Hablamos Juntos Grantee Meeting October 10 & 11, 2002 Las Vegas, Nevada The Foundation’s Vision for HJ Program structure – National Advisory Committee (NAC) • Implementation Grants and Reverse Site Visits Technology component – Call for focus group volunteers • October 11 from 7:30-9:00 AM Welcome and Opening Remarks Foundation Staff – – – – Chinwe Oyekere, Research Associate Sophia Kournelias, Financial Assistant Minna Jung, Communication Specialist Diane Montagne, Program Assistant HJ Staff Introductions – Rosa Ramirez- Deputy Director – Rebecca Romo- Program Assistant – Todd Blickenstaff- Research Associate Working together to make every program a winner Hablamos Juntos Program Goals 1. 2. 3. 4. 5. 6. Improve access to quality health care for Latinos with limited English proficiency Develop practical, cost-effective models for improving communication between Spanish speaking patients and the healthcare providers that serve them Develop a web-based resource to enable scholars and experts to build a science base around language services Distribute resources to help healthcare organizations better serve Latinos Establish HJ as the recognized leader in the field of health care interpretation and translation Advance an understanding of cost of language barriers to health providers and the implications for serving the Latino market Goals for today Overview HJ Program Orientation Meet and learn from one another Review planning year Celebrate with music and Champaign Begin team building Greenville Hospital System Greenville, SC • Principal Investigator - Frederick D. Hobby •Serving 3 states (South Carolina, North Carolina, Georgia) and 16 counties • Hope/Vision • Total population of 799,147, with 23,196 (2.9%) Latinos. •354.1 % increase in Latino population from the 1990 to the 2000 Census MedVerse Proposal Collaboration of the four largest hospitals in Upstate South Carolina – AnMed Health – Bon Secours St. Francis Health System – Greenville Hospital System – Spartanburg Regional Healthcare System Creation of an independent 501(c)3 not-for-profit organization MedVerse Organizational Structure GHS ANM ED B SSF SR H S 8 Member CompanyBoard (2members fromeachof the4 R egional A dv isory C ouncil partneringorganizations) (12 m e m be r council-qua rterly m e etings) A ffiliates ExecutiveDirector (40 m e m be r council-2 m e etings/year Support/Clerical Certified Interpretation Services TranslationServices Certified Interpreters HealthcareInterpretation Svcs. On-Site, Video, Telephone Translators Forms/Documents Certified Level 3 - A cu te /In va sive - U su a lly clin icia n s - M e d ica tio n a nd d isch a rg e p la nn ing Certified Level 2 - D ia gn o stic T h e ra peu tic M D o ffice visits R e g istra tion P a tien t e du ca tion Certified Level 1 - G re e te r G u ide D ire ctio n s G e ne ra l gue st se rvice s Educational Operational Education/Training Certification Education/Training Level 3 Certification Level 2 Level 1 Molina Healthcare of California, Inc. Long Beach, CA • Principal Investigator- Martha Bernadett, MD Serving Riverside and San Bernardino Counties • Hope/Vision • Total population of 3,254,821, with 1,229,528 (37.8%) Latinos. 79.2% increase in Latino population from the 1990 to the 2000 Census Hablamos Juntos Su Idioma Methods and Interventions Overview Access C o m m u n ity A w a re n e s s Access E n try P o rta ls A p p ro p ria te le v e l o f e n try C o n tin u u m In te rp re te rs P la n a d m in A d h e re n c e E x it P o rta ls A d h e re n c e M a tc h in g le v e l o f in te rp re te r s e rv ic e s P t u n d e rs ta n d s P ro b le m , T re a tm e n t, F o llo w -u p p la n M a tc h in g s e rv ic e p ro v id e rs C u ltu ra lly a p p ro p ria te D o c to rs , n u rs e s , e tc . H o w to g e t m o re h e lp A p p ro p ria te in te rp re te r s e rv ic e s Hablamos Juntos Su Idioma Methods and Interventions Overview Access T ra in c o m m u n ity in te rp re te rs Access T ra n s la te s u p p o rt m a te ria ls Teach access to c o n tin u u m U tiliz e M o lin a O m budsm an Teach access to P la n a d m in U tiliz e w a lle t c a rd s A d h e re n c e D e c re a s e m e d ic a l ja rg o n via C M E P ro vid e c u ltu ra l a w a re n e s s tra in in g Teach access to P la n s e rvic e s a n d a d m in A d h e re n c e M a tc h s e rvic e p ro vid e rs T ra in /u s e n e w le ve l o f in te rp re te rs D is c h a rg e m e d ic a tio n s and in s tru c tio n s Inova Health