Press release from the Office of Sen. Jorge Cabrera:
May 23, 2021
HARTFORD, CT – Today, from the state Capitol Building, state Senator Jorge Cabrera (D-Hamden) voted for the passage of a bill to declare racism a public health crisis, ensure our state is prepared for future pandemics and address the current public health challenges caused or exacerbated by COVID-19. Senate Bill 1, “An Act Equalizing Comprehensive Access to Mental Health Behavioral and Physical Health Care in Response to the Pandemic,” will head to the state House of Representatives for further debate and action.
“In the past year, the word equity has been used by many and today I am proud to join my colleagues in supporting the passage of a bill that truly places equity at the forefront,” said Sen. Cabrera. “Racism is a public health crisis, it is heartbreaking that this is true and even more heartbreaking that some choose to deny this fact, but the data is clear that the physical and mental health of people of color in this state and country is negatively impacted by racism. This is a good bill, taking a needed first step to address this public health issue that has been ignored for far too long. This bill also addresses women’s health, mental health and places us in a position to better handle future pandemics. This is the right action to deal with the issues of our time and the ones that have persisted.”
SB 1 is a comprehensive bill with health equity at its foundation to address the state’s current response to COVID-19, preparedness in the event of another major public health crisis and declares racism a public health crisis, creating a commission on Racial Equity in Public Health to document and make recommendations to decrease the effect of racism on public health. According to the National League of Cities, over “90 cities publicly declaring racism a public health crisis in 2020.” According to Pew Charitable Trusts article from June of 2020, “Black women are up to four times more likely to die of pregnancy related complications than white women. Black men are more than twice as likely to be killed by police as white men. And the average life expectancy of African Americans is four years lower than the rest of the U.S. population.” Also, per Pew, “pervasive racism is the cause,” for these inequities. The Centers for Disease Control and Prevention has also commented on the issue, “racism—both interpersonal and structural, negatively affects the mental and physical health of millions of people, preventing them from attaining their highest level of health, and consequently, affecting the health of our nation.”
Regarding the state’s COVID-19 response, SB 1 requires the Department of Public Health to conduct a study on the state’s response to the pandemic and, no later than February 1, 2022, the Commissioner of Public Health must submit a preliminary report to the legislature’s Public Health Committee with the commissioner’s recommendations.
The bill continues to address health equity by requiring the Department of Mental Health and Addiction Services to develop a mental health toolkit to help employers address employee mental health needs that arise due to COVID-19. SB 1 takes on women’s health through several improvements such as requiring the chairpersons of the Public Health Committee to convene a working group to advance breast health and breast cancer awareness, requiring DPH to conduct a study to determine whether the department should establish a state certification process for doulas and requiring the Maternal Mortality and Morbidity Review Committee established in the general statutes to annually report disaggregated data regarding the information and findings obtained through the committee’s investigation process to the Public Health Committee.
The bill advanced out of the Public Health Committee by a 22-11 tally on March 26 and received support from medical professionals, the state’s association of boards of education and non-profits and advocacy groups for social justice during the public hearing phase of legislative session. Jennifer Barahona, the chief executive officer at Norwalk ACTS said of the bill: “I am writing in strong support for SB 1 and particularly sections 6 and 7 that would declare racism as a public health crisis in the state and establish a commission to study the impact of institutional racism on public health and provide proposals to address disparities.” She continued: “Racism clearly meets the criteria of a public health crisis in that it affects large numbers of people, threatens health over the long-term, and requires the adoption of larger-scale solutions.”
Ruth Canovi, the director of advocacy at the American Lung Association of said, “SB 1 would recognize racism as a threat to public health and create a commission on disparities. These are needed first steps to create health equity in Connecticut. For example, because of systemic racism throughout our country, communities of color are often exposed to greater air pollution and bear a higher burden of lung disease. While recognizing racism as a public health threat will not immediately alleviate these disparities, it does identify the threats that currently exist.”
