AGENDA ITEM #5
March 1,2011
Action
MEMORANDUM
February 25, 2011
TO:
FROM:
County Council
A.manda
Mi~ill, Legi~lative ~nal'yst#.(.k}..
:D11i
V
Lmda McMIllan, Semor LegIslative
Analyst~\J.,'))
,
~JJY
SUBJECT:
Action:
Bill 1-11, Administration - Department of Health and Human Services
Duties
Health and Human Services Committee recommendation (3-0):
enact Bill 1-11 with the
following amendments:
• broaden the language of the health policy statement to reflect County policy of
providing services to County residents (see page 3); and
• add language to the health policy statement to reflect that health planning should
address the effects of social determinants of health on County residents (see page
4).
Bill 1-11, Administration Department of Health and Human Services - Duties, sponsored by
Councilmembers Leventhal, Navarro, and Rice, was introduced on January 18, 2011. A public
hearing was held on February 8 at which 3 speakers testified in support of Bill 1-11 (see
testimony beginning on
©9).
The County Executive generally supports Bill 1-11
(©7).
A
Health and Human Services Committee worksession was held on February 17.
As introduced, Bill 1-11 would:
• authorize the Department of Health and Human Services to provide direct access
to health care;
• authorize the Department to administer programs to reduce disparities in access to
health care, preventative health services, and human services based on gender,
race, ethnicity, and poverty;
• authorize the Department to provide health education and promotion programs;
• amend the functions of the Commission on Health; and
• generally amend the law regarding health and human services and health and
sanitation.
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Background
The 2009 US Census American Community Survey estimates that approximately 110,000 county
residents do not have health insurance that would provide a regular source of primary care. In
FYlO, the Montgomery Cares safety net clinics saw over 26,000 adult uninsured patients, a 25%
increase over the number of patients seen in FY09. A majority of those receiving care were aged 40
to 64 and 65% were women. Over half identified themselves as Hispanic.
A lack of a primary care medical home can cause people to seek medical care in emergency rooms
for conditions that can be treated in a much less costly setting. In FYI0, 3,052 low income
uninsured or Medicaid insured patients were referred from Montgomery County hospital emergency
rooms to community clinics through the Primary Care Coalition's Emergency Room Diversion
project.
In FYlO, the Care for Kids Program provided 5,000 primary care visits and 3,224 routine dental
visits to 3,366 children who are not eligible for Maryland's Children's Health Insurance Program.
Almost one-half of these children were from families with incomes below 100% of the Federal
Poverty Level ($22,050 for a family of 4).
There are disparities in access to health care and preventive health services, including health
education and promotion, and they can adversely impact health conditions among races and ethnic
groups in Montgomery County. For example, the 2009 infant mortality rate for Black babies was
10.7 per 1,000 births compared to 3.9 for Whites and 5.5 for all races. The African American
Health Program's 2009 Strategic Plan notes that 7.6% of Black residents in the county report having
been diagnosed with diabetes compared to 5.5% for the general population; Blacks comprise over
72% of all county AIDS cases; and, Black women are less likely to be diagnosed with breast cancer
but are more likely to die from it than Whites. In its 2008 health priorities report, the Asian
American Health Initiative noted that Asian Americans have a 60% higher prevalence of diabetes
compared
to
non-Hispanic Whites and that Asian Americans and Pacific Islanders account for over
one-half the chronic Hepatitis B cases and deaths from Hepatitis B in the United States. In 2008,
the Latino Health Initiative reported in its Blueprint that in Maryland in 2005, Latinos had 1.6 times
as many new HIV diagnoses as non-Hispanic vvnites; that diabetic and hypertensive end-stage renal
failure was significantly higher than for non-Latino Whites; and that the rate of obesity is a growing
problem for Latinos. All three Minority Health Initiatives have called for improved data and
research on the social determinants of health and increased access to culturally competent health
care and preventive health services.
Issues/Committee Recommendations
1. How specific should the authorization he?
Bill 1-11 would authorize the Department to
provide direct access to health care; administer programs to reduce disparities in access to health
care, preventive health services, and human services based on gender, race, ethnicity, and poverty;
and provide health education and promotion programs (©2, lines 12-16). Arva Jackson, on behalf
of the African American Health Program, urged the Council to include certain specific requirements
in Bill 1-11, including providing certain needs assessments and standards of performance (©9-1 0).
2
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These are certainly important considerations and the Committee considered these suggestions.
However, the
Committee recommended
(3-0) against adding these types of specifics to the
authorizing legislation. Council staff noted that the Committee or the Council can discuss with the
Department how this oversight and evaluation might be provided through the Health
Montgomery (community health improvement process) effort that is noted by the Executive
(©7). Will there be data points that can be used to determine whether programs provided
through the Department and other health care partners are impacting trends in areas such as
infant mortality, death rates from coronary disease or cancer, or the prevalence of Hepatitis B?
Is there the expectation that there will be some type of annual reporting to the Executive and
Council by Health Montgomery to discuss trends in healthcare? Will Healthy Montgomery in
coordination with the work of existing groups such as the Commission on Health, African
American Health Program, Asian American Health Initiative, and Latino Health Initiative
provide the type of oversight and accountability Ms. Jackson suggests?
2. Should the bill including language about appropriate funding levels?
Ms. Jackson urged
the Council to include language in Bill 1-11 requiring appropriate funding for the programs that Bill
1-11 would authorize the Department to provide (© 10).
The Committee did not recommend
amending Bill 1-11 as suggested. Council staff noted that the County has many important programs
that serve County residents and the Council makes funding decisions for all of these programs
during the annual budget process.
3. Technical amendments.
A.
Minority Health Initiatives.
Bill 1-11 would state that the Department provides staff
support to "any program created to achieve health equity among County residents" (©3, lines 36­
37). Grace Rivera-Oven, on behalf of the Latino Health Steering Committee, and Harry Kwon, on
behalf of the Asian American Health Initiative Steering Committee, urged the Council to
specifically mention the minority health initiatives in this section (©11, 28). Council staff interprets
the phrase "any program created to achieve health equity" to include the minority health initiatives,
but prepared the following amendment for the Committee to consider if members preferred to
specifically mention minority health initiatives:
.ilil
any program created to achieve health equity among County residents..
including any minority health initiative established
und~r
paragraph
(£).
After serious seriously considering this proposal,
the Committee recommended
(3-0) against
including language specifically referencing the minority health initiatives. Committee members
were concerned that access to health care is important for all residents and that the focus of the
Department's efforts should be on reducing health care disparities. Uma Ahluwalia, Director of
the Department, concurred that the bill should not be amended as requested.
3
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B. County residents v. citizenry.
The current language of Code §24-22, Policy, states
(©3, lines 39-48):
It
is the policy of Montgomery County to protect and promote the public health
and safety and general welfare by fostering the development of a health care
system that provides for all citizens, financial and geographic access to quality
health care at a reasonable cost. To accomplish this purpose it is essential that
plans for maintaining the health of the citizenry and developing health services to
meet the current and future health needs of the citizens of the county be prepared,
programs to implement these plans be developed and executed, and proposed
developments or alterations of health services be publicly reviewed and
commented upon.
Ms. Rivera-Oven suggested this language
be
modified to substitute the words "citizenry" and
"citizen" with broader language (©11). The Committee concurred with Ms. Rivera-Oven. Ms.
Ahluwalia noted that the Department already uses the word "resident" in its health materials.
The
Committee recommended (3·0)
the following amendment (©3, lines 39-53):
It
is the policy of Montgomery County to protect and promote the public health
and safety and general welfare by fostering the development of a health care
system that provides [[for all citizens,]] financial and geographic access to quality
health care at a reasonable cost for all County residents. To accomplish this
purpose~
it is essential that plans for maintaining the health of [[the citizenry]]
Collnty residents and developing health services to meet the current and future
health needs of [[the citizens of the county]] County residents be prepared,
programs to implement these plans be developed and executed, and proposed
developments or alterations of health services be publicly reviewed and
commented [[upon]]
C. Health Policy. Bill 1-11
would add the following sentence to §24-22:
Health planning should address the overall health status of County
residents and health disparities within social, economic. geographic, racial
and ethnic groups.
Ms. Rivera-Oven suggested adding the phrase "effects of the social determinants" to this section
(©12).
The Committee recommended
the following amendment (©3, lines 49-53):
Health planning should address the overall health status of County
residents,! [[and]] health disparities within social, economic, geographic,
racial and ethnic groups. and the effects of social determinants ofhealth
on County residents.
D. Direct access to health care. Bill 1-11
would authorize the Department to "provide
direct access to health care" (©2, line 12). The Council received a comment from Carol Garvey
suggesting that the word "provide" be changed to the word "assure" (©27).
