www.samhsa.gov/grants/grants-management/disparity-impact-statement In addition to the table, provide a narrative to describe the context and explain the service population. Here it is important to describe the characteristics that can affect the access of different groups to health care, such as the main language spoken, access to transport, physical disabilities, socio-economic aspects, etc. This will provide a rationale as to why funds and efforts are being used to reach underserved groups who may not connect to or benefit from the program. To follow an example of the following steps, please read the SAMHSA explanation sample in www.samhsa.gov/sites/default/files/disparity-impact-statement-example-services.pdf. Disparities impact statements measure and inform how various services are provided and received by underserved groups in the general population. These statements clarify existing inequalities and outline plans to ensure that groups affected by inequalities can achieve the same level of access, quality of care and positive outcomes as other members of the population served. Early diversion offers optimal opportunities to reduce inequities in the criminal justice system, as it can allow individuals to avoid criminal charges and the long-term collateral consequences associated with criminal proceedings. Early diversion can also address differences in behavioral health by potentially connecting individuals to care when they previously did not have access to services and treatments. However, because implicit bias and other factors that reinforce the exclusion of certain groups may persist despite general measures, it is important to clearly plan and describe how early redirection programs can be targeted to eliminate disparities. Content requirements and submission date can be found in the Notice of Award (NOA). For specific or additional information, contact your Government Project Officer (GPO) listed in the “Contracts” section of the Notice of Approval. For more information and support, check out the following resources: SAMHSA requires all grantees* to create a data-driven Behavioral Health Disparity (DIS) Impact Statement to promote equal opportunity for all to identify racial, ethnic, sexual and gender minorities most at risk of health behavioral inequalities in their funding projects and, pursuant to Executive Order 13985: Federal Government Promotion of Racial Justice and Support for Underserved Communities. In addition to having a plan to reach underserved groups, it is important to regularly review adherence to the plan, progress, and optimal resulting outcomes.
From a behavioral health perspective, quality improvement is the process of systematically using data to inform and improve how care is delivered. There are several quality improvement models that can serve as a framework for this process. At a minimum, data should be collected and analyzed to understand service accessibility, level of use, and outcomes for priority sub-populations with the group served. The implementation of the new DIS will start immediately for all funding granted from 30 September 2022. For grants awarded prior to this date, the grantee may work with their government project officer to determine the most appropriate DIS for submission. The following resources can be used as a reference and guidance when preparing the new DIS for each type of grant program: services, infrastructure, training and technical assistance. Programs that evaluators use to document and analyze processes and outcomes can use their work to assess whether the program is implemented in a way that meets cultural and linguistic needs, provides effective, high-quality programs for underserved groups, and addresses differences in behavioral health. The final step in creating a disparity impact statement is to specify how the program complies with CLAS standards. CLAS` national standards are designed to “promote equity, improve quality, and work to eliminate health inequalities by creating a blueprint for health organizations.” The 15 standards focus on issues of responsiveness to diverse cultural health needs; governance, leadership and the workforce; communication and language support; Commitment, continuous improvement and accountability. The adoption of these standards can help reduce inequalities in access, use and outcomes of services for people from different cultural backgrounds. Designing a quality improvement plan to implement standards that are currently not met by service providers is a next step towards equity.
The disparity impact assessment should identify the specific CLAS national standards targeted by the programme and include brief descriptions of this work. First, create a table with the proposed number of people to serve, divided into subgroups. These subgroups are generally organized according to demographics related to that geographic area: race or ethnicity, gender, and sexual orientation/identity status. The table should clearly indicate how many people need to be cared for within these different subgroups. It is important that documented disproportions or disparities are taken into account when determining the proposed number of people to be cared for within the different subgroups. (Further discussions on collecting data to inform this process are discussed in the next section.) In the behavioral health and criminal justice systems, there are well-documented differences in services and poorer outcomes between groups of different cultures or ethnicities, genders, and sexual orientations. To address these issues, it is important that organizations and institutions clearly understand the groups they serve and develop strategies to ensure that services and programs are delivered equitably. *SAMHSA uses the terms “fellows” and “fellows” interchangeably.
www.thinkculturalhealth.hhs.gov/assets/pdfs/EnhancedNationalCLASStandards.pdf Next, a plan should be briefly outlined to eliminate known differences, including specific measures and partners involved. These plans should be developed in collaboration with competent and trusted stakeholders representing underserved populations. The plan should include measures to address identified disparities and needs in the areas of access, use of services and outcomes: .