System Foundation Falls Church, VA • Principal Investigator - Elita Christiansen, MA, MPA •Serving 5 counties in Northern Virginia and the Washington DC metropolitan area • Hope/Vision- The goal of HJPS is to increase the regional capacity, coordination and utilization of language access services. • Total population of 1,815,197, with 201,840 (11.1%) Latinos. •99 % increase in Latino population from the 1990 to the 2000 Census •El Salvador, Peru, Bolivia, Guatemala, Nicaragua, Mexico, Dominican Republic and Columbia (22% of the total immigrants. Inova Background Founded in 1956 as a private, not-for-profit organization. Governed by a voluntary board of community members this fully integrated, comprehensive health care system provides services to individuals residing in the Northern Virginia/Washington metropolitan area. Recognized for commitment to excellence, high quality medical care and community service, Inova is ranked as the eighth most integrated health system in the nation, rated among the best hospitals nationally the last 6 years (US News and World Report) and rated the top 100 Hospitals by HCIA five of the past seven years. Inova’s comprehensive health system includes three full-service community hospitals, one acute tertiary care hospital, and a children's hospital. Inova is the principal provider of health care for Northern Virginia’s Hispanic population. According to hospital discharge data from Virginia Health Information, Inc. in a typical three-month period in the year 2000, Inova provided 67% of hospital discharges for residents of the Northern Virginia region who identified themselves as Hispanic. 60% of the language services provided at Inova hospitals is for Hispanic patients. Project Profile HJPS will include five public and private clinical test sites, with various levels of clinical services. Interpretation and translation model will be tested for their ability to meet the needs of the Latino population in Northern Virginia and improve patient-provider communication. HJPS will provide partners with the opportunity to test and evaluate multiple models to determine those best suited to their sites, resources, patients and providers. Based on the unique needs of the patients and providers at each site, HJPS will enhance existing services by strengthening (through training, etc.) those services, or by establishing new models of service that will supplement and enhance overall service delivery. Services at each site will be improved in quality, effectiveness, and acceptability. Partners Inova Health Care Services Alexandria Health Department Fairfax County Health Department Hispanic Committee of Virginia Northern Virginia Area Health Education Center Northern Virginia Community College Temple University Health System Philadelphia, PA • Principal Investigator - Raul DeLa Cadena, MD • Salud Project Consultant - Marisol Valle-Ortiz • Administrative Director - Charles Soltoff, MBA North/Lower Northeast Philadelphia service area *Population of 59,169 - 16,142 (27%) Latinos *545% increase in Latino population from 1990 to 2000 HEADLINE: New Program Translates Into Better Health Care, Friendlier Temple Temple University Health System Philadelphia, PA • Episcopal Hospital acquired by TUHS - community anxious *EH was “the Latino Hospital” *EH in severe financial condition *TUH seen as non-Latino trauma hospital • Episcopal becomes Episcopal Campus of TUH *ED, Behavioral Health expanded *Inpatient, Maternity relocated to TUH Main Campus • Temple University Hospital Main Campus *Increasing Latino volume *Language/cultural issues *“Greyhound bus station” Temple University Health System Philadelphia, PA • Internal commitment to become Latino-friendly *Salud initiative *Language services *Renovation *Customer service *Outreach & Promotion • Fragmentation constrains progress • Hablamos Juntos provides focus *Organizational attention *Access to expertise Temple University Health System Philadelphia, PA • TUHS Hablamos Juntos Model *Salud assessment & referral program at Episcopal *Dedicated, ad hoc, contracted and phone interpreters *Web-based bilingual materials for all network providers • Goals *Improve access and the patient-service “match” *TUHS Service quality *More Latino-friendly services that meet community needs. Hablamos Juntos Central Nebraska Latino Health Partners Grand Island, NE •Principal Investigator - Sarah Cunningham, PhD •Hope/Vision - Enhance access to quality health care in Central