The Committee
4
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recommended
(3~O)
retammg the word "provide" because
it
is an appropriate word that
encompasses all of the ways the Department provides direct access, including the
County~staffed
clinic in Silver Spring and administering direct access to care through contracts (Le., Montgomery
Cares).
E. Cultural and Linguistic Competence. After the Committee worksession on Bill 1
~
11,
members were made aware of a letter the Council received from Harry
K
won on behalf of the Asian
American Health Initiative urging the Council to amend Bill
1~11
to describe the Department's
programs as "culturally and linguistically competent"
(©28).
If
the Council is interested in
adding this language, Council staff suggests adding it to the Health Policy statement rather
than the Department's duties. Council staff has drafted the following amendment for the
Council's consideration:
It
is the policy of Montgomery County to protect and promote the public health
and safety and general welfare by fostering the development of a health care
system that provides [[for all citizens,)) financial and geographic access to quality
culturally and linguisti9alIy competent health care at a reasonable cost
~~
County residents. To accomplish this purpose! it is essential that plans for
maintaining the health of [[the citizenry]] County residents and developing health
services to meet the current and future health needs of [[the citizens of the
county]] County residents be prepared, programs to implement these plans be
developed and executed, and proposed developments or alterations of health
services be publicly reviewed and commented [[upon]] on.
Committee recommendation
The Committee recommended
(3~O)
approval
ofBilll~ll
with the following changes:
• broaden the language of the health policy statement to reflect County policy of providing
services to County residents; and
• add language to the health policy statement to reflect that health planning should address
the effects of social determinants of health on County residents.
This packet contains:
Bil11-11
Legislative Request Report
Fiscal Impact Statement
Letter from County Executive
Select Written Correspondence
African American Health Program
Latino Health Steering Committee
Human Rights Commission
Carol Garvey
Asian American Health Initiative Steering Committee
Circle
1
5
6
7
9
11
13
27
28
F:\LAW\BILLS\IIOI - DHHS-Duties\Action Memo.Doc
5
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Bill No.
1-11
Concerning: Administration
Department of Health and Human
Services - Duties
Revised:
2/23/2011
Draft No. 5
Introduced:
January 18, 2011
Expires:
July 18, 2012
Enacted: _ _ _ _ _ _ _ _ __
Executive: _ _ _ _ _ _ _ __
Effective: _ _ _ _ _ _ _ _ __
Sunset Date:
--!...!.No>:<.:n..:.:::e~
_ _ _ _ __
Ch. _ _, Laws of Mont. Co. _ __
COUNTY COUNCIL
FOR MONTGOMERY COUNTY, MARYLAND
By: Councilmembers Leventhal, Navarro, and Rice
AN
ACT to:
(1)
(2)
(3)
(4)
'(5)
authorize the Department of Health and Human Services to provide direct access to
health care;
authorize the Department to administer programs to reduce disparities in access to
health care, preventative health services, and human services;
authorize the Department to provide health education and promotion programs;
amend the functions of the Commission on Health; and
generally amend the law regarding health and human services and health and
sanitation.
By amending
Montgomery County Code
Chapter 2, Administration
Section 2-42A
Chapter 24, Health and Sanitation
Sections 24-22 and 24-24
Boldface
Underlining
[Single boldface brackets]
Double underlining
[[Double boldface brackets]]
1t
1t
1t
Heading or defined term.
Added to existing law by original bill.
Deletedfrom existing law by original bill.
Added by amendment.
Deletedfrom existing law or the bill by amendment.
Existing law unaffected by bill.
The County Council for Montgomery County, Maryland approves the following Act:
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BILL
No. 1-11
1
Sec.
1.
Sections 2-42A, 24-22, and 24-24 are amended as follows:
Division 7A. Department of Health and Human Services.
2-42A. Functions, powers, and duties.
2
3
4
*
(c)
*
*
5
6
Powers ofthe Department.
The Department may:
*
(4)
*
*
7
8
collect data on the health status of County residents, including
health disparities and inequities, and on the need for services and
the effectiveness ofprograms;
9
10
11
*
*
*
(15) conduct studies and investigations; [and]
(16) provide direct access to health care;
12
13
Ql}
administer programs to reduce disparities in access to health care,
preventive health services, and human services based on gender,
race, ethnicity, and poverty;
@
14
15
16
17
provide health education and promotion programs; and
carry out any other functions that are necessary to achieve the
purposes of this Section.
Q.2)
18
19
(
d)
Duties ofthe Department.
20
*
(3)
*
*
21
The Department provides staff support to [the]:
(A) the Commission on Children and Youth;
(B) the Commission on Aging;
(C) the Community Action Committee;
(D) the Commission on Child Care;
(E) the Commission on People with Disabilities;
(F) the Alcohol and Other Drug Abuse Advisory Council.
22
23
24
25
26
27
(2)
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BILL No. 1-11
28
29
(G)
(H)
(I)
(1)
the Mental Health Advisory Council.
the Juvenile Court Committee;
the Commission on Health;
the Board of Social Services;
the Adult Public Guardianship Review Board; [and]
the Victim Services Advisory
Board~
the Advisory Board for the Montgomery Cares Program;
and
30
31
32
33
34
35
36
(K)
(L)
eM)
llil
24-22. Policy.
(a)
any program created to achieve health equity among
County residents.
37
38
39
40
It
is the policy of Montgomery County to protect and promote the
public health and safety and general welfare by fostering the
development of a health care system that provides [[for all citizens,]]
financial and geographic access to quality health care at a reasonable
cost for all County residents. To accomplish this purpose,\\ it is essential
that plans for maintaining the health of [[the citizenry]] County
residents and developing health services to meet the current and future
health needs of [[the citizens of the county]] County l.'esidents be
prepared, programs to implement these plans be developed and
executed, and proposed developments or alterations of health services
be publicly reviewed and commented ([upon]]
Health planning
41
42
43
44
45
46
47
48
49
50
51
should address the overall health status of County residents.. [[and]]
health disparities within social, economic, geographic, racial and ethnic
groups. and the effects of social determinants of health on County
residents.
52
53
54
*
*
*
f:\law\bills\1101 - dhhs-duties\biIl5 (committee).doc
o
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BILL
No.
1-11
55
56
57
24-24. Functions.
(a)
To advise the County Executive and the County Council, the
Commission must:
(1)
Periodically reVIew available County public health programs,
services, and facilities and data on the health status of the County
population and subgroups within it;
(2)
Comment on gaps, deficiencies, or duplication in County public
health programs, services, and facilities.2 including health status
disparities and inequities;
58
59
60
61
62
63
64
*
(5)
*
*
65
Advise on local public health planning needs based on health
status data;
66
67
*
Approved:
*
*
68
69
Valerie Ervin, President, County Council
Date
70
Approved:
71
Isiah Leggett, County Executive
Date
72
73
This is a correct copy ofCouncil action.
Linda M. Lauer, Clerk of the Council
Date
G
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dhhs-duties\biIiS (committee).doc
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LEGISLATIVE REQUEST REPORT
Administration
DESCRIPTION:
Bill 1-11
Department of Health and Human Services - Duties
Bill 1-11 would authorize the Department of Health and Human
Services to provide direct access to health care; authorize the
Department to administer programs to reduce disparities in access to
health care, preventative health services, and human services based
on gender, race, ethnicity, and poverty; authorize the Department to
provide health education and promotion programs; amend the
functions of the Commission on Health; and generally amend the law
regarding health and human services and health and sanitation.
The 2009 US Census American Community Survey estimates that
approximately 110,000 county residents do not have health insurance
that would provide a regular source of primary care. A lack of a
primary care medical home can cause people to seek medical care in
emergency rooms for conditions that can be treated in a much less
costly setting.
To authorize the Department to provide direct access to health care,
administer programs to reduce disparities in access to health care, and
provide health education and promotion programs
Department of Health and Human Services, Commission on Health
To be requested.
To be requested.
To be requested.
To be researched.
Amanda Mihill, Legislative Analyst, 240-777-7815
To be researched.
PROBLEM:
GOALS AND
OBJECTIVES:
COORDINATION:
FISCAL IMP ACT:
ECONOMIC
IMPACT:
EVALUATION:
EXPERIENCE
ELSEWHERE:
SOURCE OF
INFORMATION:
APPLICATION
WITHIN
MUNICIPALITIES:
PENALTIES:
N/A
@
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t-.lA~
c..C
S~f
1.-1.-
ZUlI fEB -8 PM 4:
26
OFFICE OF MANAGEMENT AND BUDGET
Isiah Leggett
County Executive
j
A\1
~;:
RE~~IVEO N1'P~
F. Beach
HmUGOMc.RY
COU
DIrector
"'ntj'~'I"I\
1
.,1..
Mv-
~\)
MEMORANDUM
February 8,2011
TO:
060478
Valerie
~.V
ident,j::ounty Council
Joseph F.
