80 people at the Kick-Off in AugustAveraged about 20 people each subsequent planning session; about half internal from CDPHE's various departmentsThe rest from a variety of CBOs, academic institutions, private healthcare organizations, local public health, and engaged individual community members.Participants were recruited through a written explanation of the effort and invitation, circulated to a list of existing partners and asked them to share it widelyAll but the kick off have been held at the CDPHE campus on Cherry Creek Drive in Denver
Segments: Individual Brainstorm to Focus Question, Brainstorm further and Prioritize in Small Groups, Whole group organizes into Clusters according to similar strategic intent, Naming of the arena of focus.
A community that practices and promotes healthy livingSpecific examples brainstormed under this heading include:LGBT specific sexual health educationLGBT health educatorsAll school staff are trained LGBT communityNon-bar scene “welcome wagon” for new LGBTComprehensive and inclusive health education for CO youthCommunity ownershipGLBT community assets Unified cultural competency trainingPaid Queer youth health organizersFostering leadershipEquity across the life course Specific examples brainstormed under this heading include:Elder care/ nursing homes welcoming and competentLGBT specific aging in placeCulture of acceptance for youthEvery high school has a GSAHospice/ End of life welcoming & competentGender assignmentReproductionMeaningful Data collectionLGBT Young adults (Especially 18-21)Measured improvement in LGBT healthSpecific examples brainstormed under this heading include:100% all providers welcomingAlcohol, tobacco; other drug use (ATOD) decreaseNorm to come out to providersIdentified health outcomesReduce disparities: Tobacco, Alcohol, Suicide, and ViolenceTrans health same as LGB Health same as overall population healthChoice of 2 providers for LGBT specific careRevised & used Health equity model
Access to high quality LGBT-specific prevention intervention and careSpecific examples brainstormed under this heading include:Best Practices LGBT interventionsRelevant Dental, Mental, Physical healthcare servicesHealth care reform promote, access to and Quality of GLBT servicesEmployment assistance for LGBT communityCare based on comprehensive accessible patient history dataLGBT specific clinic Competent and LGBT-affirming health workforceSpecific examples brainstormed under this heading include:Require LGBT health curriculum (med. School)LGBT inclusive medical educationLGBT specific health professional educationLGBT sensitive health history takingPrevention workersHospital staff office, CNAs, Techs, EMTs, PAs, RNsMental health substance use workersLGBT focused CME
LGBT-affirming policies and political environmentSpecific examples brainstormed under this heading include:LGBT inclusion in CDPHE’s Office of Health Disparities (Legislation)Affirmative Action PoliciesEvery School has inclusive policyFinding sufficient funding (support) for these projectsMandates for Trans- inclusive insuranceExpand & enforce anti-discrimination lawsFull relationship recognition Total Marriage RightsInclusive Health insurance policiesSeparate benefits from marital statusMeasurement of school safetyParenting and adoptionPartnerships that advance mutual aspirationsSpecific examples brainstormed under this heading include:Health in all LGBT orgs. MissionsStatewide database of projectsState-wide inclusiveness (GEO., People of color, Trans.)Database of LGBT friendly employersCommunity partnershipLaw enforcement & criminal justice workersUnified coalition to remove GID from DSMEnd Transphobia, homophobia, and bi-phobiaFinding sufficient funding for these projectsEnd Racism
Foundation of the Vision: Collection & Sharing of Relevant Community DataSpecific examples brainstormed under this heading include:Community- Driven research/ data collection processesData set = with racial populations (S.O. & G.I.)Meaningful Data collectionTrans-inclusiveness on surveysMeasurement of school safety
1. Attitudes, Values, and Norms that Impede Social JusticeSpecific examples brainstormed under this heading include:Maintaining momentum (apathy)Ignorance and misconceptionLocal ControlPaternalismSelf-focused thinkingCivil Rights are political Stigma/HateFear based cultureFearConnection to Morality2. Competing priorities within the LGBT communitiesSpecific examples brainstormed under this heading include:Fragmented GLBT CommunityUnhealthy Community Norms (LGBT)A segmented communityCan feel daunting- major disparities in multiple areasCompeting Community interests/needs“Not my issue” thinking3. Under-developed data systems and processesSpecific examples brainstormed under this heading include:“Small population”Decentralized Data sources and effortOutdated data systemsInaccessible dataCollected data is not inclusive of LGBT populations