The Connecticut State Medical Society expressed support for several sections of SB 1, and commented overall on the bill stating, “Connecticut must tackle the issues of inequality and disparities in health care and CSMS believes this Bill includes some important steps in doing so.”
Addressing Systemic Racism
Declaration of Racism as a Public Health Crisis
- Establishes a Commission on Racial Equity in Public Health to document and make recommendations to decrease the effect of racism on public health. The commission shall be part of the Legislative Department. The Secretary of OPM or her designee and a representative of Health Equity Solutions (a “non-profit organization with a state-wide focus on promoting policies, programs, and practices that result in equitable health care access, delivery, and outcomes for all people in Connecticut”) will serve as co-chairpersons of the commission. The commission, by majority vote, shall hire an executive director to serve as administrative staff of the commission. The executive director may hire up to two executive assistants to assist in carrying out the duties of the commission.
- The commission shall, among other things:
- Support collaboration by bringing together partners from many different sectors to recognize the links between health and other issues and policy areas and build new partnerships to promote health and equity and increase government efficiency.
- Create a comprehensive strategic plan to eliminate health disparities and inequities across sectors.
- Study the impact that the public health crisis of racism has on vulnerable populations within diverse groups of the state population, including on the basis of race, ethnicity, sexual orientation, gender identity and disability, including, but not limited to, Black American descendants of slavery.
- Beginning January 1, 2022, and every six months thereafter, the commission shall submit a report to OPM and the public health and appropriations committees concerning:
- The activities of the commission during the prior six-month period.
- Any progress made in attaining the goal described in section 3 of this act.
- Any recommended changes to such goal based on the research conducted by the commission, any disparity study performed by any state agency or entity, or any community input received.
- The status of the comprehensive strategic plan required under section 3 of this act.
- Any recommendations for policy changes or amendments to state law.
Recruitment and Retention of Health Care Workers of Color
The bill requires the Commissioner of Public Health to study the development and implementation of a recruitment and retention program for health care workers in the state who are people of color. Not later than February 1, 2022, the commissioner shall report the results of such study to the public health committee. Such report shall include any legislative recommendations to improve the recruitment and retention of people of color in the health care sector, including, but not limited to, recommendations for the implementation of such recruitment and retention program.
Higher Ed Study on People of Color in Health Care Preparation Programs
Requires the Office of Higher Education, in collaboration with the Board of Regents for Higher Education and the Board of Trustees of The University of Connecticut to evaluate the recruitment and retention of people of color in health care preparation programs offered by the constituent units of the state system of higher education and the inclusion of cultural humility education in such programs. “Cultural humility” means a continuing commitment to (1) self-evaluation and critique of one’s own worldview with regard to differences in cultural traditions and belief systems, and (2) awareness of, and active mitigation of, power imbalances between cultures. Not later than January 1, 2022, the office shall submit a report, to the higher education committee. Such report shall include the results of such evaluation and any legislative recommendations to improve the recruitment and retention of people of color in such programs and include additional cultural humility education in such programs.
Racial and Ethnic Impact Statements
Requires the executive director of the Commission on Women, Children and Seniors to include an update on the status of amendments to the joint rules concerning the preparation of racial and ethnic impact statements in his annual report to the appropriations committee.
Gun Violence Intervention and Prevention Advisory Committee
Establishes a gun violence intervention and prevention advisory committee for the purpose of advising the joint standing committees of the General Assembly having cognizance of matters relating to public health and human services on the establishment of a Commission on Gun Violence Intervention and Prevention to coordinate the funding and implementation of evidence-based, community-centric programs and strategies to reduce street-level gun violence in the state. The committee shall:
- Consult with community outreach organizations, victim service providers, victims of community violence and gun violence, community violence and gun violence researchers and public safety and law enforcement representatives regarding strategies to reduce community violence and gun violence.
- Identify effective, evidence-based community violence and gun violence reduction strategies.
- Identify strategies to align the resources of state agencies to reduce community violence and gun violence.
- Identify state, federal and private funding opportunities for community violence and gun violence reduction initiatives.