B~~ector
Council
FROM:
SUBJECT:
Biu\01,
Administration - Department ofHealth and Human Services - Duties
The purpose ofthis memorandum is to transmit a fiscal and economic impact statement
to the Council on the subject legislation.
.
LEGISLATION SUMMARY
I
Council Bi1l1-11 would amend Montgomery County Code; Chapter
2,
Administration; Section 2-42A;
Chapter 24, Health and Sanitation, and Sections 24-22 and 24-24
as
follows:
.
• Authorize the Department of Health and Human Services (DRHS) to provide direct
access
to health
care;
• Authorize the DRHS to administer programs to reduce disparities in access to health care, preventative
health services, and human services based on gender, race, ethnicity, and poverty;
• Authorize the DHHS to provide health education and promotion programs;
• Amend the duties ofthe DRHS to provide staff support to the Advisory Board for the Montgomery
Cares Program and any progra:D?- created to achieve health equity among County Residents;
• Amend the functions of the Commission on Heath; and
• Generally amend the law regarding health and human services and health and sanitation.
FISCAL
Ai'ID
ECONOMIC SUMMARY
The subject legislation would not have a direct fiscal impact because it authorizes the
Department to take certain actions, but does not mandate either
that
the services be provided or specify
the level or value ofthe services to be provided. However, the department is already carrying out the
health services authorized in the proposed legislation including providing direct access to health care;
administering programs to reduce disparities
in
access
to
health care, and providing health education and
promotion programs. The
FYll
budgeted cost ofthe County's Public Health programs is
$67.5
million.
This
does not include
the
resources for behavioral health programs.
One ofthe goals ofBill
1-11
is to allow the DRHS
.to
continue to address health
disparities among specific populations
in
the County. Included among the Department's goals are
reductions
in
the incidence of asthma, hepatitis, and infant mortality. While some ofthe disparities may
have economic impacts on the ''targeted'' population and the County as a whole, these impacts are
qualitative. However, with regard to reducing the level of infant mortality, the direct economic impact
is
to ensure the life expectancy of an infant.
As
such, the increase in
an
infant's life expectancy
will
most
likely add to
the
County's total
personal
income
as
that infant achieves a productive and healthy life.
Office of the
Director
101
Momoe
J4th
Floor' Rockville,
20850 • 240-777-2800
w-ww.rnoutgomerycollntymd.goy
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OFflCEOFTHECOUNTYEXECUT~
Isiah Leggett
County Executive
IlOCKVILLE, MARYLAND
208S0
MEMORANDUM
February 10, 2011
TO:
Valerie Ervin, President
Montgomery County Council
Isiah Leggett, County Executiv''''------­
Bill 1-11, Administration-Department of Health and Human Services-Duties
FROM:
SUBJECT:
I am writing to express my support for Bill 1-11, Administration - Department of
Health and Human Services - Duties, which reflects our joint commitment to identifying and
eliminating health disparities and evaluating social determinants that impact health outcomes
among County residents. The bill is a strong affirmation of the County's determmation to
address these disparities and outcomes.
Bil1I-ii authorizes the Department of Health and Human Services (DHHS) to
administer programs that provide direct access to health care and reduce health disparities. With
the support of the Council, we are already working with our non-profit partners to provide
primary care to uninsured adults and children who live in the County. The recipients of that care
are overwhelmingly poor and members ofminority groups. Bil1I-ii recognizes the importanc,e
ofthat work in reducing health disparities.
In
fact, the largest compleIi:J.ent ofDHHS programs
serve vulnerable and needy residents of our County who disproportionately represent minority
populations defined by race, ethnicity, disability, age, or gender.
There
is
widespread recognition that significant disparities exist among various
elements of our population in health status and access to health care and human services. We
cannot design programs to combat disparities unless we can identify where the disparities exist
and the magnitude of those disparities.
To meet that challenge DHHS developed Healthy Montgomery, which is a
community health improvement process that is designed to improve the health and well being of
all County residents. A critical component of that program is the newly launched website that
provides a one-stop source ofpopulation-based data and information about community health
and the wide range of determinants that impact health such as socio-economic status, social
isolation, disabilities, housing, availability ofhealthy foods, and: air quality. My goal is that this
valuable resource will enable policymakers and DHHS to identify health disparities and social
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Valerie
Ervin.
President
February 10.2011
Page 2
detemrinants that impact population subgroups and to make optimal use of available resources to
reduce those disparities. This resource will assist the Commission on Health in meeting the bill's
charge of reviewing data and commenting on the health statUs o.f population subgroups in the
County.
I want to emphasize that I do not support any mo.dification to the bill which would
require the Commission on Health to gather any data beyond wRat is readily available. The
demand for 'staff and other resource support grows with each new responsibility and we must
avoid adding to the Commission's workload.
In
addition, while, I applaud the intentions ofthe
bill's sponsors. and support it as drafted, we must be careful not to create the expectation that the
County is obligated to fu.nd specific programs regardless of our fiscal situation.
cc:
Uma S. Ahluwalia, Director, DHHS
Kathleen Boucher. Assistant ChiefAdministrative Officer
®
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Testimony:
Tuesday February
8,
20ll-Public Hearing 1:30pm
Montgomery County Council Office -Building
Rockville, MD 20850
Introduction
Thank you for the chance to share observations and recommendations regarding Bill
1-11
on behalf of the Montgomery County Maryland's African American Health Program
Executive Committee (AAHPEC). My name is Arva Jackson. Currently I chair the
AAHPEC. TIns document was sent to the Executive Committee for review and
endorsement.
Observations·
Our working premise that this Bill, if adopted by no less than a majority of the
Montgomery County, MD Council, would codify the authority of the Department of
Health and Human Services to provide direct access to healthcare (for those in the
Montgomery County area of service); to administer (directly) programs to reduce
disparities in access to healthcare (including serVices fashioned to promote well being, so
as to prevent the onset of
ill
health); and to administer any collaborative human services
in such a manner as to avoid any disparities that were the result of discrimination based
on race, ethnicity, gender and/or poverty. ­
In addition, this bill wQuld authorize the Department of Health and Human Services to
(directly) provide (or see to the provision of) health education and promotion programs;
and would generally amend the law regarding health and human services and health and
sanitation.
Finally, this Bill would "amend the functions of the Commission on Health."
The infrastructure that would legitimize the proposed role of the Commission on Health
is not apparent to the early reader of the proposed Bill.
Recommendations
Jtwould be "comforting" if this proposed Bill were introduced with a statement of an
"Intention of Guiding Principles" i.e.
It
is the intent of this legislation, if enacted, that the following principles will be
realized through its implementation.
1.
Integrity.
• Assessmentofneeds should (shall) be conducted with
transparency; and the public given preliminary access to the
population being assessed, the conduct of the assessment
methodology; and the unequivocal evidence of the authenticity of
the results.
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II.
Equity
• Appropriate fiscal and human resources needed should (shall) be
determined and allocated on the basis of need.
III.
Quality (see Standard of Performance)
• Planning, Policy and Program determination regarding level of
service, service sustainability and service reconfiguration should
be directly related to all established Standard of Performance.
Standards of Performance
.
• An internal review committee within the DHHS should be
established to coordinate those existing policies and programs
under the aegis of the Department's operational activities-and to
advise the Director DHHS regarding the existing and possible
relations that exist between internal directives within the DHHS
that might be given additional support or reconfigured to better
contribute to the reduction of health disparities.
• An external review committee to provide oversight to the County
Council that should include representation of existing advisory
bodies regarding specific racial, ethnic disparities. This would
include health providing services that are not under the
administrative executive mandate, but where these services can
and do have an impact on the diminution of health disparities in
Montgomery County.
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LdtlfllO
STEERING
CO~lMITTEf
February 8
th ,
2011 .
Montgomery County Council
100 Maryland Avenue
Rockville, MD 20850
RE: Bill 1-11 , Administration Department of Health and Human Services -Duties
Honorable Council members:
Good evening, my name is Grace Rivera-Oven. lam a community activist, and currently member
of the Latino Health Steering Committee of Montgomery County (LHSC). Today on behalf of the
LHSC, I want to
t~ank
you for the opportunity to provide input on the review of Bill 1-11.
