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COLORADO
CONVERSATIONS
AHEC, Advocacy, Policy, and Polling
AHEC and Advocacy
Participants will be able to:
• Describe how AHEC can engage the
community on healthcare policy
• Begin to utilize real-time polling in their
healthcare policy presentations
• Define the parameters for AHECCommunity collaboration around
healthcare policy and advocacy.
Colorado Conversations Grant
1. Build Colorado AHEC Capacity for healthcare
policy and advocacy leadership
1.
Develop the Colorado AHEC Advanced Advocacy Leadership
Fellowship. We all helped develop this and took it. Several took a
formal Policy Fellowship as well
2. Build rural and community capacity for
improved healthcare advocacy leadership
1.
2.
Partner with additional organizations to fund
Fellowship and provide participants
Recruit 10-12 community leaders for Fellowship
3. Facilitate a local-statewide conversation about
healthcare policy and advocacy
1. Facilitate local discussions (5-6 per year in each
AHEC)
• This workshop will focus on our
Colorado Conversations
• Colorado Conversations
– Develop and deploy a centralized
clearinghouse of healthcare information and
conduct a series of local community events
relating to 3 major areas: the health of rural
and disadvantaged communities, access to
health insurance, healthcare providers and
medical facilities, and developing a stronger
healthcare workforce.
Workshop Roadmap
Introductions
Do part of a Colorado Conversation
Discuss how to implement Conversations
Learn about real-time polling
Discuss how you might use this approach
and this technology in your AHEC
• Complete your evaluation form
• Go home happy
•
•
•
•
•
Here’s how we start a Conversation
Provocative Title
• Tell a short story or vignette
• Introduce ourselves
• Move to the next slide
Agenda • Welcome
• Introduction to keypads
• Demographic questions – Who is in the room?
• Overview of Language Access to health care
services – What is it and what are its effects?
• Questions on Language Access – How do you
view the issue, its barriers, and effects?
• Next steps
• Adjournment
We will go through part of our
conversation on Limited English
Proficiency and access to healthcare
COLORADO
CONVERSATIONS
Language Access to Health Care Services
in Colorado
Demographic Questions
Who’s in the room?
Demographic Questions
Who’s in the room?
What is Language Access?
• Ensuring access to health care not just a matter
of having coverage and having enough providers
• Being able to communicate effectively and
navigate the system equally important to having
adequate access
• Studies show that effective communication
between providers and patients is essential to:
– access
– quality
– likelihood that patients will adhere to treatment plans
• All important to successful outcomes
What is Language Access?
• Ensuring access to health care not just a matter
of having coverage and having enough providers
• Being able to communicate effectively and
navigate the system equally important to having
adequate access
• Studies show that effective communication
between providers and patients is essential to:
– access
– quality
– likelihood that patients will adhere to treatment plans
• All important to successful outcomes
Why is Language Access important?
Language barriers can have many effects:
• Patient safety
– understanding of prescription medications and other
diagnostic explanations and directions
• Access to primary and preventive care services
– English speakers much more likely to have a usual
source of care
• Treatment effectiveness
– understanding directions and securing follow-up care
• Quality of care
– interpreted patients more likely to receive right care at
right time
• Increased costs
– excessive diagnostics, longer ED stays, more admissions
• Impacts on providers
What are the current requirements
around Language Access?
Federal Requirements
• Protection against discrimination on the basis of
national origin
– Title VI of the Civil Rights Act of 1964
• All entities receiving federal assistance mandated
to comply with standards for language access
– Health care agencies include those administering or
accepting Medicaid, Medicare or other govt programs
– Standards:
• Patients have right to receive interpretation at no cost
• Facilities must inform patients of this right in preferred
language
• Facilities must ensure competency of interpreters and only
utilize family and friends at request of patient
• Signage and written materials must be available in
common languages for that community
What are the current requirements
around Language Access?
