best practices in multilingual access- best practices in multilingual access- focus on group...

Best Practices in Multilingual Access- Best Practices in Multilingual Access- Focus on Group Practice/Community Health

Centers

Kris McCracken, Dir. of Operations

Manchester Community Health CenterManchester Community Health Center

Purpose

Provide an Overview of Community Health Centers (CHCs) and how they are Addressing a Growing, Diverse Population

Lessons Learned that could be applied to other Group Practice Settings

What is a Federally Qualified Health Center FQHC)?

A Non-Profit Organization that:

Is a Community Based Organization Governed by a Board of Directors Comprised of 51% Consumers of Services

Serves an Underserved Population or Area

Provides a Comprehensive Scope of Preventive and Primary Health Services to Anyone, Regardless of Insurance Status or Ability to Pay

Provides a Sliding-Fee Scale Based Upon Income for Those without Insurance

Receives Funding Under Section 330 of the Public Health Service Act

CHCs Served 81,000

People in 2004 in

New Hampshir

e

NEW HAMPSHIRE COMMUNITY HEALTH CENTER SERVICE AREAS

Ammonoosuc Community Health Services, Inc.

(Littleton) (Woodsville) (Warren) (Whitefield)

(Franconia)

Coos County Family Health Services

(Berlin - 2) (Gorham)

White Mountain Community Health

Center (Conway)

Speare Medical Associates

(Plymouth) (Bristol)

Avis Goodwin Community Health

Center (Dover) (Rochester)

Families First Health and Support Center

(Portsmouth)

Lamprey Health Care (Newmarket)

(Raymond) (Nashua)

Healthcare for the Homeless (Manchester)

Manchester Community Health Center

Capital Region Family Health Center

(Concord) (Hillsboro)

Partners in Health (Newport)

Health First Family Care Center (Franklin)

Language Volume (Over 10 speakers)

Interpretation Expenses FY’04-08

Service Delivery StructureINTERPRETATION RESOURCES:

-2 FTE’s dedicated Spanish Interpreters

-.5 FTE dedicated Bosnian Interpreter

-.5 FTE dedicated Somali/Mai Mai/Zigua Interpreter

-Contract with Tele-Interpreters for rare languages

-25 Independent Interpreters available (all staff have copy of the list)

-Contract with Lutheran Social Services Language Bank

-Use of Northeast Ctr. For the Deaf and Hard of Hearing as well as Granite State Independent Living for Sign Language Interpreters

-20 Total Bilingual Staff Members (Languages spoken: Spanish, French, Arabic ,Bosnian, Romanian, Russian, Swahili)

Policies & Procedures

Human Resources Perspective

Patient Perspective

ISSUES still on the Fore-Front

After hours access (answering service limitations) Tele-interpreter available for doctor through 3-way conference call.

Recruitment of bilingual direct service providers

Difficulty when referring patients out to specialty care and testing

Loss of funding to Refugee Resettlement Programs

Areas for ConsiderationNavigating the American Health Care system

Legal requirements for Interpretation (OCR)

Economic Impact of Providing Services

Adequacy of supply of bilingual/bicultural healthcare professionals

Differences in Cultural Beliefs in regards to healthcare

Availability of refugee/immigrant health records

Difficulties in coordinating care with:

Hospitals

Specialty Providers

Mental Health Providers

Social Service Agencies

VNA’s

Entitlement Programs