First, the LHSC applauds Mr. Leventhal and the members of the Health and Human Services
Committee for their vision and effort to. draft this bill. We also thank Mr. Leventhal for giving us the
opportunity to provide feedback on an earlier draft of this bill. The background section of the bill is
compelling in describing the substantial disparities in access to health care and preventive health
services; including health education and promotion, and the adverse impact, these disparities have
on all races and ethnic groups in Montgomery County. We believe this bill presents an important
opportunity to improve the current situation and to enhance the health status of all county
residents. We also believe that a few small edits could significantly strengthen this bill. We offer the
following three suggestions and strongly encourage their adoption:
I. Section 2-42A of the bill identifies duties of the Department, and for which the Department
provides staff support. We strongly believe that specifically mentioning "Minority Health" in
the list of programs (A-N) identified is an essential enhancement that would sharpen the
authority and responsibility of the Department to act in developing strategies for addressing the
health of minority populations. Offices of minority health exist in virtually every state. At the
Federal level, .the recent landmark Affordable Care Act heightened the focus on minority health
by calling for the establishment of new or reauthorization of existing Offices of Minority Health
across all of its health agencies. It also elevated the National Center on Minority Health and
Health Disparities at NIH from a Center to a full Institute. Such a robust system of focused
attention and resources to address minority health and health disparities indicates that these
programs are a recognized approach to protecting and promoting the health of these
populations. Further, academic centers exist around the U.S. and at most schools of public
health that have minority health as their mission and topic of research and service concerns.
The minority health approach deserves greater recognition as a method of improving the health
of minorities in Montgomery County. Bi1l1-11 should not shy away from acknowledging the
Department's commitment to addressing minority health and health disparities and the already
existing Departmental structures that support these activities.
II. We believe it is important to substitute the terms citizenry" and "County citizens" in Part 24-22
Policy
to
"County populations" and "County residents", in order to clarify the holistic purpose
of this bill.
Health·
MOIITCO.~f1l)'
(DUlffi'. MD
Latino Health Steering Committee of Montgomery County
@
8630 Fenton Street, 10
th
Floor • Silver Spring, Maryland 20910 • 240/777-1779; Fax: 240/777-3501
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III. The inclusion of the phrase "effects of the social determinants of health" at the end of
section 24-22 Policy is an important addition. This language is consistent with the US Public
Health Service, and most professional health organizations' recognition that improving the
health of populations and individuals must also address the social determinants of health. This
wording is the 21 st century conceptualization of the World Health Organization's framing
definition of health which goes beyond addressing just disease, illness and injuries to include
the holistic well-being of populations and individuals by also addressing the conditions in which
people grow, live, work and age, and the systems that protect and promote their health.
We are grateful for your leadership and understanding of the role and importance of all county
residents, and we look forward to continue collaborating and working with you in addressing the
needs of all community members. We would be delighted to provide further feedback and ideas as
you continue to deliberate this bill.
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Russell C. Campbell, Sr.
HUMAN RIGI:ITS COMMISSION
Testimony Support of
Bill 01-11
campbell.russell@epa.gov
2r
Testimony in support of BH11 ..11 ­
February 8, 2011
Russell C. Campbell, Sr..
Chairman of the Montgomery County Human Rights
Commission
Good Afternoon, Honorable Members of the Montgomery County
Council
Honorable Valerie Ervin, President of the Montgomery County
Council
My name is Russell Campbell and I am here representing the ,
Montgomery County Human Rights Commission in supporting
Bill Number 1·11
We who reside in Montgomery County are often affected by
disparity in the health care delivery system as it relate.s to poor
and minority residents of our County. Having equal access to'
sufficient and quality health care is not onl.y a human right 'hut a
human necessity. We have worked long
and
hard to bring forth
the African American Health' Program, the Hispanic Health
initiative and other programs such ,as these, and fully
understand the need for continual programs and legislation to .
assure the elimmnation of the disparities in our health care
system. ihere are disparities in access to health care services
and preventive health services, which can adversely impact
,health conditions among minorities
in
Montgomery County.
All we have to do is to look at the statistic related to this issue to
fully recognize the severity of the problem. As you know The
African American Health Program's 2009 Strategic Plan notes
that 7.6% of Black residents in the county report having been
diagnosed with diabetes compared to 5.5%for the general
. population; Blacks comprise over 720/0 of all county AIDS cases;
and,' Black women are less lIKely to be diagnosed with breast
cancer but are more likely to die from it than Whites. In 2908, the
latino Health Initiative reported that, Latinos had 1.6 times as
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many new HIV diagnoses as non-Hispanic Whites; that diabetic
and hypertensive end-stage renal failure was significantly higher
than for non-Latino Whites; and that the rate of obesity is a
growing problem for many of our people because lack of heaith
education in dietary consumption. All three Minority Health
efforts have called for improved data and research on the social
determinants of health and increased access to' culturally
competent health care and preventive health services.
We have made some progress over the last 12 years in
developing heath efforts to provide better care for our poor'and
minorities in the County. First with the African American health
Initiative under County Executive Doug Duncan which eventually
help to pave the way for our Hispanic and Asian health
initiatives.
.
It is time we put into place greater strength to these efforts to
provide open health care in Montgomery County to aU of the
residence. It is hoped that the Federal Health Acts will lead us to
greater participation but we need to make sure Montgomery
County continues to provide these services.
Many minorities struggling to live in Montgomery County are not
covered with insurance to have good health service. Many
newly unemployed are struggling to survive arid Hope that their
health and the health of their children remain good. However,
they need more than good luck they need good health care.
We support this efforts set forth in the Bill to address the health
disparity experience by our residence and need to have laws in
place to help those who need care.
We support efforts to direct the concern addressed in Bill 01-11 '
and hope that the Council will work vigorously to fight for those
who cannot fight for themselves. To stand up for those who
cannot stand for themselves and to unremitting advocates to the
health of all of our people. Thank you for you allowing me to
speak.
'
®
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Always
Think Pink
By Msache Mwaluko
As a means to raise awareness,
educate and empower the community
about breast cancer, the Astra Zeneca
Foundation, the American Academy
of Family Physicians, and Cancer
Care Inc. designated October as the
National Breast Cancer Awareness
Month (NBCAM) in 1985. For the past
25 years, the NBCAM organization has
been educating communities about .
the disease, encouraging women to
perform self breast exams and providing
numerous resources. (NBCAM ,2010)
According to the American Cancer
Society, more than 192,000 women were
diagnosed with breast cancer and more
than 40,000 women were expected to
die from the disease. Men were expected
to account for
1
%
of breast cancer
cases (1,910) and more than 400 men
were expected to die from this disease.
More Caucasian women are diagnosed
with breast cancer compared to Black
women,but death rates are higher in
Black women at every age.
• Pulling in of the nipple or pain in the
nipple area.
• Nipple discharge other than breast
milk, including blood.
• Any change in the size or the shape of
the breast.
• Pain in any area of the breast.
Breast Cancer Screening
Guidelines: It is recommended that:
• Starting age 30-39: A woman should
have a clinical breast exam conducted
by a physician or a nurse at least every
3
years.
• Starting age 40: A woman should have
a mammogram done annually. This is
the best method of cancer detection.
Vision: African Americans
in Montgomery County will
be as healthy and safe as the
rest of the population.
Mission: To eliminate health
disparities and improve the
number and quality of years
of life for African Americans.
Early detection is key!
Although October is designated as
Breast Cancer awareness month,
you can continue to do your part all
year round to detect any signs
and'
symptoms
of
breast cancer.
Cancer can be detected by a
mammogram in its early stages
b~fore
any symptoms may appear. When found
early, the chances of
a
woman surviving
from breast
cancer are
higher,
5-YEAR
SURVIVAL RATE
, What should a woman look for?
In the early stages of breast cancer, a
lump is too small to feel and does not
cause any visual changes, and thus it
is very importantfor women to have
their annual mammograms. As it g'rows,
however, breast cancer can cause
changes in how the breast looks and
feels. (CDC, 2010)
These changes include:
• A new lump in the breast or underarm
(armpit).
• Thickening. or swelling of part of
the breast.
• Irritation or dimpling of breast skin,
• Redness or flaky skin in the nipple
area or the breast.
inside:
2
From the Director's Desk
3
The Fatherhood Series
!IS
74%
4 Red Ribbon Report
5
Health Freedom WaLl{
c~'~I.~;;.::t:l~:~~~~~f1~~~~
HfB
5 Diabetes Corner
7 AAHP Announcements
S
Resources
IV
Source: American Cancer Society
'These
numbers are correct
as
written (stage 1118
shows
worse
survival than stage
liIe).
cont/nued on p·.6
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From the Director's Desk
Recognizing our Family Caregivers
By
Darlene
L
Coles, Project Director
Many articles have called those of us in our 40s as the "sandwich generation." The
sandwich generation is defined as a group who is taking care of their aging parents
while supporting and caring for their own children.
While November is designated as National Family Caregiver Month, it's important to
recognize those who take the time to care for others all year round. The observance
was developed to draw attention to those of us facing the challenges of caregivers
to any family members.
.
One of its central themes is that we who are family caregivers need to take care
of ourselves and protect our physical and mental health in order to live happier,
more fulfilled lives and to be better able to provide the best care possible for our
loved ones.