Nebraska •Headline in 2005 - Central Nebraska Health Partners: One Voice •Total of 193,153 Latinos in catchment area •11.3% of Latinos •377.3% Growth from 1990-2000 Rural Collaboration A Way of Life Central Nebraska Area Health Education Center Grand Island, NE CN-AHEC Service Area Serving six rural counties in Central Nebraska: Adams, Buffalo, Colfax, Dawson, Hall, and Platte 713% 832% 93% 254% 371% 1120% En Español Central Alabama Alliance for Latino Health Birmingham, AL • Principal Investigator - Lisa Theus, MPH •Serving the Greater Birmingham area: Jefferson, Blounty, Shelby, and St. Clair counties • Hope/Vision • Total population of 921,106, with 16,598 (1.8%) Latinos. •341% increase in Latino population from the 1990 to the 2000 Census H ablam os Juntos A labam a Hablamos Juntos Alabama P ro je ct O versig ht C o m m ittee E n E spanol, Latino C om m unity, A lliance, M ed ical and Interpreter E xp erts, P rovider P artners L isa Th e us P roject D irector P ro je ct C o o rd in a tor T o be hire d U A B E va lua tio n Te am C o n sulta n ts P ro je ct Sta ff D r. Joseph T elfair E valuation T ea m C oordinato r K ayce M addux, R ay A bles, F austo P atin o D ispatchers, Interpreters LATINOS IN ALABAMA 79% are from Mexico 13% are from Guatemala 8% are from the rest of Latin America 274% increase in Latino population between 1990 and 2000 in Jefferson County alone Some experts say 100,000 Latinos in Greater Birmingham area (Census says 16,500) Local health department had over 17,000 Latino visits in 2001 School of Public Health- University of North Texas Health Science Center Forth Worth, TX • Principal Investigator - Fernando M. Trevino, PhD MPH •Serving Tarrant County • Hope/Vision• Total population of 1,446,219, with 285,290 (19.7%) Latinos. •103.9% increase in Latino population from the 1990 to the 2000 Census UNTHSC President: Ronald R. Blanck, D.O. SPH GRADUATE SCHOOL OF BIOMEDICAL SCIENCES TEXAS COLLEGE OF OSTEOPATHIC MEDICINE Dean: Fernando Treviño, Ph.D. DEPARTMENT OF SOCIAL & BEHAVIORAL SCIENCES Chair: Héctor Balcázar, Ph.D. Háblenos de su salud DEPARTMENT OF HEALTH MANAGEMENT & POLICY DEPARTMENT OF EPIDEMIOLOGY DEPARTMENT OF BIOSTATISTICS TEXAS INSTITUTE FOR HISPANIC HEALTH Health Care T & I Program Director: Holly E. Jacobson, MA, ABD Center for Cross-Cultural & Community Health Director: Héctor Balcázar Training Center for Spanish-Speaking Public Health Professionals DEPARTMENT OF ENVIRONMENTAL & OCCUPATIONAL HEALTH Háblenos de su salud Center for Cross-Cultural & Community Health TEXAS INSTITUTE FOR HISPANIC HEALTH Training Center for Spanish-Speaking PH Professionals HEALTH CARE T & I PROGRAM DEPARTMENT OF SOCIAL & BEHAVIORAL SCIENCES SPH COURSES PROVIDER TRAINING COMMUNITY AWARENESS CROSS CULTURAL COMMUNICATION CROSS CULTURAL COMMUNICATION HÁBLENOS DE SU SALUD LEGAL RIGHTS AND RESPONSIBILITIES LEGAL RIGHTS AND RESPONSIBILITIES LATINO HEALTH ISSUES LANGUAGE NETWORK ETHNICITY, CULTURE AND HEALTH TEXAS-MEXICO BORDER HEALTH ISSUES COMMUNICATION STRATEGIES IN PH STUDENT CREDIT HOURS MPH DrPH DO PA OTHER ALIANZA COMUNITARIA FM/TCOM CLINICS CONTINUING ED CREDITS PRACTITIONERS ADMINISTRATORS STAFF RESIDENTS OTHER TCPHD PHO OMCT CLINICS COMMUNITY CHURCHES COMMUNITY CENTERS ADVERTISING PROMOTION OTHER DIAMOND HILL MHMR CLINICS PPNT CLINICS The Regional Medical Center at Memphis Memphis, TN • Principal Investigator - Brenda D. Partee, MD • Serving a150-mile radius that encompasses Tennessee, Arkansas, and Mississippi • Total population of 897,472, with 23,364 (2.6%) Latinos. •229 % increase in Latino population from the 1990 to the 2000 Census Hope To actively identify, strategically plan and adopt a process to eliminate healthcare provider, institutional, and patient communication barriers that limit access to culturally competent and linguistically appropriate comprehensive healthcare for the Memphis/Mid-South Latino Community. 