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!
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