4. Deficient public and professional educationSpecific examples brainstormed under this heading include:Conflating Sex and GenderMisperceptions of Sexual OrientationUncoordinated efforts to improve medical educationFull Medical CurriculumDiscouragement of LGBT-focused research“I want to help but I don’t know how”Limited knowledge of Trans Health, Needs, and IssuesUnidentified Best PracticesAttitude and motivation (education /training)5. Inequitable and ineffective policiesSpecific examples brainstormed under this heading include:Issues are lower priority to decision makers“APPARENTLY” small populationUnmotivated LegislatorsState-based mandates don’t work because of local controlUnenforced PoliciesPolicy Implementation and Enforcement6. Diffuse and deficient social support systemsSpecific examples brainstormed under this heading include:Top-Down Decision-MakingInaccessible services for homebound seniorsOverworked providersFragmented resources and receptivenessDecentralized Effort7. A dysfunctional and biased health care systemSpecific examples brainstormed under this heading include:“Label- Based” HealthcareBiased health care systemOverall health care system has accessibility and patient-centeredness challengesLimited knowledge of Trans health, Needs, and IssuesUnmotivated providersUndeveloped Communication ( Healthcare system to/from LGBT communities)Inflexible it systems (Electronic Medical Record)
These questions, along with this overview of the plans to date, will soon be posted online for public review and comment. We are extremely interested in hearing from as many people, and from as many diverse communities across Colorado, as possible so that the final plan is strengthened in its responsiveness to the needs of all Colorado’s LGBT people.
Goal & Primary ObjectiveOverarching Goal: Reduced health disparities in Colorado’s Lesbian, Gay, Bisexual, and Transgender (LGBT) population.Primary Objective: By June 1, 2012, Establish a strategic plan, with 2-year strategies and 180-day implementation actions.
4 Phases of Our Planning ProcessVision ◦ In 2021, what is in place to help address the health and wellness of the LGBT communities in Colorado?Barriers & Obstacles ◦ What are the barriers that keep us from reaching our vision?Strategic Directions ◦ What are the two-year strategic directions that will move us past barriers towards our Vision?Implementation ◦ What are the accomplishments for the next year?
What’s Happened So FarEvent DateKickoff (Engaging Partners) August 31, 2011Environmental Scan September 8, 2011(Data & Policy Background)Participatory Planning Sessions •Developing a Vision September 20, 2011 (7.5 hrs) •Identifying Barriers & October 11, 2011 (4 hrs) Obstacles •Identifying Strategic October 11, 2011 (4 hrs) DirectionsPublic Comment November – December, 2011Implementation Planning January – May, 2012
How the Planning Happens: Foundational Values: • Participation • Teamwork • Consensus • Creativity • Action A flexible but structured alternation of discussing in small groups and whole group Process developed by the Institute of Cultural Affairs, part of their Technology of Participation trainings
Segments of Group Planning Work Individual Brainstorm on Focus Question Brainstorm further and Prioritize in Small Groups Whole group organizes into Clusters according to similar strategic intent Naming of the arena of focus
The VisionIn 2021, what is in place to help addressthe health and wellness of the LGBTcommunities in Colorado? 3 “pillars” of our vision were identified Along with one Foundational PrerequisiteColorado is working towards: 1. Healthy and Happy LGBT People and Communities 2. Excellence in LGBT Health Programs & Services 3. Liberating Policies, Partnerships, & Strategic Action
Vision Pillar #1:Healthy, Happy LGBT People & Communities A community that practices and promotes healthy living Equity across the life course Measured improvement in LGBT health
Vision Pillar #2: Excellence in LGBT Health Programs & Services Access to high quality LGBT-specific prevention intervention and care Competent and LGBT-affirming health workforce
Vision Pillar #3: Liberating Policies, Partnerships, & Strategic Action LGBT-affirming policies and political environment Partnerships that advance mutual aspirations
The Foundation of The VisionThe above pillars of the vision must be grounded and supported byCollection and Sharing of Relevant Community Data
Barriers & Obstacles What are the barriers & obstacles that would keep us from reaching our Vision?◦ 7 Major Categories of Obstacles were identified◦ Presented here in order of how impactful they are perceived to be… the first is thought to be the most challenging – the one “at the center of the storm” The second was thought to be second-most challenging, and so on.