Some of the ways that we can support those who are the caregivers of
young, elderly or sick family members are to:
.
1. Offer a few hours of break time to a family caregiver so that they can spend time
with friends, take a walk or simply relax.
2. Send a card of appreciation or a bouquet of flowers to brighten up a family
caregiver's day.
3. Use your connections to local businesses to offer a free service for family
caregivers.
4,. Offer comic relief! Purchase tickets to a local comedy club, give a family caregiver
your favorite funny movie to view, or provide them with a book on tape.
5. Offer to prepare dinner for a caregiving family in your community.
Did you Know...
Practicing good oral hygiene
such as brushing and flossing
your teeth and gums each day
can help to reduce your risk
of developing serious health
issues. Take preventive
steps now and Smile to a
Healthier You!
For information about free or
reduced priced dental services
in Montgomery County call
continued on p,6
Dining in the Right Direction!
Learn how to prepare this and many more future healthy recipes we wi\! feature to
help you achieve a healthier lifestyle!
Spicy Black-Eyed Peas with Rice
• 1 T canola oil
• 2 C frozen black-eyed
peas (no salt added)
• 1 C minced onions
.. 1 C diced tomatoes
• 2 cloves garlic,
minced
• Crushed red pepper
-to taste
• 2 T dried Italian
seasoning blend
• 1 tsp black pepper
• 1
Y2
C water
• :4
tsp salt (optional)
• 1 1/3 C cooked brown
rice
Heat oil in 3-quart saucepan over medium heat; add
onions and cook 4 minutes or until beginning to turn
light golden color, stirring often. Add garlic, cook 15
seconds.
Add water. black-eyed peas, tomatoes, Italian
seasoning and pepper to onion mixture; stir and bring
to a boil over high heat. Reduce heat to a simmer;
cover and cook 18 to 20 minutes or until tender.
Use slotted spoon to remove black-eyed peas.
Reduce liquid by cooking on high 2 to 3 minutes. Add
reduced liquid to black-eyed peas and stir. If adding
salt, add it at the end. Serve peas over brown rice.
Makes 61/3 cup bean mixture and 1/3 cup rice
1-800-899-3906.
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ONEHEALTHYLlFE.ORG
Message from the Editor
SMILE Program Testimnnial
The Fatherhood Series
By Xerxeser Kayode
Infant mortality continues to disproportionately threaten the lives of many African
American infants within the United States. The root causes of this health disparity
are unknown, but several risk factors such as drug and alcohol abuse, poor
nutrition, insufficient prenatal care, and stress have been identified. As of now,
the majority of the risk factors seem to involve the health of the mother, but are
there other external factors that may have an impact on the infant's biological and
cognitive development? One factor being addressed
is
the role expectant fathers
play prior to, during, and after pregnancy and its influence' on the health of an infant.
According to the U.S. Census Bureau,
1
out of every
3
children
(33%)
live without
their biological father and approximately
2
out of every
3 (66%)
A!rican American
children live in fatherless homes.
The importance of father involvement in the African American/Black community
is arguably one of the most talked about issues for many years; however its
relationship to pregnancy, birth outcomes and the family's health has been under­
studied. The African American. Health Program has taken strides to provide support
for fathers and expectant fathers through its Childbirth and Breastfeeding Education
classes in which special sessions are devoted to providing education just for them.
The following article was written by a first time Dad whose son is enrolled in the
AAHP SMILE program. He was asked to give us some insight into what fatherhood,
means to him.
It
is the second in the "Fatherhood Series." The second article is
a testimonial written by an expecting father who attended one of the S.M.l.L.E.
Childbirth and Breastfeeding Education Classes.
To Who It may Concern,
My'nameIs
D.~,
VVarni;lr.
!am29
years'
01~~bQytt9,have
fir~t
son.
I~m
writing
this~~~J9'ally,
to express my
extrerrf~tilatiori
for this program.
I
foul1ditt9, be
very educational, well
;'un,~rid
facilitated, not to mention needed,
I
fe,el the promam caters to all
class levels, races and ages.
I
enjoyed the inrormation'about
, birthing, and caring for the baby,
but especIally
I
enjoyed'the male
se9ment of the Seminar. Please
continue,this program for it
emP9wers
Rarent~
with
the tools
tliey' needto
Thank you very much.
succeed. '
The Joys of Being aFather
By Dillon
Morrison
Participants
in
,The
Dads Class
at a SMILE Childbirth
and
BreastfeedingEducation Class.
I
always knew that some day Iwanted to be a father. Being
, a father to me is not just being part of the reproduction
process. A father can be any male that supports and
cares for a child.
On September
3, 2009
a day clearly engraved in my
head. The day
I
found out
I
was to be a father.
I
remember
screaming and shouting "Yes! Yes!
I
knew it!"
I
pretty
much started telling everyone right away.
I
must admit even though their was instant
elation, so many thoughts and feelings ran through me. This was to be my-first child
and I wanted to be the best father that
I
COUld. Having a great father relationship with
'my dad,
I
had big foot steps to follow in and fill.
With all the excitement to start off their was some stressing in the very beginning.
Our health insurance didn'fhave prenatal coverage, so after many phone calls and
switching insurance plans every thing came together. Due to that, the first ultra'
sound didn't come for months, and when it did I was ready to burst with excitement.
To see him was an amazing sight to behold, no words could describe the pride and
vVe
1vant
to
hear from
you!
Submit
your
comments
and s1;lggestions at:
www.onehealthylife.org
click on the
CONTACT US
tab.
continued on P,Q
@
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HIV RED RIBBON Report
Watch Out!
This STD is on the Rise
By Abirnboia Idowu; DrPH, CHES
Research shows that more than 20 diseases fall within the sexually transmitted
diseases group, and an infected'person can transmit any of these through intimate
sexual contact to their partner or spouse. A recent press release from the Centers
for Disease Control and Prevention reproduced below highlights the continued
nationwide high incidence of herpes simplex virus type 2 that is a sexually
transmitted disease.
February
7th
is National
Black
HIV/AIDS
AwareneSs Day
March 10 is
National Women
&
Girls
HIV/AIDS
Awareness
Day
th
The reporting of herpes simplex virus is not as stringent as it is for other STDs such
as chlamydia, gonorrhea, syphilis and HIV and therefore, it is not part of prevention
education. This recent reporting and its disproportionate prevalence among black
women should be enough reason to have prevention education on herpes for the
benefit of the AAHP target population. The HIV unit of MHP will be addressing
this issue with continuous mention of incidence of herpes in all STD prevention
education provided to the residents of the County.
We hope that various groups, associations, community and faith based
organizations will continue to partner with AAHP in the effort to eliminate disparity in
the prevalence and incidence of SrDs in the nei.ghborhoods.
CDC STUDY FINDS U.S. HERPES RATES REMAlf':J HIGH
1in
6
Americans Infected; Highest Prevalence among Women and
AMcan~Americans
Jl
T.I.E.
your life to
a
healthy sex life!
Get Tested!
Get Involved!
Get Educated!
Call 301·421·5425 for more
information and for
a free
HIV
test.
About 1 in 6 Americans (16.2 percent) between the ages of 14 and 49 is infected with
herpes simplex virus type 2 (HSV·2), according to a national health survey released
today by the Centers for Disease Control and Prevention. HSV·2 is a lifelong and
incurable infection that can cause recurrent and painful genital sores.
The findings, presented at the 2010 National STD Prevention Conference, indicate
that herpes remains one of the most common sexually transmitted diseases (STDs)
in the United States.
.
The new estimate, for
2005~2008,
comes from CDC's National Health and Nutrition
Examination Survey (NHANES), a nationally representative survey of the U..S.
household population that assesses a broad range of health issues,
The findings suggest relatively stable HSV·2 prevalence since CDC's last national
estimate (17 percent for 1999·2004), because the slight decline in prevalence
between the two time periods is not statistically significant.
The study finds that women and blacks were most likely to be infected. HSV-2
prevalence was nearly twice as high among women (20.9 percent) than men (11.5
percent}, and was more than three times higher among blacks (39.2 percent) than
whites (12.3 percent). The most affected group was black women, with a prevalence
rate of 48 percent.
continued
on
p.
7
@
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Always Think Pink
(continued from cover)
Join the Fight.. .What you can do.
• Host a Pink Party to raise awareness
about the importance of breast
screening and raise money for
a charity.
• Participate in one of these walks
to raise funds for breast cancer
research, free mammograms for the
uninsured and educational materials.
American Cancer SOciety ­
Making strides against breast
cancer walk. Washington DC.
1-800-227-2345 or makingstrldes.
acsevents.org
.' Avon Walk for Breast Cancer ­
Walk for 2 days covering 39 miles.
