease reimbursement to hospitals and practitioners….[meaning] even fewer [medical professionals] will be willing to take these patients, so there will be long, long lines for people just to get the kind of care they need.”
Marcos Pesquera, Dr. Malcom Joseph, William “Bill” Robertson together.
Dr. Carson proposed several solutions on how to address disparities from tort reform to adopting a food stamp model in health care to encourage the rationing of health care dollars. He noted that such efforts would encourage individuals to go a clinic rather than an emergency department, which costs significantly more. After a thought-provoking presentation from Dr. Carson, the afternoon panelists described examples of innovative programs, campaigns, and approaches implemented at each hospital system. The development of a targeted and personalized approach to meeting the unique needs of their patient populations was unanimously credited to partnerships. When asked how partnerships are used to address issues contributing to health equity, each panelist answered: Martine Charles, Inova Health System: “We support and bring voice to a coalition. Everything we do has to be in our partnership; we’ve gotten past always thinking that we have all the answers.” The audience actively engaged during the afternoon panel presentations.
2012 Annual Conference Proceedings Page 33
RECOMMENDATIONS AND CONCLUSION Danielle Marks, Sinai Hospital of Baltimore Baltimore: “We work very closely with the Baltimore City Health Department and their Healthy 2015 plan and we try aligning with their initiatives.” Deidre Washington & Eme Martin, Adventist HealthCare HealthCare: “We have partnerships with Prince George’s Health Department…and the Dennis Avenue Clinic in Montgomery County. Our partners have also been a huge help in providing feedback and advice.” The insight behind how these organizations prepare for upcoming health reform changes as well as partnering with community organizations, illustrates that continuous effort is needed to address the ever-changing environment in which healthcare operates. In conclusion, understanding population changes and analyzing differences in outcomes are critical to being
Left to right: Talya Frelick, Nancy Flores, Dr. Deidre Washington, Alfredo Colina, Dr. Ben Carson, Eme Martin, Marcos Pesquera, Mary Manan, and Dr. Marilyn Lynk
able to prepare for effects on the quality of care provided. This year’s 2012 Health Equity Report begins to demonstrate the importance and the impact of such an analysis. It is our hope that organizations will adopt similar practices to provide the best care for their communities.
7ඍඁ Aඇඇඎൺඅ Hൾൺඅඍඁ Dංඌඉൺඋංඍංൾඌ Cඈඇൿൾඋൾඇർൾ Dൾർൾආൻൾඋ 3, 2013
2012 Annual Conference Proceedings Page 34
CONFERENCE ATTENDEES LIST
Conference
A
List
On behalf of the Center on Health Disparities and Care First Blue Cross Blue Shield, we would like to thank all who attended and supported our conference. The conference was a success not only because it offered opportunities to learn and share best practices with one another, but also because a great number of individuals from health care and non-health sectors alike participated actively in the event. In the pages to follow, we have provided a list of all the conference attendees, their respective organizations, and their contact email addresses. We encourage continued knowledge-sharing and partnering among individuals and across organizations from both within the health sector and across non-health sectors to reduce the impact of health disparities. Join us as we Partner Toward a Healthier Future!
2012 Annual Conference Proceedings Page 35
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Ahluwalia
Uma
Montgomery County Govt Dept of Health & Human Serv
uma.ahluwalia@ montgomerycountymd.gov
Alday
Charlie
Centers for Medicaid and Medicare
charlie.alday@cms.hhs.gov
Alvarado, MA
Elena M.
Montgomery County Department of HHS
elena.alvarado@ montgomerycountymd.gov
Ambrose
Brian
American Sign Language, Inc.
Ancona
Vincent M.
Amerigroup Community Care
Anderson
Helen
Adventist HealthCare
handerso@adventisthealthcare.com
Antzoulatos
Eleni
Suburban Hospital
eantzoulatos@suburbanhospital.org
Assani-Uva, MS RD
Adeline A.
Medical Nutrition Consultant LLC
addy_uva@yahoo.com
Baker
Bruce
CHEER
Bamba
Fatou
Adventist HealthCare
fbamba@adventisthealthcare.com
Baskin, Mrs.
Barbara F.
Montgomery Hospice
tjamestaylor@montgomeryhospice.org
Battle, ACSM
Yusef R.
The Fit Solution
Battle-Brooks, Esq.