Barriers that would keep us from reaching our Vision1. Attitudes, Values, and Norms that Impede Social Justice2. Competing priorities within the LGBT communities3. Under-developed data systems and processes
Barriers that would keep us from reaching our Vision4. Deficient public and professional education5. Inequitable and ineffective policies6. Diffuse and deficient social support systems7. A dysfunctional and biased health care system
Strategic Directions What are the strategic directions that will move us past the barriers & obstacles toward our Vision?◦ 6 Strategic Directions were identified
Strategic Direction #11. Enhancing Skills and Education a. Launch an inter-disciplinary conference “Queering Public Health” b. Train LGBT health advocates c. Promote existing education and development programs d. Create a LGBT-focused Continuing Medical Education course e. Inform about difference b/w behavior and identity (as these relate to health) f. Educate the LGBT Community on intergenerational issues g. Target message about participation research
Strategic Direction #22. Identify and Promote an Inclusive LGBT Policy Agenda a. Promote transgender representation in public health actions b. Establish inclusion of LGBT health within the Office of Health Disparities at CDPHE c. Ensure inclusion of LGBT health standards included in the Affordable Care Act d. Promote marital and family recognition to improve LGBTQ health e. Demand affirmative action f. Demand Trans inclusion in Health Care Reform Agencies
Strategic Direction #33. Develop a sustainable process to coordinate research and develop benchmarks a. Identify missing data fields in the written/electronic medical record b. Identify the social determinants of health for LGBT communities c. Add LGBT questions to existing health surveys d. Include under-represented LGBT communities in research e. Develop targeted LGBT health benchmarks (which include socially-determined health factors) f. Create a LGBT health research collaborative g. Promote collection of sex orientation and gender identity by H.C. providers h. Create template for data collection on LGBT health and develop buy-in to use it i. LGBTQ planning regarding the Youth Risk Behavior Survey (YRBS) j. Inform about difference b/w behavior and identity (as these relate to health)
Strategic Direction #44. Change Attitudes and Beliefs a. Pilot “LGBT 101” in schools (Elementary through College) b. Organize youth to demand LGBT-inclusive sex education c. Develop a social marketing campaign about LGBT health i. educates, unifies, participatory d. Develop a “Healthy LGBT” Movement/Education Primary Prevention e. Organize against misinformation and fear promoted by Focus on the Family f. Create a “Welcome Wagon” (to orient Colorado newcomers to LGBT resources)
Strategic Direction #55. Compile Existing Information and Resources on the state of LGBT Health in Colorado a. Compile existing standards & research b. Map resources (allies and advocates, including faith- based organizations) c. Develop an inventory of inequitable policies d. Identify existing LGBT health initiatives e. Develop on-line database of research projects and funding
Strategic Direction #66. Engage Community Partners a. Enlist LGBT organizations as partners b. Engage health organizations with non-LGBT specific focus in this work c. Engage faith-based allies d. Expand individual dialogue and storytelling (such as the Kaiser Permanente video “OUT”) e. Educate voters about candidate positions on LGBT health issues f. Stop accepting sponsorships from alcohol, tobacco, and prescription drugs companies g. Expand broad-based community engagement (school counselors/ social workers) h. Accessing Artists to promote new narratives
Thanks to our FunderFunding for this project is made possible from a grant from the U.S. Department of Health and Human Services as a “Healthy People 2020 Action Project”
Now, we’d like your input: When you consider these 6 overall strategies, do you feel we‟ve missed any major strategic directions that need to be included? Do you feel that any of the 6 strategies are „missing the mark‟ and need revising or expanding in particular ways? Do you have any additional comments you‟d like to offer either specific to the 6 major strategic directions, or about the plan overall?
Join in the Work & the Fun! Next Planning Session is January 5th, 2012 Session Objective: To refresh memories about our progress this Fall, review additions made from the public comment process, and divide into smaller subgroups Subgroups will meet regularly at CDPHE, and online, throughout the Spring. CONTACT: Julie Graves if you‟d like to participate – everyone is welcome!
Questions? Need more Info? Julie Graves, M.S. Project Coordinator Evaluator, Prevention Services Division CO Department of Public Health & Environment firstname.lastname@example.org (303) 692-2079
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