- Develop a public health and community engagement strategy for the Commission on Gun Violence Intervention and Prevention. By January 1, 2022, the committee shall submit a report on its findings and recommendations to the public health and human services committees. The committee shall terminate on the date that it submits such report or January 1, 2022, whichever is later.
Demographic Data Collection
Requires any state agency, board or commission that directly, or by contact with another entity, collects demographic data concerning the ancestry or ethnic origin, ethnicity, race or primary language of residents in the health care context to:
- Collect such data in a manner that allows for aggregation and disaggregation of data.
- Expand race and ethnicity categories to include subgroup identities as specified by the Community and Clinical Integration Program of the Office of Health Strategy and follow the hierarchical mapping to align with United States Office of Management and Budget standards.
- Provide the option to individuals of selecting one or more ethnic or racial designations and include an “other” designation with the ability to write in identities not represented by other codes.
- Collect primary language data employing language codes set by the International Organization for Standardization.
- Ensure, in cases where data concerning an individual’s ethnic origin, ethnicity or race is reported to any other state agency, board or commission, that such data is neither tabulated nor reported without racial or ethnic data.
Addressing the State’s COVID-19 Response
Requires the Department of Public Health to conduct a study on the state’s COVID-19 response. Not later than February 1, 2022, the Commissioner of Public Health shall submit a preliminary report to the public health committee. Such report may include the commissioner’s recommendations.
- Any policy changes and amendments to the general statutes necessary to improve the state’s response to future pandemics, including, but not limited to, recommendations regarding provisions of the general statutes or the regulations of Connecticut state agencies that should automatically be waived in the event of an occurrence or imminent threat of an occurrence of a communicable disease, except a sexually transmitted disease, or a public health emergency declared by the Governor.
- How to improve administration of mass vaccinations, reporting and utilization of personal protective equipment supply during a public health emergency, cluster outbreak investigation and health care facilities’ care for patients.
Mental Health Toolkit
Requires the Department of Mental Health and Addiction Services to develop a mental health toolkit to help employers address employee mental health needs that arise due to COVID-19. The toolkit must:
- Identify common issues and their symptoms.
- Provide information and other resources on actions that employers may take to help employees address these issues.
- The bill requires DMHAS to post the toolkit on its website by October 1, 2021
Breast Health and Breast Cancer Screenings
Requires the chairpersons of the public health committee to convene a working group to advance breast health and breast cancer awareness and promote greater understanding of the importance of early breast cancer detection in the state. The working group shall identify organizations that provide outreach to individuals, including, but not limited to, young women of color and high school students, regarding the importance of breast health and early breast cancer detection. Not later than February 1, 2022, the working group shall submit to the public health and appropriations committees, on legislative proposals that will improve breast cancer awareness and early detection of breast cancer.
Doula Certification Study
Establishes a statutory definition of “doula” as “a trained, nonmedical professional who provides physical, emotional and informational support, virtually or in person, to a pregnant person before, during and after birth and requires the Department of Public Health to conduct a scope of practice review inclusive, of the general statutes to determine whether DPH should establish a state certification process by which a person can be certified as a doula.
Maternal Mortality and Morbidity Task Force
Requires the Maternal Mortality and Morbidity Review Committee established in the general statutes to annually report disaggregated data regarding the information and findings obtained through the committee’s investigation process to the public health committee. Such report may include recommendations to reduce or eliminate racial inequities and other public health concerns regarding maternal mortality and severe maternal morbidity in the state.
Improving Access to Care
Implicit Bias Training at Hospitals
Beginning October 1, 2021, the bill requires hospitals to include implicit bias training as part of their regular training to staff members who provide direct care to women who are pregnant or in the postpartum period. Under the bill, “implicit bias” means an attitude or internalized stereotype that affects perceptions, actions, and decisions in an unconscious manner and often contributes to unequal treatment based on someone’s race, ethnicity, gender identity, sexual orientation, age, disability, or other characteristics.
This press release was produced by the Office of Sen. Jorge Cabrera. The views expressed here are the author’s own.