Renee
State's Attorney, Prince George's County, MD
rebrooks@co.pg.md.us
Beane, RN
Mary L.
Montgomery County DHHS
beaneml@comcast.net
Bennett
Terri
Adventist HealthCare
tbennett@adventisthealthcare.com
Berger
Leanne
Adventist HealthCare
lberger2@adventisthealthcare.com
Bien
Lian
Adventist HealthCare
lbien@adventisthealthcare.com
Bigelow
Adrienne
NIH Federal Credit Union
Bloom
Marc
Washington Adventist Hospital
mbloom@adventisthealthcare.com
Brader
Sharon
Washington Adventist Hospital
sbrader@adventisthealthcare.com
Bradshaw
Evelyn
BlueCross BlueShield
vadim.pogosov@carefirst.com
Brown
Ellen
Montgomery County Govt
ellen.brown @montgomerycountymd.gov
Brown
Nigel
Adventist HealthCare
nbrown2@ahm.com
Brown
Lt. Governor Anthony G.
State of Maryland
brian@asli.com vincent.ancona@amerigroup.com
bruce@communitycheer.org
info@fitsolution.org
2012 Annual Conference Proceedings Page 36
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Bull, MD
Jonca C.
FDA
Bulluck
Anglia
Anglia Bulluck LLC
Burton, RN, C
Martha
Delmarva Foundation
Caballero
M. Christina
Dialogue On Diversity
Email jonca.bull@fda.hhs.gov poo4chie21@yahoo.com burtonm@dfmc.org dialog.div@prodigy.net
Calikoglu, PHD Sule
Health Services Cost Review Commission
Carrier
Amy
Washington Adventist Hospital
Carson, MD
Benjamin
Johns Hopkins University
Carter
William
US Food and Drug Administration
Chapelle
Bill
Adventist HealthCare
wchapell@adventisthealthcare.com
Charles, MPH
Martine
Inova Health System
martine.charles@inova.org
Cheston
Ned
Riverside Health, Inc.
Cobb, JD/MP
Leigh S.
Advocates for Children & Youth
lscobb4@gmail.com
Cochran
Dan
Shady Grove Adventist Hospital
dcochran@adventisthealthcare.com
Coleman
Kathy
Adventist HealthCare
Coleman, RN
Andrea
Mont County DHHS
andrea.coleman @montgomerycountymd.gov
Coleman, RN, B
Tannyka O.
African American Health Program
tannyka.coleman @montgomerycountymd.gov
Colina
Alfredo
Adventist HealthCare
Collins
Kelly
LifeWork Strategies
Condgon, Pharm
Heather
Universities at Shady Grove
Cover
Tom
MD State Assembly
Creekmur, RN
Pamela B.
Prince George's County Health Department
Dark, J.D.
Okianer Christian
Howard University School of Law
Darling
Helen
National Business Group on Health
Dashiell, MS, R Terrie O.
LifeBridge Health
Davis
Brian
D and D Enterprises
Davis
James
Riverside Health, Inc.
sule.calikoglu@maryland.gov acarrier@adventisthealthcare.com
william.carter1@verizon.net
ncheston@myriversidehealth.com
rlazo@adventisthealthcare.com
acolina@adventisthealthcare.com hcondgon@rx.umaryland.edu
pbcreekmur@co.pg.md.us odark@law.howard.edu
tdashiel@lifebridgehealth.org miragebjd@aol.com jdavis@myriversidehealth.com
2012 Annual Conference Proceedings Page 37
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Davis, Ed.D
Molly
George Mason University
Dennis
Alanna W.
Johns Hopkins Hospital
Desdunes
Valery
Adventist HealthCare
Dixon
Denise
African American Health Program
Donnell
Shari
The Grant Group, LLC
Douge
Malcolm
Oakdale High School
Email mdavi7@gmu.edu awilkin3@jhmi.edu vdesdune@adventisthealthcare.com denise.dixon @montgomerycountymd.gov sdonnell@thegrantgroup-llc.com malcolmdouge@yahoo.com
Douge, MD,MP Jackie
Frederick County Health Department
jdouge@frederickcountymd.gov
Drumheller
Kevin
Adventist Behavioral Health
Ebersole
Samantha R.
Providence Hospital
seberso@provhosp.org
Edelin
Tanya M.