5 Centers of Excellence Trauma Center Burn Center Wound Center Newborn Center High Risk OB 15 outpatient clinics Ambulatory Center The University of Memphis Working Group on Latino Issues Brenda D. Partee, MD Assistant Medical Director Principal Investigator Marcela Mendoza, PhD. Center for Research on Women Steve Redding Regional Economic Development Center S. Howard Locke Strategic Planner Lilian Gorham Manager, Interpretive Services Ruthbeth Finerman, PhD. Luchy Sepúlveda Burrell Regional Economic Department of Development Center Anthropology Vision That the Latino community, especially those with limited English proficiency, and healthcare providers will see significant change because of the efforts of The Regional Medical Center at Memphis and it’s partners to insure access to culturally competent and linguistically appropriate healthcare. Envision that the healthcare quality of life for the Latino community will be greatly enhanced. Envision that the efforts of the En Memphis: Hablamos Juntos program can be “regionalized” to impact communication barriers to healthcare throughout the Memphis Latino community and the tri-state region of Tennessee, Mississippi, and Arkansas. Envision that the processes developed can be replicated to address this issue for any culture and in all settings where language and culture barriers impede access to appropriate comprehensive healthcare. CHOICE Regional Health Network Olympia, WA • Principal Investigator Kristen A. West • Hope/Vision • Serving 5 counties North Pacific, Thurston, Mason, Grays Harbor, and Lewis •Total population of 413,538, with 19,747 (4.8%) Latinos. •126% increase in Latino population from the 1990 to the 2000 Census Our Region Washington State Hispanic 10-year increases* Mason Number of Physicians 167% Grays Harbor Mason Co. Public Health & Health Services 178% Primary Care Mason General Hospital Grays Harbor Community Hospital Peninsula Community Health Center Grays Harbor Health & Social Services Department Providence St. Peter Hospital CIELO Mark Reed Hospital Thurston Thurston Co. Public Health & Social Services Department Sea Mar Community Health Center (Clinica de la Comunidad) 33 20 2,672 Lewis 34 29 2,501 Mason 17 8 4,057 Pacific 7 7 1,928 1,744 T hurston 139 246 Region 226 304 93% Pacific Co. Health & Social Services Department Willapa Harbor Hospital Providence Centralia Hospital Rural Clinic (PHEC) Pacific Lewis Co. Department of 143% Health & Social Services Specialists People Served per PCP Lewis 170% Morton General Hospital *Source: 2000 Census CHOICE is… a nonprofit consortium of rural and urban partners dedicated to improving the health of our region. We meet our vision through collective decision-making and action. We advocate for and progress toward a future state of health care delivery characterized by: – – – – Access to affordable services; Improved service quality and coordination; Good patient outcomes and service effectiveness; Local delivery of quality services with a minimum of duplication; – Accountable to standards of achievement; and – Collaboration between urban and rural health care providers. This is a Social Justice Issue Charity Is giving Is kind Is donating what is surplus for essentials Does good Is comfortable Requires no change Is easy to give Requires no critical analysis Is interested in warming hearts and reducing immediate suffering Social Justice Is sharing Is fair and just Equitably distributes resources for essentials Makes right Can be uncomfortable Requires change Is hard to achieve Requires complex analysis Is interested in ending charity Our Approach to Finding Resources Resources Owned by Me Resources Not Owned by Me Move Away From Scarcity Thinking… Resources Owned Resources Not by Me Owned by Me Resources Owned Public Resources Resources of Others by Others Resources Not Owned by Others Private Resources Untapped Resources To Create Abundance Resources Owned by Me Public Resources Resources Owned by Others Resources Not Owned by Others Resources Not Owned by Me Resources of Others Requests Offers The Source of Abundance Private Resources Untapped Resources Neighborhood Health Plan of Rhode Island Providence, RI • Principal Investigator - Brenda Whittle •Serving all of Rhode Island • Hope/Vision• Total population of 173,618, with 52,146 (30.0%) Latinos. •108.7% increase in Latino population from the 1990 to the 2000 Census NHPRI - Su Salud Program NHPRI insures nearly 50% of all children in Providence, 69% of all Latinos in Providence, and 45% of all Latinos in Rhode Island. • Our Members • Our Mission- a perfect fit • Language Services as a priority. • Partners What We Hope to Accomplish • Reimbursement system for the four partner sites. • This program could clearly serve as the model for the statewide expansion and for other insurance providers as well since RIte Care mandates interpreter services as a covered benefit. • For NHPRI and its partners to develop a program to serve as a model for other providers and in other languages. What a powerhouse of talent!