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Nursing Contact Hours, CME

and CHES credits are available.

Please visit www.phlive.org to fill out your evaluation and complete the post-test.

Evaluations

Bridging Gaps: The Vital Role of Cultural Competence in Healthcare

December 18, 2014

Wilma Alvarado-Little, M.A. M.S.W.

– Language Access Advocate

James O’Barr, M.S.W.– Migrant Health Coordinator, N.E. Region, Hudson

River Healthcare, Inc.

Featured Speakers

The planners and presenters do not have any financial arrangements or affiliations with any commercial entities whose products, research or services may be discussed in this activity.

No commercial funding has been accepted for this activity.

Disclosure Statements

University at Albany School of Public Health

New York State Department of Health

Thank You to Our Sponsors

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Beliefs, customs and ways of life of a particular society, group, place or time period

A way of thinking and behaving that exists in an organization Not limited to race or ethnicity Examples of cultures and sub-cultures:

– First and second generation immigrants– Regional cultures: Upstate New York, Long Island– Lesbian, Gay, Bisexual, Transgender (LGBT)

– Unhoused or homeless community

Culture Concepts

Examples

Socio-cultural norms that promote smoking

Gender and socio-cultural norms influencing access and acceptance of contraceptives

Social reframing of substance abuse addicts from criminals to chronic disease sufferers

Culture and Health

Services that are respectful of, and responsive to, individual cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs and employed by all members of an organization (regardless of size) at every point of contact.

Culturally and Linguistically Appropriate Services (CLAS)

OMH, 2013

The CLAS Standardsin Health and Health Care

• Published in 2000 by the Health and Human Services (HHS) Office of Minority Health 

• Re‐published in 2013

The National CLAS Standards The Case for Culturally and Linguistically Appropriate Services

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The Case for Culturally and Linguistically Appropriate Services

The Case for Culturally and Linguistically Appropriate Services

The Case for Culturally and Linguistically Appropriate Services The National CLAS Standards

1. Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.

Principal Standard

OMH, 2013

Peekskill Area Health Center First center in HRHCare system Opened in 1975 Federally Qualified Health Center

Mission: To increase access to comprehensive primary and preventive health care and to improve the health status of our community, especially for the underserved and vulnerable

Hudson River HealthCare (HRHCare)

HRHCare’s Founding Mothers:Willie May Jackson, Pearl Woods, Jeannette Phillips, Mary Woods

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Board of Directors

Must be comprised at least 51% by users of the health center and representative of the community

Health Center Leadership

1989 Migrant Health Grant

Large migrant and seasonal farmworker population

Serving the five counties of the mid-Hudson Valley

Migrant Health

Core Methods Outreach into the farms and

camps with regular activity

Bi-lingual and bi-cultural medical, administrative and outreach staff

The Migrant Health Program Theme 1

Governance Leadership Workforce

2. Advance and sustain organizational governance and leadership that promotes CLAS and health equity throughpolicy, practices, and allocated resources

3. Recruit, promote and support a culturally and linguistically diverse governance, leadership and workforce that are responsive to the population in the service area.

Standards on Governance, Leadership and Workforce

4. Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis.

Standards on Governance, Leadership and Workforce (cont.)

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Theme 2

5. Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services

6. Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing

Standards on Communication and Language Assistance

7. Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided

8. Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area

Standards on Communication and Language Assistance (cont.)

Theme 3

9. Establish and infuse culturally and linguistically appropriate goals, policies, and management accountability, into organization’s planning and operations

10. Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into continuous quality improvement activities

11. Collect and maintain accurate and reliable demographic data

Standards on Engagement, Continuous Improvement and Accountability

12. Conduct regular assessments of community health assets and needs

13. Partner with community to design, implement, and evaluate policies, practices, and services

14. Create conflict resolution processes that are culturally and linguistically appropriate

15. Communicate the progress in implementing CLAS

Standards on Engagement, Continuous Improvement and Accountability (cont.)