Kaiser Permanente Health Plan
tanya.m.edelin@kp.org
Evers
Robin
Sinai Hospital of Baltimore
Fischer
Ben
Washington Business Journal
Flores
Nancy
Adventist HealthCare
Flowers
Willie
Park Heights Community Health Alliance
Folawewo, RN
Olatunji O.
Coppin State University
folatunji563@gmail.com
Forrester
Alfonso
Kaiser Permanente
mcforrester@verizon.net
Fowler
Michelle M.
Greater Baden Medical Services, Inc.
Frelick, MPH,
Talya
Adventist HealthCare
tfrelick@adventisthealthcare.com
Fried
Ashley
Adventist HealthCare
afried@adventisthealthcare.com
Frisby
Winchell Z.
Novo Nordisk, Inc
Gaitling
Joneyse
National Business Group on Health
Galen
Steven M.
Primary Care Coalition of Montgomery County, Maryland
Gama
Ismael
Adventist HealthCare
Garza, Phd,
Mary A.
University of MD
George, MPH
Phyllis
Epilepsy Foundation
kdrumhel@adventisthealthcare.com
revers@llifebridgehealth.org
nflores2@adventisthealthcare.com wflowers@phcha.org
mfowler@gbms.org
wnfr@novonordisk.com flesch@businessgrouphealth.org steve_galen@primarycarecoalition.org
igama@ahm.com magarza@umd.edu pgeorge@efa.org
2012 Annual Conference Proceedings Page 38
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Girardeau
Canary
Summit Health Institute
Gomez
Maria S.
Mary's Center
Gonzales
Alisha
Universities at Shady Grove
Gooch
David
Kelly Benefit Strategies
dgooch@kaig.com
Grange, PT
George R.
Adventist Rehabilitation Hospital of Maryland
rgrange@ahm.com
Green
Denesecia
Centers for Medicaid and Medicare
denesecia.green@cms.hhs.gov
Greenberg
Dawn
Centers for Medicaid and Medicare
dawn.greenberg@cms.hhs.gov
Hammen
Jayne
Centers for Medicaid and Medicare
jayne.hammen@cms.hhs.gov
Hansen
Dennis
Shady Grove Adventist Hospital
Hart
Jeffrey
KPMAS
Hochron
Jean
Montgomery County Department of Health and Human S
Hodge
Mark
Montgomery County DHHS
Holmes
Maggie L.
The Grant Group, LLC
Holt
Eusi I.
BETAH Associates, Inc.
Houston, MD, M
Avril
HRSA
HoustonCrockett, MPH C
Dianne
Amerigroup
dianne.houston-crockett@gmail.com
Howell, MPH
Kesi
DHHS/NIH
howellk2@mail.nih.gov
Huang, RN
Susan S.
Montgomery county Health Department
Hunter
Gregory
Hunter Cleaning Services
Hunter, MBA
Joyce M.
Vulcan Enterprises LLC
joyce@vulcanenterprises-llc.com
Hussein, RN, D Carlessia A.
DHMH Minority Health and Health Disparities
diane.walker@maryland.gov
Hykes-Waddell Katie
Walden University
Igomu, MD
Bishop A.
cgirardeau@shiveinc.org smorales@maryscenter.org
leden@adventisthealthcare.com jeffrey.a.hart@nsmtp.kp.org ardell.simmons @montgomerycountymd.gov mark.hodge@montgomerycountymd.gov mholmes@thegrantgroup-llc.com eholt@betah.com ahouston@hrsa.gov
susan.huang@montgomerycountymd.gov huntercleaningservices@hotmail.com
katie.hykes@waldenu.edu evonne.nwankwo@gmail.com
2012 Annual Conference Proceedings Page 39
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Isaac
Pat
Silberstein Insurance Group
pat@silbs.com
Jackson
Beverly A.
Washington Adventist Hospital
bev_j@comcast.net
Jackson, RN,BS
Saundra G.
The African American Health Program
saundra.jackson @montgomerycountymd.gov
Jacques
Danielle
Montgomery County Government
danielle.jacques @montgomerycountymd.gov
James, Mrs.
Terrie F.
Montgomery Hospice
Jenkins, RN
Rosa M.
Montgomery County Government
rosa.jenkins@montgomerycountymd.gov
Jenkins, RN
Rosa M.