April30-May 1, 2011. WashIngton
DC. 1-888-540-WALK. or
www.avonwalk.org
The Susan G Komen Foundation
- Race for the Cure- Held every
June in Washington DC. June 4,
2011. 703-416-RACE(7223) or info@
globalraceforthecure.org
• Check on these locally available
breast cancer resources.
'" Holy Cross Hospital Mammogram
Assistance Program (MAPS) ­
Provides free breast screening
for low income and uninsu'red
women aged 40 and above
residing in Prince George's and
Montgomery County. CaB 301­
754-7162.
~
Breast and Cervical Cancer
Screening Program. Provides
yearly breast and cervical cancer
screening and follow-up for low
.<
income, uninsured/underinsured
female residents of Montgomery
County- Call 240-n7-1750.
Sources
1. Centers for Disease Control and p,revention
(CDC), Breast Cancer Symptoms (August, 2010)
http://www.cdc.govlcancer/breasVbasiC_info/
symptoms.htm.
2. National Breast Cancer Awareness Month
(September 2010). http://www.nbcam.orgl
abouCnbcam.cfm
3. American Gancer Society. Breast cancer survival
rates by stage (September 2010), Retrieved
from~
http://www.cancer.orgICancerJ8reastCancerl
DetailedGuidelbreast-cancer-survi'lal-by-stage.
4. Making Strides Against Breast Cancer
(September 2010) www.cancer.orgllnvolvedl.
..J
MakingStridesAgainstBreastCancer
5. Susan.
G.
Komen Foundation Race for the
cure. http://globalrace.info-komen.org/site/
·PageNavigatorlhq..,90earnJace_2010
6. Avon Walk For Breast Gancer htt,D:IJwww.
avonwalk.orgl
From the Director's Desk
(continued from
p.2)
6. Locate information, resources andlor
a support group on the intemet and
give it to a family caregiver that you
may know.
Take time to celebrate those who take
the time to care for others and mark
this as a time for all of us to thank,
support, educate, and celebrate family
caregivers across the Country.
If you are taking care of elderly or loved
ones with special needs, don't be afraid
to ask a family member, friend or close
colleague to do any of the above things
to help you. Most people are happy to
help once they know how! .
Yours in Health,
Darlene Lyric Coles
The Joys of Being aFather
(continued from p.3)
joy that I felt in that instant. I reveled
in the things most fathers take for
granted. I attended as many doctors
appointments as I could, since I had
so many questions of my own. Their
was so much I know I needed to know.
I remember watching him moving
around in her tummy, I would feel his
kicks and talk to him every chance I
got.
Whenever we had a sonogram, my
anticipation increased for the day when
we would meet and I could hold him.
knowing our lives would never be the
same and that we had been completed.
Three days later we bought him home
and the journey had just really gotten
started. Being his father not only meant
providing for him financially, feeding
him and changing diapers. It also meant
I had to nurture him physically and
emotionally. Thus far the physical part
. has been the hardest. in the beginning
he would wake every two hours, I was
a walking zombie. It's now almost six
months later, and he is almost sleeping
My son was born May 10, 2010 and I felt through the night. The emotional part
comes so naturally and easily, when I
so blessed he was perfect in every way.
For the second time I never knew I cO.uld look at him I couldn't imagine our lives
without him.! count it a blessing to be
love another human being as I did my
first born. I remember holding him and
able to cuddle him every day and let him
know how much he is loved and the joy
he brings.
Being Keagans' father I have had so
many proud moments. Seeing him smile
for the first time, watching him as he
contorts his body trying to figure out the
dynamics of turning over.
II0Ya
that he
knows my voice and seems to know in
his own way that I am his father. I enjoy
reading to him, and seeing his reaction
to the pictures and colors on the pages.
Thus far fatherhood is everything and
more than I could have imagined. I
can't say that I know all there is to know
about being a father. Every day I learn
something new and I embrace the
challenges that are yet to come.
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ONEHEALTHYtlFE.ORG
Health Freedom Walk: APath to
Wellness: Seeking Conductors
to Lead
Walking Groups
Did you know that heart disease is the #1 killer of men and women of all races in the
United States? Major risk factors of heart disease include hypertension, obesity,
smoking, a sedentary lifestyle, ahighsalt intake, and stress. (www.cdc.gov)
The African American Health Program (AAHP) of Montgomery County, MD invites
you to Begin Your Journey with the Health Freedom: A Path to Well ness Program.
This is an innovative program aimed at increasing physical activity while making
creative use of Maryland's integral role in the Underground Railroad.
Just as Harriet Tubman was named conductor of the Underground Hailroad, we are
seeking leaders or "Conductors" to start a Circle of Friends (COF) Walking Group at
your church, worksite or organization, school or with family and friends.
Your Preparation to Wellness starts with a Coriductor training and 6 weekly one­
hour sessions. Weekly Sessions Include: health and wellness information, history
lessons of the Underground Railroad and weekly gifts to all members.
The 1
st
15 conductors to respond will be eligible to receive a stipend of $125.00
dollars upon recruiting a group of 7 individuals or $150.00 for a group of 10 or more
and fulfilling all specified requirements.
At the end of the 6 weeks, The Health Freedom: A Path to Well ness Celebration Walk
will take place on Saturday June 11,2011 at Woodlawn Manor Park in Sandy Spring,
MD.tt is acetebration of your group's commitment and accomplishments on your
journey to well ness.
To sign up to be a Conductor, call the African American Health Program at
301-421
~5445.
Be a part of this exciting adventure to a new and healthier you and develop
leadership and fitness skills along "the way.
For more information, visit www.onehealthyllfe.org or www.healthfreedomwalk.com.
Diabetes Corner·
DIABETES DINING CLUBS
at 6:30pm-9;OOpm
Goshen United Methodist Church
19615
Goshen Rd., Gaithersburg,
MD 20875
March
4,
April
4, May 2, June 2
Mount Calvary Baptist Church
608 N.
Horner's La., Rockville, MD
20850
March 14, April 11,
May
9, June 13
Mount Jezreel Baptist Church
420
University Blvd., East,
Silver Spring, MD 20901
March 24, April 28,
May
26,
June
23
-Dinner
contribution -
$5.00
Enjoy physical activity, healthy food, meeting
new friends, and learning new thingsl
Must register one week before club night.
FREE
DIABETES SELF
MANAGEMENT CLASSES
(four·week course)
at
5:00pm-9:00pm
Wheaton Woods Baptist Church
13200 Arctic Ave., Rockville,
MD
20853
Tuesday,
March
1.0, 17, 24,
31
Up County Regional Center
12900
Middlebrook Rd.,
Germantown, MD 20874
Tuesday, AprilS,
12, 19,26
Wheaton Ubrary
SAVE THE DATE
Health Freedom: A Path to Wellness Celebration Walk!
Saturday June
1l,
2011
Woodlawn Manor Park
Sandy Spring, MD 20860
Interested
in
volunteering at the Walk?
Ca11301-421-5445 for more information.
11701
Georgia Ave., Wheaton,
MD
20902
Thursday,
May 5,12,19,26
Stewartown
Homes
9310
Merust La., Gaithersburg,
MD 20876
Wednesday,
June
1, 8,15,22
-Dinner contribution -
$5.00
Classes include: educational materials!
activities, light dinner; door prizes
CALL DIANE HERRON
301~421-5767
TO REGISTER
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ONEHEAlTHYLlFE.ORG
HIV RED RIBBON Report
(continued from pA)
As with other STDs, biological factors
may make women more susceptible
to HSV-2 infection. Additionally, racial
disparities in HSV-2 infection are likely
perpetuated because of the higher
prevalence of infection within African­
American communities, placing
African-:Americans at greater risk of
being exposed to herpes with any given
sexual encounter.
"This study serves as a stark reminder
that herpes remains a common and
serious health threat in the United
States. Everyone should be aware of
the symptoms, risk factors, and steps
that can be taken to prevent the spread
of this lifelong and incurable infection,"
said Kevin Fenton, M.D., director of
CDC's National Center for HIV/AIDS,
Viral Hepatitis, STD, and TB Prevention.
"We are particularly concerned about
persistent high rates of herpes among
African-Americans, which is likely
'contributing to disproportionate rates
of HIV in the black community."
Research shows that people with
herpes are two to three times more
likely to acquire HIV, and that herpes
can also make HIV-infected individuals
more likely to transmit HIV to others.
CDC estimates that over 80 percent of
those with HSV-2 are unaware of their
infection. Symptoms may be absent,
mild, or mistaken for another condition.
And people with HSV-2 c,an transmit
the virus even when they have no visible
sores or other symptoms.
"Many individuals are transmitting
herpes to others without even knowing
it," said John M. Douglas, Jr., M.D.,
director of CDC's Division of STD
Prevention. "We can't afford to be
complacent about this disease. It is
important that persons with symptoms
suggestive of herpes-especially
recurrent sores in the genital area­
seek clinical care to determine if these
symptoms may be due to herpes and
might benefit from treatment."
