The Issue
People with disabilities nationally encounter more difficulty accessing health care and receiving preventive services than their counterparts without disabilities, even though they have greater health needs due to their chronic diseases and secondary health conditions.
It’s no different in Delaware. Delawareans with disabilities experience significant gaps when it comes to obtaining screenings, receiving routine care, learning about public health promotions and in their health outcomes compared to people without disabilities. Because one’s health can affect chances of reaching one’s potential – in education, in employment, in the community – we need to eliminate disparities in access to care and in health outcomes. The quality of our lives depends on it.
The Assessment
Before setting about the work of eliminating health disparities in Delaware, CDS had to identify the disparities. That assessment came in January 2015, with CDS’s release of The Current Landscape for Disability and Health in Delaware.
Drawing on national and state health surveys and Medicaid claims data, the report, made possible by a grant from the Centers for Disease Control and Prevention and the National Center on Birth Defects and Developmental Disabilities, found troubling gaps. Respondents reported inaccessible doctors’ offices that “cannot … accommodate people in wheelchairs;” health care professionals who often speak with an aide “instead of asking [the patient]”; and an office that can’t perform a pap smear because a patient “cannot get on the table.”
The Plan
To alter the landscape, CDS, the Delaware Department of Health and Social Services and a diverse contingent of 60 advocates and experts from throughout the state developed (with funding from the Centers for Disease Control and Prevention) The Plan to Achieve Health Equity for Delawareans with Disabilities.
Its goals – strengthening Delaware’s capacity to promote health equity, achieving compliance with civil rights laws and regulations protecting people with disabilities, and creating a culture that’s conducive to achieving health equity – are accompanied by 88 tactical steps meant to scale them. The steps span requiring the use of accessible medical equipment in medical settings, promoting the inclusion of assistive technology in covered insurance services, and identifying professional resources to conduct home and facility accessibility assessments.
Implementation
Upon the release of the Plan to Achieve Health Equity in 2015, then DHSS Secretary Rita Landgraf announced she was making health equity for people with disabilities “a department-level priority.” To that end, with an assist from CDS, DHSS launched an inclusion policy meant to raise consciousness about disability among DHSS staff and vendors. It calls for increasing trainings and accommodations, incorporating a requirement to address vulnerable populations into Request for Proposal language, and collecting disability statistics to quantify the success of the policy in addressing health equity.
CDS is also helping implement the Plan by cultivating and developing disability cultural competency among dental professionals, and educating state and community stakeholders and the public on the imperative to close the health disparities gap.