Montgomery County Government
rosa.jenkins@montgomerycountymd.gov
Jepson
Robert
Adventist HealthCare
rjepson@adventisthealthcare.com
Jones
Susana
Adventist Rehabilitation Hospital of Maryland
Joseph III, MD MP
Malcolm N.
CareFirst BlueCross BlueShield
Jurlano, RN
Maria C.
Washington Adventist Hospital
Kayode
Xerxeser
African American Health Program
Kelly
Ariana
MD General Assembly
Kersmarki
Maureen S.
Adventist Health System
Kessel, MD, M
Woodie
Dartmouth
Kettleman
Maggie
Adventist HealthCare
mkettlem@adventisthealthcare.com
Khuc
Nikko
Adventist HealthCare
tkhuc@adventisthealthcare.com
Kick, MSPH
Sandy E.
Maryland Women's Coalition for Health Care Reform
Kronz
Leslie
Inova Health System
leslie.kronz@inova.org
Laird, RN
Aurelia
Bon Secours Baltimore Health System
aurelia_laird@bshsi.org
Lam
Betty
Montgomery County Govt Dept of Health & Human Serv
betty.lam@montgomerycountymd.gov
Lambert, MD
Carla J.
People's Community Wellness Center
Lazo
Reina
Adventist HealthCare
tjamestaylor@montgomeryhospice.org
sjones5@ahm.com malcolm.josephmd@carefirst.com mjurlano@ahm.com xerxeser.kayode @montgomerycountymd.gov ariana.kelly@house.state.md.us maureen.kersmarki@ahss.org wkessel@gmail.com
sandy@mdchcr.org
clammd@yahoo.com rlazo@adventisthealthcare.com
2012 Annual Conference Proceedings Page 40
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Lee
Daniel
Ad Astra, Inc.
Lee
James
Adventist HealthCare
LeggettJohnson, MD
Susan
Kaiser Permanente
Email daniel@ad-astrainc.com zdivecha@adventisthealthcare.com susan.leggett-johnson@kp.org
Lettlow, Dr.PH Helen
Montgomery County Health and Human Services
ardell.simmons @montgomerycountymd.gov
Liarakos
Sofia
Sinai Hospital of Baltimore
sliarako@lifebridgehealth.org
Lichty
Judy
Adventist HealthCare
Lord-Adem
Wilhelmina
Adventist HealthCare
Louis-Charles, RN
Myriam
Montgomery County DHHS
Lowet
Peter
MobileMed
Lynk, PhD
Marilyn
Adventist HealthCare
MaloneyKrichmar, Ph.D.
Diane
Sinai Hospital of Baltimore, Inc.
Manan
Mary
Adventist HealthCare
mmanan@adventisthealthcare.com
Manisundaram
Arumani
Adventist HealthCare
inamuraa@gmail.com
Manisundaram
Lavell
Adventist HealthCare
inamuraa@gmail.com
Margot
Skip
Shady Grove Adventist Hospital
Marks
Danielle
Sinai Hospital of Baltimore
Martin, MPH
Eme
Adventist HealthCare
Martinez, M.A. Luis G.
MC Dept, of Health and Human Services
Mast
Angela M.
Inova Health System
Matheson
Rodney
Frederick Memorial Healthcare System
McFarland
Shakaya
BETAH Associates, Inc.
Melendez
Rose
Washington Adventist Hospital
Meltzer
Neil
Sinai Hospital of Baltimore
jlichty@ahm.com myriam.louis-charles @montgomerycountymd.gov plowet@mobilemedicalcare.org mlynk@adventisthealthcare.com dkrichma@lifebridgehealth.org
leden@adventisthealthcare.com
emartin2@ahm.com luis.martinez @montgomerycountymd.gov angela.mast@inova.org rmatheson@fmh.org smcfarland @healthybabieshealthyyou.org rmelende@ahm.com
2012 Annual Conference Proceedings Page 41
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Mittleman
Matthew
Delmarva Foundation
Montes, MPH
Henry
JHM Consultation
Moukouri
Chantal
Adventist HealthCare
Murphy
Valerie
Energy FCU
Nathan
Joy
BETAH Associates
Email mittlemanm@dfmc.org jhmon54@aol.com cmoukour@adventisthealthcare.com jnathan@betah.com
Nathan-Pulliam Shirley
MD General Assembly
shirley.nathan.pulliam @house.state.md.us
Newmeyer
Joyce
Washington Adventist Hospital
jnewmyer@adventisthealthcare.com
Nicholson
Paul
Washington Adventist Hospital
pnichols@adventisthealthcare.com
NielsenSwanson
Verbelee J.
