Latino AIDS Commission Says HHS Plan Needs to Include LGBTs

The Latino Commission on AIDS as an Hispanic, LGBTQ and communities of color serving organization is concerned with the Health and Human Services (HHS) Strategic Plan FY 2018-2022.

The plan must set a precedent for reducing the burden of disease nationally through its focus on access to affordable treatment, advancement of research, implementation of evidence-based interventions, expansion of populations served, and inclusion of all stakeholders. We strongly believe that the investment in our public health sector will save billions of dollars by preventing an increase of major and complex health conditions that impact our nation.

We applaud the activities listed in the plan, from addressing social determinants of health, to improving access to affordable and quality care under our healthcare system, to applying research and promotion of basic sciences, to the inclusion of all relevant stakeholders.

However, we strongly believe we must fulfill the multiple aims of reducing health disparities, care and treatment, the plan must include the Lesbian, Gay, Bi-sexual, Trans, and Queer (LGBTQ) communities, communities of color and migrant populations, which constitute a substantial portion of the population who face health disparities. The plan needs to outline strategies to reduce healthcare costs themselves. This includes drug prices, which are beyond what the market can reasonably bear, and are one of the most significant drivers of public and private coverage costs in the U.S.

The plan puts a big emphasis on patient or consumer personal responsibility throughout. HHS has governance of numerous anti-poverty programs: Medicaid, TANF, SNAP, child-support, and LIHEAP (referred to as health care, cash assistance, food stamps, child-support, heat assistance), to name a few. "Personal responsibility," usually means wanting the consumer to have some consequences associated with their utilization trends.

The mention of "removing barriers" without clearly identifying them to discuss strategies for removing them. We recognize the plan mentions the role of Faith-based organizations, we believe they are very important, but HHS must include all key institutions and community-based organizations to develop a broad-based engagement to improve the healthcare and wellness in the U.S., Puerto Rico and the U.S. Virgin Islands.

Improve and clearly state ties between goals, objectives, and strategies to performance metrics, which are critical for a successful strategic plan. We also strongly recommend a strong public engagement to be able to comment on the metrics of the plan.

The plan needs to address health disparities in connection to race or ethnicity, not just call them disparities, but outline where they are and commitment to address all of them. There are strategies linked to "culturally competent care" that need be incorporated.

We urge HHS improve language in the strategic plan and make it more comprehensive and, inclusive of communities that are highly impacted by structural health disparities. We must also have in mind emergency situations and the impact on health, in light of the current tragedies related to the impact of natural disasters, such as what is happening Puerto Rico, and the U.S. Virgin Islands. Dealing with emerging and rampant health issues, such as the opioid-heroine crisis that is destroying communities across our nation, also need to be included.