State Requirements
• More limited in scope than federal requirements
– specific to industries and particular situations
– managed care, services for developmentally disabled,
administration of state health coverage programs, mental
health and long term care facilities, senior care services
Credentialing Organizations
• Many credentialing organizations have
requirements that go beyond federal and state
mandates
– e.g.: Joint Commission on Accreditation of Healthcare
Organizations has strict requirements before granting
accreditation
What can communities and facilities
do to support Language Access?
Individual providers, health care facilities, and other
local health agencies can take immediate action to
support access for residents with LEP in their
communities
•Simple changes to organizational policies
– Bilingual (or multilingual) signage
– Translated medical and administrative forms
– Partner with local groups to provide trained volunteer
interpretation
•Basic changes to organizational climate
– Spanish language magazines / TV in waiting rooms
– Training staff to be culturally competent
– Overall culture of inclusiveness and respect
Where can I go for more information?
• U.S. Department of Health and Human Services,
Office of Minority Health:
http://www.omhrc.gov/
• Colorado Department of Public Health and
Environment, Office of Health Disparities:
http://www.cdphe.state.co.us/ohd/
• Colorado Progressive Coalition:
http://www.progressivecoalition.org/
• Hablamos Juntos, Language Policy and Practice
in Health Care:
http://hablamosjuntos.org/
Let’s shift a bit
• That was an abbreviated
Conversation
• Break
• 5 minutes stretch
• Next Up:
AHEC
how to do this in your
San Luis Valley
Area Health Education Center
PRESENTS
“Colorado Conversations for
Better Health Care Policy”
Do you think Colorado needs to reform its Health Care System?
Are you satisfied with your Health Care Costs?
Do You have Health Care Insurance?
If these and other questions regarding health care services in
Colorado concern you, please attend the
Student Conversation on Better Health Care Policy
Date of presentation: April 23, 2009
Location: Porter Hall - Room 128
Time: 6:00 p.m.
Pizza will be served!
Conducted the San Luis Valley
Area Health Education Center
These Conversations are funded in part with a grant from
The Colorado Trust through the Colorado AHEC System Office
Costilla County Department of Social Services and
Costilla County Public Health Agency
Schedule of Conversations
DATE
LOCATION
TOPIC
CONTACT
COMMENTS
11-13-09
8:30 a.m.
SCWFC
Primary Care Workforce
Aquino Gallegos
Betty Velasquez
Monte Vista Office
11-21-09
5:00 p.m.
SLV Immigrant
Resource Cntr.
Language Access to Health
Care Services
Antonio Sandoval
Immigrant Population
Tierra Nueva-Ala.
12-11-09
9:30 a.m.
Costilla County
DSS/Nursing Serv.
12-11-09
@ Noon
La Llave
Language Access to Health
Care Services
Robin Leist,
Mili Myskiw
Presentation to
La Llave Staff
2-17-10
2:00 p.m.
SLV BOCS
Migrant Program
Language Access to Health
Care Services
Dr. Mary Valerio
Presentation to staff
TBD
Valley Wide Health
Systems
Primary Care Workforce
Antonio Gurule
Leadership Staff?
1-25-10
ASC Nursing
Program
Primary Care Workforce
Aida Sahud
Elaine Regan
Adams State
College ES 244
SLV DSS
Primary Care Workforce
Individual
Directors
Meet with each
Individual county
TBD
Language Access to Health Ramona Archuleta
Care Services
6 Individual Counties
In conjunction with
Nursing Services!!
2-11-10
9:00 a.m.
Alamosa County
Public Health Dept.
Language Access to Health
Care Services
Julie Geiser
Planning Meeting
2-4-10
Dec. or Jan.
SLV Immigrant
Resource Cntr.
Language Access to Health
Care Services
Antonio Sandoval
Collaborative
TBD
SLVRMC
Language Access to Health
Care Services
Helen Lester
Will get back to me
2-18-10
Alamosa Kiwanis
Colorado Primary
Care Workforce
Duane Bussey
12:00 Noon at SLV
Pizza Company
Where do we do these talks?
