Left to right: David Guthrie- CT CDC Public Health Advisor; Louise Butcher – ADA; Ann Elwell- Qualidigm; Debby Russo- Qualidigm; Sharon Mierzwa- Ct State Health Department- Diabetes Control Program; Eileen O’Keefe- HH; Neil Grey, MD Physician champion, HH; Marisol Cruz- Marino, RN HH; Katherine McCormack, Dir. Hartford Health Department; Mayor Michael Peters; Ed Johnson, DMD, St. Francis Hospital; Rose Maljanian, RN HH, Chairperson, Hartford Hospital; Nichalos Abourizk, MD Physician champion, St. Francis Hospital; Rolando Martinez- Hispanic Health Council; Suzette Benn, Urban League, Co-chairperson Urban League.

IMPROVING THE HEALTH OF HARTFORD
CALLS TO ACTION
Diabetes Call to Action Task Force

EXECUTIVE SUMMARY

On November 30, 1999, Mayor Michael Peters joined the City of Hartford Diabetes Call to Action Task Force members in front of their banner on Capital Avenue "Control Your Diabetes, Live a Better Life" for a banner signing ceremony. In concert with diabetes Awareness month, the banner was displayed to increase public awareness of diabetes and provide some information on where to get help for those afflicted with the disease. The ceremony on November 30 marked the end of diabetes awareness month and a kick off of another year of the Diabetes Call to Action Task Force’s outreach efforts.

As a result of the Mayor’s Blue Ribbon Task Force which concluded it’s work in 1995, the Community Health Partnership Steering Committee was formed to address the reorganization of Public Health and assess the health status of Hartford residents. A preliminary analysis and Hartford Health Survey was conducted to set the stage for identifying and addressing the issues. It was noted in the preliminary analysis that Hartford has exceptional resources and exceptional efforts targeted at improving the health of the people of Hartford. All agreed that the efforts would have a greater impact if they were better coordinated among healthcare and community organizations and if identification, prioritization and evaluation of issues and efforts were data driven through population information. A formal Call to Action by the City Health Director along with the Public Health Advisory Council and the Steering Committee serve to provide an umbrella for activities that surround any given health issue.

Diabetes was announced as the first Call to Action commenced in January, 1998.

This Call to Action resulted in the formation of the Hartford Diabetes Health Coalition, consisting of; the Hartford Health Department, the Urban League of Greater Hartford, the Hispanic Health Council, St. Francis Hospital and Medical Center, Hartford Hospital, the State Department of Public Health, Charter Oak Terrace/Rice Heights Health Center and Community Health Services Health Center, the American Diabetes Association, and the Visiting Nurse Association of Greater Hartford. The coalition is a sub-group of the Community Health Partnership and operates under the auspices of the City of Hartford Health Department.

The scope of activity for the Call to Action was determined to be adults residing in the City of Hartford that have pre-existing diabetes or were determined to be at risk for having diabetes. A multi-pronged approach was planned to include primary, secondary and tertiary prevention targeting both providers and recipients of health care. Examples of activities are as follows:

• provider education programs for physicians and APRNs, house staff and staff of community based clinics on ADA standards of care

• community outreach screenings and education which has screened over 550 persons to date

• homebound program designed to reach those unable to come out for screening events.

• creation of a library of approved educational materials and an
• awareness programs on Public Access television.

The Diabetes Call to Action Task Force will enter it’s third year in January, 2000. The scope of the group’s work will be expanded to include adolescents with Type 2 with the assistance of Connecticut’s Children’s Medical Center. The group will continue to address providers and the Hartford community at large to fight the devastating complications associated with Diabetes through early detection and better control.

Progress on each Call to Action is reported at the monthly Public Health Advisory Council meetings.

 To view the Diabetes Call to Action reports, please visit our publications page.

Mayor's Blue Ribbon Task Force On Public Health

EXECUTIVE SUMMARY

Findings

The Major's Blue Ribbon Task Force on Public Health finds that the City of Hartford is home to some of the most technologically advanced health care facilities in the world. These hospitals and outpatient clinics provide services to large number of medically indigent Hartford residents. Yet, despite our efforts, residents continue to be in poor health. Although socioeconomic status has a major impact, we believe that health status can be substantially improved through better structuring and better defining the role of the Hartford Health Department in a partnership for public health. We believe that failure to take action will result in higher taxes and in higher insurance premiums for the average citizen to pay for uncompensated care.

Mission

The primary focus of the Hartford Health Department (HHD) should not be to treat people who are sick, but rather to identify the causes of illness and injury in the city and to reduce or eliminate them. In addition, the department should work with other agencies and institutions to assure that the most important medical services are available and accessible to residents, are of the highest quality, and are used appropriately.

Recommendations

To accomplish this mission, the health department must develop a new paradigm, a public/private partnership anchored by sound, new contemporary relationships between multiple entities that represent rich and diverse resources. It must have the appropriate tools as well as the proper mix of skills and support to become an equal partner in the city's public health delivery system. As this partnership is developed, it will help each of our agencies improve the health status and services to the citizens of Hartford. The department can then play a major role in improving access to primary care and in building a system to keep all residents healthy.

This task force report recommends that the health department be changed to one that can provide the surveillance planning, and emergency response to disease and environmental threats; that can protect health and safety; that can increase responsiveness to elected officials and the public; and that can increase the effectiveness of our healthcare delivery network.

The Report recommends fundamental organizational changes at the Hartford Health Department, both in form and in function. It suggests that a Board of Health be established and that the Board have specific public health responsibilities and authority. It suggests that student health services would benefit from a coordinated, collaborative relationship with HHD. Environmental health authority and responsibilities, currently derived between two departments, should be centralized and coordinated, and exploration of the potential for creating a regional health district should be explored. Vital functions of the HHD will include the establishment of a health statistics capacity that assures accurate information is available, grants management that identifies, attracts and prudently utilizes grant dollars available, and health education and information readily available and routinely distributed.

The Report identifies that there is a defined need for increased and improved service delivery of preventive and primary health care. This reorganized Health Department will enhance family-focused outreach and education and assure the availability of resources that will assist providers in developing programs and services that are culturally and linguistically appropriate. The Report further recommends that the Department regularly elicit and make available to providers consumer input that will positively influence the elimination of the various barriers to care.

The report details recommendations that the Department assures the continuous provision of child development services. This includes initiation of a city-wide task force to address policy and program issues germane to this specialty, the development of a population-based tracking system and inventory of services.

Additionally, the Department would provide appropriate consultation and support to community-based agencies, while facilitating appropriate referrals.

The Report and its Recommendations are offered to the Mayor for his careful review and approval. Implementation of the Recommendations will commence immediately upon receipt of said approval and consistent with the time frames detailed in the Report.