Center for Elimination of Disproportionality and Disparities

Center for Elimination of Disproportionality and Disparities

Joyce James

Associate Deputy Executive Commissioner

Sheila Sturgis Craig

Disproportionality and Disparities Project Manager

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Mission

To partner with Health and Human Service Commission agencies and external stakeholders to identify and eliminate disproportionality and disparities

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What is Disproportionality and Disparity?

• Disproportionality is the overrepresentation of particular group or race in a system compared to their representation in the general population.

• Disparity is the unequal or different treatment or services provided to one group as compared to another group. It is how one is treated or the types, quantity , quality, of services made available.

• Health disparities are often referred to as the disproportionate burden of disease, illness and mortality associated with personal characteristics, such as race, ethnicity, age and gender. Other characteristics that are also associated with adverse health conditions and contribute to health disparities may include financial circumstances or place of residence, functional or developmental status, and sexual orientation.

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Activity

Dot Exercise

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History, Foundation, and Expansion of the Work

Project Hope:Project Hope:

Began in May 2002

Community Vision, Mission and Goals • Community focused, data-driven• Maximizing and improving existing services• Identifying gaps• Current Status

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Legislation 2005• In January 2005, the 79th Texas Legislature passed

Senate Bill 6. The bill ordered a thorough investigation of disproportionality in child welfare. • Texas Health & Human Services Commission, along with the

Department of Family & Protective Services, released data confirming the existence of disproportionality.

• A second report evaluated the policies of CPS and described plans to address disparities found in the system.

• A State Leadership planning meeting was held, followed by Regional Planning Meetings in the 5 sites with the highest rates of disproportionality, including Houston as the first region! Those meetings resulted in the formation of Regional Advisory Committees comprised of local community leaders, other child and family serving systems, and Texas State Strategy members.

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Legislation 2007 Statewide Expansion

• In September 2007 the 80th Texas Legislature passed Senate Bill 758 Allowed for expansion of Disproportionality Work in Texas Statewide.

• Disproportionality advisory committees are currently located in all 11 Texas Regions and 13 Disproportionality Specialists have been hired for each region with a State Manager and Specialist at the state office level reporting to CPS Assistant Commissioner.

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Establishment of CEDD

• This work has laid the foundation for expansion and continued system improvement within HHSC and other systems serving vulnerable citizens.

• The creation of the new Center by Executive Commissioner Tom Suehs exemplifies the Health and Human Services Commission’s commitment of leadership at the highest level of HHSC – unprecedented across other states and jurisdictions, elevating Texas as the national leader in addressing disproportionality and disparities.

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Legislation 2011 Further Statewide Expansion

• Senate Bill 501 Establishes in Law an Interagency Council (IC) lead by Joyce James in the Center. The IC will identify and examine disproportionality in Child Welfare, Education and Juvenile Justice, review and analyze statistics, research findings, service delivery methodologies, best practices and provider training curricula. It will also issue reports on their findings, monitor agencies progress in eliminating health and health access disparities, provide information on unmet service needs and help develop resources for eliminating disparities.

• requires all HHS agencies and TEA, Juvenile Justice, Criminal Justice, health and mental health,

• The bill amends the Health and Safety Code to remove references in provisions of law relating to an office for the elimination of health disparities within HHSC to refer instead to the center for elimination of disproportionality and disparities.

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SB501 Partners• HHSC, CEDD, DADS, DARS, DSHS, DFPS• Juvenile Justice• Texas Education Association (TEA)• Office of Court Administration (OCA)• Texas Judicial System• Office of Attorney General (OAG)• Permanent Judicial Commission for Children, Youth and

Families• Community Based Rep• Faith-Based Rep• Foster Care Youth Alumni• Medical Community Reps

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Texas Child Welfare Data 2010

 African

American Anglo Hispanic Other Native American

Population 12.2% 36.9% 47.2% 3.5% 0.2%

Alleged Victims 21.2% 31.4% 43.0% 4.1% 0.2%

Confirmed Victims 21.1% 31.5% 43.7% 3.5% 0.2%

Children Removed 27.9% 31.4% 37.5% 2.8% 0.3%

Children Awaiting Adoption at the End of the Year 35.3% 25.2% 37.6% 1.7% 0.2%

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Texas Cross Systems Data

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Texas Deaths by Race/Ethnicity

Chart 2a: Deaths by race/ethnicity for top ten leading causes for Texas, 2005

5 30 55 80 105 130 155 180 205 230 255 280 305

Septicemia

Nephritis, Nephrotic Syndrome,Nephrosis Kidney disease)

Influenza and Pneumonia

Diabetes Mellitus

Alzheimer's Disease

Accidents (Injuries)

Chronic Lower RespiratoryDiseases

Cerebrovascular Disease (Stroke)

Malignant Neoplasms (Cancer)

Diseases of the Heart

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se o

f D

eath

Age-adjusted death rates per 100,000 population

White* African Am Hispanic

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Texas Preterm birth rates by mother's race, 2005

Premature births are important contributing factors to low birth weight and infant mortality.

129.3

187.8

134.0

116.6

137.5

6070

80

90

100

110

120

130

140150

160

170180

190

White African Am Hispanic Other Total

Mother's race/ethnicity

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er 1

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birt

hs

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HIV Data for Youth 11-17 year old

Chart 10a: 2007 HIV infection rates for Texas adolescents (11-17)

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7.1

1.41.9

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2

3

4

5

6

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White African Am Hispanic Total

Race/ethnicity

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Activity

Why Are People Poor?

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The Texas Model

• Data Driven Strategies• Leadership Development • Cultural Competent Workforce• Community Engagement• Cross Systems Collaborations• Training Defined by Anti-Racist Principles• An Understanding of the History of Institutional

Racism and the Impact on Poor Communities and Communities of Color

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History of Institutionalized Racism

• Impact on Poor Communities

• An Analysis of Power

• Race: The Power of an Illusion-

Episode Three

“The House We Live In”

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Internalized Racial Oppression

Internalized Racial Inferiority•Denial•Mimicking•Distancing•Colorism•Protectionism•Exaggerated Visibility•Ethnocentrism

Internalized Racial Superiority•Individualism•Distancing•Right to Comfort•Paternalism•Minimalize•Denial•Arrogance

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Video

“A Girl Like Me”

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Partners

• Casey Family Programs• State Taskforce on Disproportionality• Health Disparities Taskforce• Universities• Supreme Court Judicial Commission• Court Appointed Special Advocates (CASA)• Texas Juvenile Probation Commission (TJPC)• Texas Center for the Judiciary• Regional Disproportionality Advisory

CommitteesJoyce

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Center for Elimination of Disproportionality and Disparities

Success is dependent on mutual accountability at every level across every system, so that the end result is elimination of disproportionality

and disparities.

Joyce

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Contact Information

Joyce JamesAssociate Deputy Executive Commissioner,Center for Elimination of Disproportionality and [email protected](512) 487-3396

Sheila Sturgis CraigDisproportionality and Disparities Project Manager, Center for Elimination of Disproportionality and [email protected](512) 487-3359

Linda WrightCommunity ActivistFort Worth, [email protected]