How DHHS is addressing the health disparities exposed by COVID-19

Jun 22, 2020

In Maine and across the country, racial and ethnic minorities have been disproportionately affected by COVID-19. Action is needed urgently to address these disparities and the Maine Department of Health and Human Services (DHHS), in coordination with the Governors Coronavirus Response Team, is committed to further steps to improve our response.

As DHHS Commissioner Jeanne Lambrew wrote in a June 14 op-ed published in the Sun Journal:

"The COVID-19 pandemic has revealed great acts of humanity and all that is good about Maine people, as we come together to face these challenging times. But it also has revealed deep and painful inequities worthy of our attention and action."

Here in Maine, black people comprise only 1.4% of the population, but account for about 24% of all COVID-19 cases, according to data posted on the Maine CDC website. Hispanics comprise 1.7% of Maines population, but 3% of all COVID-19 cases.

Throughout the pandemic, DHHS has regularly met with stakeholders to inform our work to address racial and ethnic disparities and we have recently expanded that engagement to include community leaders and advocates for racial and ethnic groups in Maine, including people of color, New Mainers and Tribal leaders. These meetings allow for real-time updates from DHHS and the solicitation of immediate advice, input, and requests from impacted communities.

These meetings complement Maine CDCs engagement with individuals and communities directly affected by outbreaks. DHHS has also increased translations of public health information about COVID-19 in to as many as 11 different languages to ensure that all Mainepeople know how to stay safe.

While there is more work to do, DHHS has taken steps to improve our response to improve public health and strengthen social services. This includes:

  • Expanding access to testing: The recent expansion of testing capacity has enabled Maine CDC to offer testing for anyone who is at an increased risk of infection, regardless of whether they are experiencing symptoms. Given known disparities, this includes people of color in Maine.
  • Supporting individuals in quarantine or isolation. Through contracts with MaineHousing, safe quarantine and isolation sites are available in Portland, Lewiston, Bangor and Augusta for individuals who lack the ability to safely quarantine or isolate at home. DHHS is contracting with Community Action Programs, Catholic Charities and Wabanaki Public Health to help deliver social services to individuals in need of help while isolating or quarantining. These services will be delivered in culturally appropriate ways with translation, interpretation, and with cultural brokering when needed.
  • Connecting those affected by COVID-19 to social services. The support for individuals who are under quarantine or isolation is part of a wider DHHS program to help individuals affected by COVID-19 through temporary social support services. These services include psychosocial care, housing, food-related support, health prevention activities, transportation-related services, and outreach and education. DHHS hired Dr. Sharon McDonnell, who has extensive experience leading social supports and contact tracing for infectious disease outbreaks around the world, to direct this program.
  • Increasing access to life-saving health coverage: MaineCare covers COVID-19 testing and treatment for members, including those with the Emergency MaineCare benefit. MaineCare also covers testing and other diagnostic services for uninsured individuals. MaineCare created guidance on COVID-19 testing coverage for these groups, which were translated into several languages and distributed widely. More broadly, MaineCare is advancing health equity through a Robert Wood Johnson Foundation grant designed to identify and test effective ways to reduce disparities through alternative payment models. As part of this grant, MaineCare is exploring ways to provide financial support and incentives to integrate Community Health Workers into the delivery of care. MaineCare is also working across DHHS Offices and with other partners to better incorporate race and ethnicity data into its work to identify and strategize around areas of disparity.
  • Addressing the pandemics psychological impacts. Maine DHHS has supported the Maine FrontLine WarmLine to provide psychological first aid to first responders and staff of health care facilities. Many individuals on the front lines of the pandemic, including those working in congregate care settings, are from New Mainer communities and other communities of color. The Office of Behavioral Health has ensured that interpreter services are available and developed marketing materials translated into 7 languages that will be distributed to these facilities. The Office is also developing contracts with Ethnically Based Community Organizations to retain the services of Community Health Workers who will provide outreach, assessment, support, education, and resource linkages to communities disproportionately affected by COVID-19.
  • Targeting support for group home workers. The Office of Aging and Disability Services is working with cultural brokers to prevent and control the spread of COVID-19 in group homes for adults with intellectual disabilities. The Office is collaborating with Maine CDC, provider agencies, and cultural brokers provided through Catholic Charities on initiatives that are being piloted at two residential agencies with diverse work forces. This includes identifying and addressing issues that may have created barriers to fit-testing staff for N-95 masks and adapting training materials to be culturally accessible.
  • Supporting and preparing parents: The Office of Child and Family Services has provided translated guidance and resources for parents, including Before you Get Sick, Make a Plan. The Office also issued a letter to resource parents with information about how to talk with children and youth about racism and recent protests.

DHHS remains committed to addressing health disparities, which began well before COVID-19 and exist well outside its boundaries. We continue to assess how best to meet these challenges in the days, months and years ahead.

Update: DHHS’ most recent responses to stakeholder questions and requests is available here (PDF).