2025 -- H 5849

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LC001942

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND

HUMAN SERVICES

     Introduced By: Representatives Tanzi, Alzate, Cotter, Speakman, Carson, Donovan,
Potter, Cruz, Stewart, Kislak, and Cortvriend

     Date Introduced: February 28, 2025

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. The general assembly hereby finds and declares that:

     (1) Since its inception, Rhode Island's Equity Zone (RIEZ), formerly known as Health

Equity Zone (HEZ) has expanded to fourteen (14) distinct communities, with more than one

thousand eight hundred (1,800) individual leaders and three hundred (300) organizations across

twenty (20) sectors to advance community transformation that supports all residents, especially

those who have been historically underserved.

     (2) These Equity Zones have demonstrated impact as follows:

     (i) Between 2018-2022, social vulnerability dropped by twenty-one percent (21%) in RIEZ

communities, compared to non-RIEZ communities with little to no change (four-tenths of a percent

(0.4%) decrease). During this time, RIEZs’ strategic actions improved health status, economic

opportunity, and social well-being in their communities.

     (ii) People living in RIEZ communities were twice as likely to rely on public insurance

than non-RIEZ communities. Yet, the average per-person public insurance costs are significantly

lower in RIEZ communities than non-RIEZ communities, resulting in significant public insurance

savings over time.

     (iii) At the onset of the COVID-19 pandemic, as residents faced challenges accessing food,

healthcare, and maintaining employment and housing, social vulnerability rose across all Rhode

Island communities. However, the increase in social vulnerability was much lower in RIEZ

communities. In non-RIEZ communities, the increase was fourteen percent (14%), compared to

only a two percent (2%) increase in RIEZ communities. This demonstrated greater resilience in

RIEZ communities, who were better equipped to withstand and overcome the challenges of the

pandemic and meet the urgent needs of their residents.

     (iv) Findings show that RIEZ communities are linked to decreasing chronic disease over

time. Many RIEZ communities are seeing much lower rates of chronic disease than expected, based

on their level of social vulnerability. For example, high cholesterol and heart disease in certain

RIEZ communities are dropping much faster than the state average.

     (3) These Equity Zones elevate community voice to:

     (i) Determine which services need to be provided locally by collaborative partners;

     (ii) Strengthen relationships between community members and organizations to create a

foundation of mutual respect, cultural responsiveness, and humility;

     (iii) Advocate for effective and meaningful policy-change;

     (iv) Utilize resources effectively to avoid duplication and maximize shared impact; and

     (v) Restructure decision-making processes to be more democratic and build civic

engagement.

     (4) The RIEZ network creates a forum for sharing and collaborating across the entire state.

     (5) This model is recognized as a national best practice for addressing upstream social

determinants of health.

     (6) Resources are not distributed equitably across the state and under-resourced

communities suffer; Equity Zones fill this gap.

     (7) Funding levels have not kept pace with the needs of communities. State funding for the

Equity Zones has declined in recent years, even as the demand for equitable, community-driven

solutions has increased. Without sustained investment Rhode Island risks losing the infrastructure

that has made RIEZ a national model for addressing systemic inequities.

     (8) Equity Zones play a burgeoning role as the state's primary strategy for community

transformation, driving health, economic and environmental equity.

     (9) While the Rhode Island Department of Health has historically played a central role in

the RIEZ initiative, the initiative’s expansion requires a “whole of government” approach that

includes other state agencies, such as those focused on housing, economic development,

transportation, and workforce initiatives. The RIEZ model must be formally recognized as the

state’s primary strategy for equitable community improvement, with the executive office of health

and human services coordinating funding, technical assistance, and interagency collaboration to

ensure long-term sustainability.

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     SECTION 2. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human

Services" is hereby amended by adding thereto the following section:

     42-7.2-21. Equity Zones.

     (a) The executive office of health and human services (EOHHS) is hereby directed to

convene and support a network of equity zones whereby local multisector collaboratives of

nonprofits, service providers, advocates, community members, state agencies, and municipalities

can address social determinants of health at a local level.

     (b) The EOHHS shall support equity zones to:

     (1) Support resident leadership development, civic engagement, and capacity-building

efforts to ensure that those most affected by inequities are leading the solutions;

     (2) Address root causes of health and economic disparities locally; and

     (3) Share lessons learned and best practices between equity zones to deepen collective

impact statewide.

     (c) To this end, the EOHHS shall:

     (1) Collect, track, analyze, and share data that is relevant to the equity zones;

     (2) Offer direct assistance to improve the quality, functionality and capacity of equity

zones;

     (3) Connect equity zones to technical assistance providers where need surpasses what

EOHHS can offer directly; and

     (4) Coordinate with other state departments beyond the department of health on issues such

as housing and economic development, to ensure a "whole government" approach.

     (d) State appropriations for this purpose shall be combined with federal dollars to fund the

equity zone network infrastructure, with a goal of equitably sustaining existing equity zones.

     SECTION 3. This act shall take effect on July 1, 2025.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND

HUMAN SERVICES

***

     This act would mandate that the EOHHS assemble a network of equity zones where local

multisector groups of nonprofits, service providers, advocates, community members, state

agencies, and municipalities can address social factors of health at a local level.

     This act would take effect on July 1, 2025.

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