Keeping the 'Health in Rhode Island Plan' Front and Center
The Long-Term Health Planning Committee remains committed to maintaining the priorities of the Plan as a “North Star"
Guiding coordination and decision making
The Health in Rhode Island plan, developed by a committee of local health and healthcare experts convened by the Rhode Island Foundation, has identified priorities and outlined a commitment to addressing those needs over the long-term. From the outset, the goal of the committee was not to dictate a prescriptive set of actions or supersede existing work, but instead, to help define and communicate a broader vision and priorities to guide coordination and decision making over the next decade. Over the last year, the committee has continued to meet and discuss how the members, both individually and collectively, can continue work to enable the Health in Rhode Island plan to inform and influence investment, partnership, and policy in the state.
The need for greater health equity in our healthcare system and in our pandemic response and recovery efforts has also reinforced the committee’s commitment to using data to identify and address the root causes of poor health outcomes, including systemic barriers and socioeconomic factors that impact individual and community health.
A key component of the long term plan is ensuring that relevant health metrics are monitored over time to track progress and identify emerging priorities. There is significant interest in how the COVID-19 pandemic has impacted key health metrics. Due to the lag time in data being available and the delay between incident and impact, we do not yet have the full picture of COVID’s impact. However, since our data dashboard went live in 2020, we will be able to show trends from the years preceding, during, and following the pandemic in future updates.
- Providing the most appropriate care for people in the most appropriate setting.
- Focusing upstream on root causes and investing in affordable housing, food security and transportation to address underlying inequities and influencers of health disparities.
- Improving behavioral health outcomes by focusing on access to care, coordination of care and prevention.
- Reducing wasteful spending in order to redirect resources to social determinants and improve affordability.
- Ensuring sustainability, accountability and oversight of the group’s vision, and maintaining progress in key areas where Rhode Island performs well.
The data dashboard can be accessed at HealthinRI.com.
Informing and supporting work through data
The need for greater health equity in our healthcare system and in our pandemic response and recovery efforts has reinforced the committee’s commitment to using data to identify and address the root causes of poor health outcomes, including systemic barriers and socioeconomic factors that impact individual and community health. The committee, in partnership with Healthcentric Advisors, created a data dashboard that combines a holistic view of health with a long-term vision for improvement – bringing together data from multiple sources and providing a platform where it can be monitored, and will become more valuable over time.
One additional significant step the committee took this year was to reinforce and deepen its commitment to this work through the agreement of four guiding principles.
These principles came about as a result of important conversations within and beyond the committee around how to ensure that any actions and advocacy of the committee would be undertaken in a way that focuses on (1) the root causes and conditions of inequalities, (2) the specific needs of marginalized communities, (3) systemic change, and (4) delivering enduring change and solutions. These guiding principles are now the cornerstone of the committee’s work.
- Equity – The actions and advocacy undertaken by the Health in Rhode Island committee and subcommittees will address the root causes and conditions of systemic inequalities based on race, gender, sexual orientation, disability, economic status. These causes and conditions directly lead to health inequalities in Rhode Island and underly disparate access and barriers for historically marginalized and oppressed communities to safe and affordable housing, food security, transportation, high-quality education, and a healthy environment.
- Impact – Given the commitment to racial equity and addressing other systemic inequalities, the actions and advocacy undertaken by the Health in Rhode Island committee and subcommittees will prioritize the specific needs of marginalized communities, with a focus on re-orienting existing systems and pushing for greater investment to address historic and continuing injustices.
- Focus - The actions and advocacy of the Health in Rhode Island committee and subcommittee may focus on short-term “wins” but always as part of an overall goal towards systemic change, transforming a system that has not served all Rhode Islanders equally.
- Sustainability - Recommended actions and advocacy of the Health in Rhode Island committee and subcommittee will aim to deliver enduring change and solutions that enhance the health and wellbeing of historically marginalized and oppressed communities.
Across all of these interrelated planning efforts, there have been several common themes:
Health equity for all – ensuring all Rhode Islanders have the opportunity to be in optimal health, and live, work and play in healthy communities.
Access to high-quality, affordable, and accessible care – focusing resources to maximize health outcomes for Rhode Islanders, reduce waste in the system, ensure appropriate care in the most appropriate settings, and truly support behavioral health needs across the population. All Rhode Islanders deserve to be well, from head to toe.
Eliminate disparities – focus (and in some cases, re-focus) resources on addressing underlying inequities that influence health, and invest in the root causes of these disparities, such as access to safe and affordable housing, a high-quality education and stable income sources.
Support and develop the workforce – ensure that the health sector workforce reflects the community it serves; adequately compensate, train and support health sector workers; and develop the health sector workforce of the future.
Ensure sustainability, accountability and oversight – Changing systems is challenging. With sustainable plans, clear oversight and the ability to hold stakeholders accountable, that change is possible.
Key crosscutting themes
In addition to key issues that fall within the Health in Rhode Island priorities, such as the ongoing crisis of child and adolescent behavioral health, during the committee and subcommittee meetings throughout 2021 and early 2022, we identified overarching priorities to target for specific attention and advocacy. These crosscutting themes touch several, if not all, of the Health in Rhode Island plan’s priorities. One key example of this was Workforce Development, Sustainability, and Diversity.
In order to achieve the priorities of the Health in Rhode Island plan, Rhode Island needs a sufficient and stable healthcare workforce. Workforce challenges and shortages across all care settings, though particularly long-term care, were laid bare over the last year – revealed and accelerated by the impacts of the ongoing COVID-19 pandemic. Providing appropriate care in the appropriate settings for all of Rhode Island’s diverse residents requires additional investment in workforce and workforce infrastructure. This includes foundational work of creating workforce-related data systems to better understand gaps in the current workforce, increasing workforce diversity, addressing barriers to entry and advancement in the workforce, and improving workforce retention. There is a clear connection between a sufficient and stable healthcare workforce and a sufficient and stable health system. The committee will continue to identify where it can help influence and make impact around this vital issue.
Our continuing commitment
Beginning in 2022, a Policy subcommittee will also be formed. The genesis of this subcommittee is the need to be able to respond to some of the timely and crosscutting issues that have arisen through the committee and subcommittee's work. The goal is for the subcommittee to identify and recommend where the full committee might influence legislative, regulatory, statutory, and policy-making opportunities, while recognizing that on many issues, there will not be sufficient alignment among members.
We will continue to work with a broad range of stakeholders committed to advancing and sustaining the specific priorities and strategies identified in the Health in Rhode Island vision. Our collective goal of achieving these priorities is driven by an understanding that healthcare is just one part of keeping people healthy and that solutions must address the systemic issues in our health system and general state infrastructure. By maintaining the data dashboard, we will ensure that data remains at the center of the implementation, sustainability, and accountability of the Health in Rhode Island vision, and that we remain committed to tracking disparities and ensuring equity is centered in all of our work.