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Hudson River HealthCare

Creating a Culturally Competent Organization

Supervising a Diverse Workforce Orientation – Front Desk: Working With Culturally

Diverse Communities Medical Interpreter Training Culturally Sensitive Communication Skills Communication Techniques for Diverse Communities Nurse Training – Working With Diverse Communities Planetree – Patient Diversity

HRHCare Training

Expanded to five sites Included two farmworker health

centers

Established a Cultural Competency Committee Integrating cultural and linguistic

competence into every aspect of Health Center staff operations

Peekskill Area Health Center – 1994

Policies: Equity Annual Board of Directors review

Procedures: Review of Training and materials Health Promotor/Promotora & Community Health Workers

Data: Patient Experience and Quality Indicator Reports Clinical Programs Quality Data

HRHCare Cultural Competence Committee Activities

Services Patient Education and Self-Management programs

Outreach and staff recruitment in community settings

Special Groups – LGBT, Elderly

HRHCare Cultural Competence Committee Activities (cont.)

Assessment of Language Line use at all sites

Medical Interpreter Training In-house, 6-week course for staff

HRHCare Linguistic Competence

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HRHCare 2013 Patient/Board Demographics

Patients BoardAA 19,564 4Hispanic/Latino 45,050 7White 30,356 9Asian 1,201 0American Indian/Alaska NativeHawaiian/ Pacific Islander 550 0

New York State-wide Spanish AIDS Hotline (SIDA)

– Hotline: 1-800-233-7432

Hudson River Healthcare – 1-844-HRH-Care (1-844-474-2273)

Resources

Where can you find more information about the National CLAS Standards? Think Cultural Health

www.thinkculturalhealth.hhs.gov

J. Nadine Gracia, MD, MSCE, Deputy Assistant Secretary for Minority Health, and Director of the Office of Minority Health U.S. Department of Health and Human Services

Christine Montgomery, Management and Program AnalystProject Officer, Think Cultural Health, Office of Minority Health

C. Godfrey Jacobs, Senior Program Manager, SRA International, Inc.

Acknowledgements

Bridging Gaps: The Vital Role of Cultural Competence in Healthcare

Questions?

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Nursing Contact Hours, CME and CHES credits are available.

Please visit www.phlive.org to fill out your evaluation and complete the post-test.

Thank you!

Evaluations

December 2014 Public Health Live Bridging Gaps: The Vital Role of Cultural Competence in Healthcare

REFERENCES AND RESOURCES (URL’S EMBEDDED) Think Cultural Health: the Department of Health and Human Services website for the CLAS Standards New York State Spanish AIDS (SIDA) Hotline Centro Civico’s Community Development Initiative Hudson River HealthCare Slides 12-15: Kaiser Family Foundation fact sheet, based on U.S. Census Bureau, 2008, Projected Population by Single Year of Age, Sex, Race, and Hispanic Origin for the United States: July 1, 2000 to July 1, 2050. Advancing Effective Communication. The Joint Commission Multicultural Health Care: A Quality Improvement Guide. National Center for Quality Assurance LaVeist, T. A., Gaskin, D. J., & Richard, P. (2011). The Economic Burden of Health Inequalities in the United States. Fact Sheet retrieved from the Joint Center for Political and Economic Studies website Improving Patient Safety Systems for Patients with Limited English Proficiency (2012). Agency for Healthcare Research and Quality, Rockville, MD. Lindholm, MD, Mary; Hargraves, PhD, J. Lee; Ferguson, MD, Warren J.; and Reed, PhD, George. Professional Language Interpretation and Inpatient Length of Stay and Readmission Rates (2012). Journal of General Internal Medicine. The Use of Interpreters to Improve the Quality and Safety of Healthcare Through Better Communication in Obstetric Patients: Effect on Primary Cesarean Delivery Rate (2012). Master of Science in Healthcare Quality and Safety (MS-HQS) Capstone 2 Presentation, Thomas Jefferson University. Education in Palliative Care and End-of-Life Care for Oncology: Cultural Considerations When Caring for African Americans. Module 7: Communicating Effectively. National Institutes of Health: National Cancer Institute.

- continued

Cultural Competency: Respecting and Responding to LGBT Health Needs, National Coalition for LGBT Health When Health Care Isn't Caring (2010). Lambda Legal Survey on Discrimination Against LGBT People and People Living with HIV National Center on Birth Defects and Developmental Disabilities, Overcoming Barriers: NCBDDD 2012 Annual Report Alliance of Community Health Plans Foundation Family Centered Maternity Suites: Holy Cross Hospital (2007). Appendix C in Making the Business Case for Culturally and Linguistically Appropriate Services in Health Care: Case Studies from the Field Slide 26: Youdelman, M. The High Cost Of Language Barriers In Medical Malpractice (2009). The National Health Law Program