April 4, 2012

Indiana Joint National Public Health Week Conference

What is standardized REL data?Specific method of collecting, recording and reporting REL data that is the

same across all areas (uniform questions and categories)

REL data is reported by the individuals served (“self-reported”) or their families and/or caregivers

Standardized method collects, records, stores and reports REL data that is accurate, comparable, and consistent (electronic vs. manual)

Develop strategy to prepare, implement, monitor and sustain adherence to standardization guidelines

What is the rationale?To make certain all individuals served receive high-quality

care

To identify and reduce disparities

To provide culturally and linguistically appropriate services and materials

To ensure equitable access to health care

To develop quality improvement programs

To comply with regulations

National Movement for REL Data Collection

American Recovery and Reinvestment Act (ARRA) 2009 requires hospitals and providers to collect REL data as part of the eligibility for meaningful use payments

Patient Protection and Affordable Care Act of 2010 requires health care programs that receive federal funds to collect REL data

Title VI of the Civil Rights Act of 1964 requires agencies that receive federal funds must provide interpretation to individuals with Limited English Proficiency

Joint Commission requires hospitals to collect race, ethnicity, and preferences for spoken language and written information

U.S Department of Health and Human Services, Office of Minority Health, National Partnership for Action to End Health Disparities Goal #5 Research and Evaluation – improve coordination and utilization of research

and evaluation outcomes

REL Workgroup

• Purpose• Explore current methods of race ethnicity data

collection and make recommendations to state and local agencies about the collection of race ethnicity data

• Goal• Standardize collection and reporting of race

ethnicity data across the state

Literature ReviewRace and ethnicity are not genetic but rather social

constructs that evolve over time

Broad racial groups do not adequately describe diversity of population

Collection of socio-economic information is important

Evidence supports inclusion of Hispanic Latino category within the race question

Race ethnicity data collection is dynamic

Community Input

Obtain feedback from the community through focus groups

REL workgroup developed focus group script to understand what people think about race, ethnicity and language questions asked in a hospital or clinic

Focus Groups Twelve focus groups conducted with 124 participants

Selected counties in Central, Northern and Southern regions of Indiana

LanguagesEnglish and Spanish

Participant demographicsAgeGenderRace/EthnicityEducational attainment

Focus Group Demographics

Focus Group Demographics

Focus Groups Demographics

Focus Groups Demographics

Highlights When asked about the benefits of collecting REL information:

Many participants indicated REL data in health care will help to provide culturally competent care

Majority of participants reported it is important to ask REL questions in hospital or clinic to make certain that appropriate care and services are provided

Many participants would like to report this information on paper rather than verbally

When asked getting reassurance that the REL information will not affect health care Majority racial/ethnic minority participants indicated that it is very to extremely

important that they receive reassurance that REL data will not affect health care

When asked about collecting race and ethnicity information: Some participants expressed concern, suspicion and lack of trust about the collection

of race/ethnicity data reporting that this information would negatively impact on care

When asked about collecting language information: Majority of participants were not concerned about the collection of data on language

REL data collection projectsNational:

Aligning Forces for Quality and Hospital Quality Network projects funded by the Robert Wood Johnson Foundation

Health and Human Services, Office of Minority Health REL projectState

Indiana Hospital Association planning to roll-out REL project statewide

RegionalCentral Indiana Alliance for Health project funded by the Robert

Wood Johnson Foundation

Next StepsDisseminateEngageRecommendAdaptRestructureImplement

Questions

Thank youAdrienne Durham, MPHHealth Disparities EpidemiologistIndiana State Department of HealthEpidemiology Resource Center2 North Meridian StreetIndianapolis, IN 46204317.233.7895 Fax 317.233.7805adurham@isdh.IN.gov

Thank YouChandana Saha, PhD, MPHResearch AssociateIndiana Minority Health Coalition3737 North Meridian Street, Suite 300Indianapolis, IN 46208 317.920.4011 Fax 317. 926.4012 c.saha@imhc.org