Florida Hospital
Mittleman
Matthew
Delmarva Foundation
Montes, MPH
Henry
JHM Consultation
Moukouri
Chantal
Adventist HealthCare
Murphy
Valerie
Energy FCU
Nathan
Joy
BETAH Associates
verbelee.nielsen-swanson@flhosp.org mittlemanm@dfmc.org jhmon54@aol.com cmoukour@adventisthealthcare.com jnathan@betah.com
Nathan-Pulliam Shirley
MD General Assembly
shirley.nathan.pulliam @house.state.md.us
Newmeyer
Joyce
Washington Adventist Hospital
jnewmyer@adventisthealthcare.com
Nicholson
Paul
Washington Adventist Hospital
pnichols@adventisthealthcare.com
NielsenSwanson
Verbelee J.
Florida Hospital
Noll
Emily
Lifework Strategies
Nuguid
Pauline
Adventist HealthCare
Nwabukwu
Ify
African Women's Cancer Awareness
NwankwoIgomu
Amaka
O'Connor
Mary
Governor's Workforce Investment Board
Ogide-Alaeze
Theresa
Associated Health Resource Center, Inc
Oladimeji
Oluwatomi
Women's Cancer Control Program
verbelee.nielsen-swanson@flhosp.org enoll@lifeworkstrategies.com pnuguid@adventisthealthcare.com ify.awcaa@yahoo.com evonne.nwankwo@gmail.com moconnor@gwib.state.md.us ahrccare7@gmail.com tomi.oladimeji @montgomerycountymd.gov
2012 Annual Conference Proceedings Page 42
CONFERENCE ATTENDEES LIST Last Name Ottoviani
First Name Joe
Organization
Energy FCU
Owens, MD, M Steven
Directors of Health Promotion & Education
sowens@dhpe.org
Pangilinan, MBA,C
Caterina
Adventist Behavioral Health
Passmore
Susan R.
UMD Center for Health Equity
spassmor@umd.edu
Pauk, MPH,
Jennifer
Primary Care Coalition
jennifer_pauk @primarycarecoalition.org
Pavlin
Dick
Perez
Marta
Adventist HealthCare
Perry
LaVerne
The Leukemia & Lymphoma Society
Pesquera
Marcos
Adventist HealthCare
Pesquera, R.D.
Kinny M.
Kaiser Permanente
Petrova
Yelena
Ad Astra, Inc.
Pham
Huy
NIH Federal Credit Union
cpangili@adventisthealthcare.com
pav9@verizon.net mperez@ahm.com laverne.perry@LLS.org mpesquer@adventisthealthcare.com katharina.pesquera@kp.org lena@ad-astrainc.com
Philipsen, JD, P Nayna C.
Coppin State University
nphilipsen@coppin.edu
Portillo
Martin A.
Amerigroup Inc. (Maryland)
Portillo
Sonia
Holy Cross Hospital
portills@holycrosshealth.org
Preston
Leni
Maryland Women's Coalition for Health Care Reform
leni@mdchcr.org
Rafiq, MD
Shahid
Frederick Memorial Healthcare System
RAS6@fmh.org
Reinckens, RN
Tina
Coppin State University
jreinckens@coppin.edu
Reynolds, RN
Gina
Amerigroup, Maryland
reynoldsgd66@msn.com
Rios
Patricia
Suburban Hospital
Rios
Elizabeth
Adventist HealthCare
Robertson
Bill
Adventist HealthCare
Rodriguez
Cecily J.
Virginia Dept. of Behavioral Health and Development
rodriguezccia@yahoo.com
Ross
Samuel
Bon Secours Hospital
samuel_ross@bshsi.org
martin.portillo@amerigroup.com
prios@suburbanhospital.org erios@adventisthealthcare.com
2012 Annual Conference Proceedings Page 43
CONFERENCE ATTENDEES LIST Last Name
First Name
Organization
Salmon, RN, M
Michelle
Sinai Hospital of Baltimore
msalmon@lifebridgehealth.org
Satrom
Ken
Amerigroup
Scribner
Jacqueline
Coppin State University
8522jackie@comcast.net
Shim
Eunmee
Shady Grove Adventist Hospital
leden@adventisthealthcare.com
Simms
Ginny
Richard J. Princinsky & Associates, Inc.
gsimms@rjpassociates.com
Singleton
Knox
INOVA
Smith
Christopher
UM School of Pharmacy
Song
Samil
Universities at Shady Grove
Spackman
Christi L.