Combination of Prevention
Approaches Needed to Reduce
National Herpes Rates
Although HSV-2 infection is not
curable,there are effective medications
.
.
. - ,"',". "".
" . ' " .'
...
~.'
available to treat symptoms and prevent
outbreaks. Those with known herpes
infection should avoid sex when herpes
symptoms or sores are present and
understand that HSV-2 can still be
transmitted when sores are not present.
Effective strategies to reduce the risk
of HSV-2 infection include abstaining
from sexual contact. using condoms
consistently and correctly. and limiting
the number of sex partners.
CDC does not recommend HSV-2
screening for the general population.
However, such testing may be useful
for individuals who are unsure of their
status and at high risk for the disease,
including those with multiple sex
partners, those who areHIV-positive,
and gay and bisexual men.
###
Peferences:
http://www.cdc,gov/nohhstp/newsroom/
hsv2pressrelease,html
">-' ,,,,,.
AAHP Announcements
4th Annual Hearth Health Screening
&
Education Event
Saturday, February 12, 2011 (snow date: Saturday, February
19),
10:00am-2:00pm
Holy Cross Hospital Professional
&:
Community Education Center
1500 Forest Glen Road, Silver Spring, MD 20910
Register at www.healthyheartmc.eventbrite.com or call
301·754·8800
Matemaland
Child Health
2011 Calendars are In!
Go to
www.onehealthylife.org
FREE
Smoking Cessation Classes
January
6 -
February 24, 2011
Montgomery County Health
Dept of Dennis Avenue
Prostate Screenings
Twice a Month
Piccard Drive Health Center
1335 Piccard Drive,
.. Rockville,
MD
20850
.Call
240-777-1222
(Registration Required)
to view a copy or call 301-421-5445
2000 Dennis Avenue, Silver Spring, MD
20902
to
request
one.
For more information
or
to register,
call
301·879·7933
For more events, visit www.onehealthylife.org or www.facebook.com. Search African .A.t:Derican Health Program
 PDF to HTML - Convert PDF files to HTML files
African
fIealth Program
~merican
••
RESOURCES
~1!!;"',
African American Hea'th Program
AAHP S.M.I.LE. Program
inc.
240-777-1833
240-777-1833
24Q-777-1750
1-888-477-2669
301-421-5767
240-777-1734
240-777-3848
14015 ,New Hampshire Avenue
Silver Spring, MD 20904
P: (301) 421-5445
F: (301)421-5975
onehealthylife.org
Breast and Cervical Cancer Screening
2424 Reedie Drive, Wheaton
The Partnership for Prescription Assistance
Diabetes Education Classes through Maternity,
Family Planning, Child Health Services
Smoking Cessation
Oral Health
COMMUNITY CLINICS
The African American Health Program is
funded
by
the Montgomery County Department
of
Hearth and Human Services and
administere~
by
BETAH Associates, Inc,
This mataria[ may be reproduced.
AAHP NEWSLETTER
Xerxeser Kayode, Editor-in-Chief,
EDITORIAL COMMITTEE:
• Darlene Coles, RN, MBA
• Abimbola Idowu, DrPH, CHES
• Brenda Lockley, RN, MS
• Msache Mwaluko
OTHER CONTRIBUTORS:
• Dillon Morrison
Community Clinic, Inc.
L.:A.M.I. Famiiy Health Clinic
Mobile Medical Care, Inc.
Colesville Adult Dental Center
The People's Community liVeliness Center
• Men's Clinic' Prostate Cancer Screening. Women's Clinic
301-340-7525
301-434-8400
301-493-2400
301-384-9795
301-847-1172
301-977-5255
240-777-1772
240-777-1869
240-777-1635
Colorectal, Prostate.. Oral Cancer Screening
G.O.S.P.E.L. Program
HIV/AIDS Services, 2000 Dennis Ave., Silver Spring
Maternity, Family Planning, Child Health Services
SERVICE ELIGIBILITY UNITS
Germantown, 12900 Middlebrook Rd.
240-777-3591
240-777-3120
240-777-3066
Wi
www.facebook.com/search African
FOLLOWUSON
... American Health Program
Rockville, 1335 Piccard Dr.
Silver Spring, 8630 Fenton
st.
www.twitter.com/onehealthylife
'Can't find a Montgomery County Government service? Call
240-777-1245
or
visit My Montgomery
a:t
www.montgomerycountymd.govfmymontgomery
••
. 7
African
,T
~erican
}Iealth
Program
14015 New Hampshire Avenue
Sifver Spring, Maryland 20904
 PDF to HTML - Convert PDF files to HTML files
The influx of Latino people into Montgomery County over just the
past two decades has helped transform this County into the most
diverse one in Maryland.
As
the Latino population continues to
grow, its contributions to the County's economic, political, social
and cultural landscape
will
continue to increase and accordingly,
County services must reflect evolving demographics and related
health trends.
The Latino Health Initiative (LHI)of the Montgomery County
Department of Health and Human Sefv"ices was established in
July 2000 ·with the support of the County Executive and County
Council.
OUR MISSION
The mission of the LHI is to improve the quality of life of Latinos
living in Montgomery County by contributing to the development
and implementation of an integrated, coordinated, culturally and
linguistically competent health wellness system that supports,
values, and respects Latino families and communities.
OVERALL FUNCTIONS
Enhance coordination between existing health programs and
services targeting Latinos.
Provide technic31 assistance to programs serving the Latino
community.
Develop and support models of programs and services to
adequately reach Latinos.
Advocate for policies and practices needed to effectively reach
and serve Latinos.
WHO IS INVOLVED
WITH THE
LHI?
The LHI is comprised of staff members from the Department of
Health and Human Services and a group of volunteer professionals
and community leaders. These individuals work as
a
team to
inform the Latino cOIIlLllUnity about the LHI and to collect
feedback from them regarding their health concerns. In addition,
this group acts as the planning body for the LHI and advocates to
improve the health of Latino communities.
FOR MORE INFORMATION ABOUT THE LHI
For more information about the Latino Health Initiative, please
visit our website at www.lhiinfo.org.
Latino Health Initiative.
Montgomery County
Department of Health and Human Services
. 8630 Fenton Street, lOth Floor
Silver Spring, MD 20910
Phone: 240-777-3221
 PDF to HTML - Convert PDF files to HTML files
BLUEPRINT
FOR LATINO HEALTH
In 2000, soon after the LHI was established, the Latino Health Steering
Committee engaged in a two year long intensive community participatory process
to determine the major health priorities crucial to improving the health of
Montgomery County Latinos. This effort culminated with the development of the
Blueprint for Latino Health in Montgomery County Maryland.
Every five years, the Blueprint is updated in response to the changing sodal­
political landscape and to the progress achieved in the prior five years. The
document offers socio-demographic and health profiles of Montgomery County
Latinos, and it also outlines seven action-oriented priority areas each accompanied
by policy recommendations:
A. Improving Data Collection, Analysis and Reporting
B. Ensuring Access to and Quality of Health Care
C.
Ensuring the Availability of Culturally and Linguistically Competent Health
Services
D.
Enhancing the Organizational Capacity of Latino Community-Based
Organizations to Provide Health Services
E. Enhancing Community Participation in Decisions that Impact the Health of
Latinos
F.
Expanding Health Promotion and Disease Prevention Efforts Targeting Latino
Communities
G.
Increasing the Number of Latino Health Care Professionals Working
in
the
County
PURPOSE
OF THE
BLUEPRINT FOR LATINO HEALTH
The Blueprint plays a pivotal role in guiding the LHI programs and activities and
in informing, engaging and mobilizing policy and decision makers, stakeholders
and community members. The Blueprint aims to help readers:
• Make strategic and programmatic decisions that
will
better correspond to the
needs oflow-income Latino people.
• Obtain funding and other support fr()m government and private sources for
programs that correspond to the needs of the Latino community.
• Support policy initiatives and budget requests from local and State
governments that
"Will
further the health interests of the Latino community.
• Enhance collaborations with academic and non-profit organizations to
increase resources, funding, and support for programmatic activities.
HOW
CAl~I
GET
A COpy OF
THEBLUEPRlNT?
The Latino Health Initiative's 2002-2006 and 2008-2012 Blueprints are available
for free atwww.lhiinfo.org.
 PDF to HTML - Convert PDF files to HTML files
Major
Programs and
Activities
Comltlunity Programs and
Campaigns
"Ama tu Vida" CamDailm
..
l:)
The
"Ama
tu
Vida"
campaign promotes health
and wellness in theLatino community. The
':4.ma tu Vida",
c'ampaign invites the community
to make a commitment to living a healthier life,
and encourages them to adopt lifelong health
promotion and disease prevention habits.
