Supporting Children with Disabilities Lessons from the Pandemic: Proceedings of a Workshop (2022) / Chapter Skim
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6 Health Equity
6 Health Equity
Pages 49-58
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From page 49... ...
There are a number of contributing factors to these disparities, said Raphael, including lack of access to care, underlying disparities in health conditions, living in dense and multigenerational housing, having parents who work in higherrisk occupations and settings, and medical mistrust and racism. Children with disabilities or medical complexities also faced a number of challenges during the pandemic, including risk of severe illness or death, lack of access to regular services in clinics or home, shortages of medical equipment, and difficulty with remote learning.
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From page 50... ...
Third, there is a need for changes to payment systems, including preserving the pandemic flexibilities in Medicaid prior authorization policies, and the reimbursement of family caregivers. Fourth, said Raphael, there is a need to collect and analyze outcomes and social determinants according to characteristics including race, ethnicity, and primary language.
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From page 51... ...
There are no high-speed internet providers in many areas of Alaska; some of Fuentes' clients in the high rural and frontier populations simply could not access telehealth. Moving Forward In order to provide quality care for children with disabilities in a reas like Alaska, said Fuentes, there are several changes that need to be made.
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From page 52... ...
The program utilizes promotoras, community health workers who are from a similar culture and geographic community as the participants, and incorporates common Spanish sayings and cultural values. Lopez stressed that fostering relationships with the family is an essential part of the program, and that home visits reduce barriers to participation.
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From page 53... ...
In addition, she said, it was essential to create and maintain flexible expectations, to have trusted community members as champions of the project, and to have diverse organizational partners including those from schools and clinics. ECHO AUTISM The current system for autistic children and their families is set up around a lot of inequities, said Kristin Sohl (University of Missouri- Columbia School of Medicine)
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From page 54... ...
The goal is to develop local expertise and community access to care; Sohl said that in the state of Missouri, all children are within 45 miles of an ECHO autism primary care clinician. In addition, the virtual nature of the program allows them to reach individuals across the world in order to empower local experts to lead and share.
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From page 55... ...
At ECHO Autism, Sohl said, they continued to develop strategies and partnered with primary care colleagues to figure out what could work. Leaving people out, whether because of the pandemic or because they live too far away, she said, cannot be an option.
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From page 56... ...
Are they seeing leaders that demonstrate how to minimize power differentials, or how to elevate people whose voices historically have not been heard? In addition, we need to challenge the assumptions that people with disabilities are less than or incapable.
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From page 57... ...
HEALTH EQUITY 57 • Raphael: Families who are not typically part of the process would be included in the conversation and given a seat at the table; when we don't include all perspectives, health inequities are often propa gated or worsened.
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