Silberstein Insurance Group
Spence
Weymouth
Washington Adventist University
St.Clair, RN, M
Arilma M.
NAHN DC Chapter
Stasiuk, DO
Christina A.
Cigna
Stewart
Mark
Delmarva Foundation
Stutz
Ben
Lt. Governor Anthony Brown's Office
Suarez
Rhea
Adventist HealthCare
rsuarez@adventisthealthcare.com
Swanson
Christy
Washington Adventist Hospital
cswanso2@ahm.com
Sweeney
Thomas
Washington Adventist Hospital
tsweeney@adventisthealthcare.com
Talavera
Melina I.
Adventist HealthCare
mtalaver@ahm.com
Taylor
Michelle
BETAH Associates, Inc
mtaylor@betah.com
Taylor, MD
Duane J.
Montgomery County Medical Society
Taylor, MSW
Diane H.
Prince George's County Health Department
Teal, MD
Cydney T.
Union Hospital of Cecil County
Thomas, PhD
Stephen B.
UMD Center for Health Equity
Tillman, MD, M
Ulder J.
MC DHHS
ken.satrom@amerigroup.com
christo9@umaryland.edu cspackman@silbs.com wspence@wau.edu arilmapanama@hotmail.com castas@cigna.com stewartm@dfmc.org ben.stutz@maryland.gov
levisagemd@onebox.com dhtaylor@co.pg.md.us cteal@uhcc.com sbt@umd.edu ulder.tillman @montgomerycountymd.gov
2012 Annual Conference Proceedings Page 44
CONFERENCE ATTENDEES LIST Last Name Townsend
First Name Crystal
Organization Healthcare Initiative Foundation
Email crystal.townsend@hifmc.org
Triantis, RN, M Maria
Delmarva Foundation
triantism@dfmc.org
Uchegbu, MA, M
Gloria C.
Epilepsy Foundation
guchegbu@efa.org
Vazquez, MS
Maria J.
HOC/ Consultant
Vo
Anh
Montgomery County HHS
Wadhwani, Ph.D
Kishena
Agency for Healthcare and Research Quality
kishena.wadhwani@ahrq.hhs.gov
Wagner, MD
Randall
Washington Adventist Hospital
rwagner@adventisthealthcare.com
Washington, PhD
Deidre V.
Adventist HealthCare
dwashin2@adventisthealthcare.com
Watson
Jeff
Practice Dynamics, Inc.
Wheeler, MPA
Tawana l.
The People's Community Wellness Center
Widerlite
Paula S.
Adventist HealthCare
Williams
Rod
INOVA
Wilmer
Roger
Frederick Memorial Healthcare System
stjames1811ame@hotmail.com
Wilson, MA, M Cheri
Hopkins Center for Health Disparities Solutions
chwilson@jhsph.edu
Wong
Jeremy
Adventist HealthCare
Wong, MD
Arturo
Young
Kevin
Adventist Behavioral Health
Zaghab
Roxanne
UM School of Pharmacy
rzaghab@rx.umaryland.edu
Zalewski
Sharon J.
Primary Care Coalition of Montgomery County
sharon_zalewski @primarycarecoalition.org
vazquez51@verizon.net anh.vo@montgomerycountymd.gov
jwatson@lifebridgehealth.org twheeler_tpcwc@tpcbc.org pwiderli@ahm.com rod.williams@inova.org
wongjeremy1@gmail.com awong31@hotmail.com kyoung7@ahm.com
Please contact us: Center on Health Disparities 820 W. Diamond Avenue Suite 400 Gaithersburg, MD 20878 Phone: 301.315.3677 Fax: 301.315.3135
Learn more on the web: www.adventisthealthcare.com/disparities Friend us on Facebook: http://www.facebook.com/HealthDisparities
820 West Diamond Avenue ● Suite 400 ● Gaithersburg, MD 20878 Phone: 301.315.3677 ● Fax: 301.315.3135