Program for Licensure of Foreign -Trained
Health Professionals
This program is a multi-institutional
collaboration of the LHI, Montgomery College,
Holy Cross Hospital, Washington Adventist
Hospital and Workforce Investment Board. The
program provides a comprehensive, integrated
and coordinated approach to effectively address
· the needs and decrease the challenges and barriers
Latino nurses encounter in Maryland to obtain
the nursing license. The program incorporates
four components: support and guidance system,
academics, practical exposure to the U.S.
healthcare system, and mentoring.
Asthma Management Program
This program is designed to increase
the knowledge of Latino parents of
children with asthma regarding,the
condition and its management, and
increase awareness and utilization
of pediatric clinical services. The
desired outcome is Latino families
who are empowered to appropriately
self manage asthma in their children.
· Smoking Cessation Program for Latinos
The goal of the program
is to reduce the
prevalence of cigarette
use among low-income
Latinos who live or
work in Montgomery
County. Smoking
cessation interventions
are available to current
smokers willing to
try
to
· quit smoking..
Health Promoters Program
"Vias de la Salud"
The mission of the HPP is to
improve the health and well
being of the low-income Latino'
community in Montgomery
County through training and
empowerment of Latino health
promoters to promote healthy
behaviors, facilitate access to health services,
and advocate ofhealth policies that benefit the
community.
Busn del
tab8eD
y
13
salud
de so familia
System Navigator
&
Interpreter Program
The goal of this program is to guide, provide
resources and professional medical interpretation
in a culturally competent manner in order to
facilitate access to health care for low-income,
uninsured Latinos. Another component of
the program is the Bilingual Health Services
Information Line (301-270-8432) which informs
callers of existing health and human services and
other related programs in Montgomery County
and assists them to successfully access these
services.
Latino Youth Wellness Program (LYWP)
This program provides the unique opportunity
for participating youth between the ages of 12-19
and their families to engage in a holistic approach
to wellness by including components that address
mental, physical, social, environmental and
, emotional issues in a culturally and linguistically
competent manner. This program has a
component to improve physical fitness.
 PDF to HTML - Convert PDF files to HTML files
Special Projects
,
Emergency Preparedness Project'
This project is a collaborative effort
between the Latino Health Initiative
and the Montgomery Advanced Practice
Center (APC). This project intends to
increase awareness, understandi."1g and
knowledge of public health emergency
threats among low income Latino
families and to develop and test culturally
and linguistically appropriate educational
interventions. The project uses the health
promoter model as a strategy.
--_."---"-".-"'"­
,-
..
-
"'"""""--
...
-
......
;;::~-;~=:;;~~
=~-=:.::.-:::~-",::-
...
....
"".~-..-
Workgroups
Latino Data Workgroup
Under the auspices ofthe Latino Health
Steering Committee, this
Workgro~p
,
brings together stakeholders to '
collaboratively develop and implement '
an action plan that
will
enhance the
current system for collecting, analyzing,
, and reporting health data on'Latinos in
Montgomery County.
How
to
Deal
with
Latino Data:
A Guide for
Montgomery County
Service Providers
t ........
rY.J~h
t..-"",,,,
?1..w~1l~'7~l\L..;-yi.,,~
o.p.oow.:t>t"n~;!!<o
,IN!
U.m:u"~n.
Community Engagement Workgroup
Under the auspices of the Latino Health Steering Committee, this
Workgroup seeks to unite stakeholders in Montgomery County to
increase community participation in decisions that impact the health
of the Latino community by increasing the number and capacity of
Latino service providers, community leaders and consumers who lead
efforts to improve health.
The Latino Health Initiative,'s list of programs and activities is available
at 'yI;"WW.lhiinfo.org.
The Latino Health Initiative's website contains many resource materials
that can be downloaded and used. Any material may be photocopied
or adapted to meet local needs without permission from the LHI,
provided that the parts copied are distributed' free or at cost Cnot for
profit) and that credit is given to the Latino Health Initiative of the
Department of Health and Human Services, Montgomery County,
Maryland. The LHI would appreciate receiving a copy of any material
in which parts of LHI publications are used,. MaterialCs) should be sent
to LHI, 8630 Fenton
St.,
10th floor, Silver Spring, MD 20910.
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Page 1 of 1
--_._-_
........
_
..
_
..
-
.......
_._
..
_.
__
._
....•............
From:
Sent:
To:
Cc:
Mihill, Amanda
-~
...............•
-.-.-
.....
-
....
-.-
...
-
..
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..
-.----,.-
....•.
----,-,------
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..
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-.-
--~----.---~.
Carol Garvey [cgarvey@garveyassociates,com]
Thursday, February
to,
2011
8:57 PM
Ervin, Valerie; Councilmember George Leventhal; Navarro, Nancy; Rice, Craig
McMillan, Linda; lVIihill, Amanda; Ahluwalia, Uma; Tillman, Ulder
Subject: Bill 1-11
TO THE MONTGOMERY COUNTY COUNCIL:
I support Bill 1-11 and its intent to address health care needs and health equity, but, in addition to
the wording changes in Section 24-22 suggested by Grace Rivera-Oven, I suggest a small but
. important word change in Section 2-42 A. (c) (16):
The word "provide" in that line should be changed to "assure."
RATIONALE: HHS no longer "provides" direct access to health care, although in the past they
provided pediatric well child care, prenatal care, and family planning. What HHS does now is
works with private groups to "assure" that health care can be provided. It does this by providing
seed money rather than full support to a host of private organizations affiliated with Montgomery
Cares. HHS funding comprises
-35%
of the resources utilized by these organizations, and it is the
private organizations, rather than HHS, which provide direct access.
(Direct health care services in Montgomery County are now limited to the very old and
traditional public health functions of preventing and treating communicable diseases of public
health importance - influenza, TB, HIV, and STDs).
Public health organizations have been guided in recent decades by the seminal 1988 treatise
THE FUTURE OF PUBLIC HEALTH, published by the Institute of Medicine. This document defined 3
roles for public health departments:
ASSESSMENT of the health status of the area for which the agency is responsible,
POI.lCY DEVELOPMENT to address the issues identified through assessment, and
ASSLIRANCE that services exist to provide the services deemed to be necessary.
This work has stimulated health departments around the United States and in Montgomery
County to divest themselves of many of their direct services. The rationale is that health
department budgets are both finite and undependably variable, making it difficult to meet the
ongoing needs of a local population. The private health care system is far larger and more
stable, with greater elasticity in its resources to meet the needs of the population. The role of
health departments is to work with the private sector to help them become more responsive to
the needs of the population.
The work done by the Montgomery County Department of Health and Human Services is
completely aligned with the Institute of Medicine premise, and Bill 1-11 would codify this
approach. However, "assure" in line 16 is a far more accurate verb than "provide," and it is far
more consistent with current public health theory and practice.
Carol Garvey
211112011
 PDF to HTML - Convert PDF files to HTML files
• Asian American
Health Initiative
Steering Committee
February 15,2011
Council President Valerie Ervin
Montgomery County Council
Councilmember George Leventhal
Chair, Health and Human Services Comm ittee
Montgomery County Council
Dear Council President Ervin and Council member Leventhal:
On behalf ofthe Asian American Health Initiative Steering Committee (AAHISC), we are writing to
express our support for the B
ill
I-II,
introduced by Councilmember Leventhal and co-sponsored by
Councilmember Navarro and Councilmember Rice.
According to the U.S. Census Bureau, racial minorities account for about 50.7% of the total
Montgomery County population. Asian Americans are the second fastest growing ethnic minority group
in the last decade and comprise about 13.9% ofthe County's population. This culturally-diverse group is
often linguistically isolated, creating barriers to quality healthcare.
We believe that the bill will better enable the Department of HeaIth and Human Services to continue
serving the County's most vulnerable and underserved communities. To further strengthen the bill, the
AAHISC would like to offer the following comments:
• Section 2-42A of the bill states duties ofthe Department and Powers of the department (c). We
strongly believe that it is important to add the terms "culturally and linguistically competent"
when describing department programs and services.
• Section 2-42A of the bill states duties ofthe Department and where department provides staff
support (d). We strongly believe that it is important to include language that recognizes and
supports the Department's existing work on "minority health".
Thank you for this opportunity to provide our comments. We look forward to working with the Council
to build a healthy community.
Sincerely, .
;.,
'i
-_·_· ·. . ··7
I~~"
(
Harr ..... won, Ph.D., M.P.H., CHES
Chair
Asian American Health Initiative Steering Committee
CC:
Nancy Navarro, HHS Committee Member
Craig Rice, HHS Committee Member
Uma Ahluwalia, Director, DHHS
Betty Lam, Chief, Office of Community Affairs, DHHS
~
}f
J.'
MengK. Lee
Vice Chair