•
•
•
•
Our Boards
Our Students
AHEC Partners
Community Groups
– Rotary
– Chamber of Commerce
– Hospitals and Clinics
Alamosa County Public Health Agency
What Topics?
• Short-term responsive
– House Bill 09-1293
The Colorado Healthcare Affordability
Act (2009 Colorado Legislative Session
– Health Care Reform 101 –
– Colorado Fiscal Policy – with Bell Policy
Center (2010 Ballot Initiatives)
• Long-term
– Limited English Proficiency
– Advocacy and Policy 101
Sign-In Roster serves many purposes
• Real-time key pad polling
• Other uses
– Evaluation of programs
– Get demographics of participants
– Start a discussion
– Classroom – test class and address
problem areas
– Other?
Why Key pad polling
• Collect data
• Start a discussion
– Anonymous
– Can comment on how the group
answered
– Engaging to audience to get
immediate feedback
– Ask for audience participation.
• Specifically ask for folks to talk. One
answer or the other.
• Gives them the sense they are not alone
Guatemalan Community
EVALUATION FORM
Guage for Presentation Effectiveness
Help plan next Conversation
Allows audience to provide feedback
Find out what topics are of interest
to audience
Assists in reporting to funder
Colorado Conversations
•
•
•
•
50 Conversations
>2000
Broad and Deep
Start with Broad Conversations
– From these develop deeper long-term
relationships
– Ongoing conversations
– Individual policy ideas
• Action step
Based on today’s discussion and my current
understanding of this issue I would be willing to:
Select choices, then push
(choose up to 4 responses)
“Enter” on keypad.
1.
2.
3.
4.
5.
6.
7.
8.
Urge my institution to begin to offer (or
increase) clinical placements
Become a preceptor
Post the Workforce Collaborative’s report on
my website
Contact my state legislator by phone, email,
or mail to express support for some or all of
these policies.
Testifying during a committee hearing at the
Capitol
Join the Health Care Workforce group at
EngagedPublic.com in order to stay
informed and get involved
Other
None of the above
78%
11%
11%
0%
1
2
3
0%
0%
4
5
6
0%
0%
7
8
Mini-Bighorn and ongoing
conversations
• Lamar
• Sterling
• Aurora Chamber
• LEADS
Polling Logistics
• Let’s actually build a question and
then answer it.
• How to engage the group using
polling and immediate answers
• What question shall we ask.
• Healthcare policy
– Federal reform
– Local issue
• Turning Point Technology – Real Time
Polling.
http://www.turningtechnologies.com/
•
• Colorado Trust Foundation initiative to
expand healthcare coverage.
http://www.coloradotrust.org/programareas/expanding-coverage
COLORADO
CONVERSATIONS
End
Abstract
•
Colorado AHEC conducted a statewide effort to improve the
knowledge and skills of community members to participate in
healthcare policy and advocacy work. This interactive workshop
will provide participants with the basics on how to engage
community members in healthcare policy and advocacy work
using innovative and interactive real-time polling technology.
•
•
•
•
•
The Colorado AHEC is conducting a statewide effort to improve the knowledge and skills of
Colorado community members to participate in healthcare policy and advocacy work. After
participating in an online health policy course, the Colorado AHECs actively engaged their
local communities in Conversations for Better Healthcare Policy. These Conversations were
developed and deployed using a centralized clearinghouse of healthcare information and by
conducting a series of local community events relating to 3 major policy areas: access to
primary care, institutional policy for Limited English Proficient community members, and
healthcare workforce. In the first year over 37 Conversations were conducted reaching over
900 community members.
Colorado Conversations include the innovative use of real-time polling devices to increase the
interactive nature of our presentations. The real-time polling is a valuable tool to increase
conversation, interaction, and data collection.
The workshop will be divided into 2 general sections. The first will be to describe the
Colorado Conversations, our topics, mission, and methods for engaging the community in
meetings and events while maintaining a neutral convener role. We will include interactive
components as the participants identify ways to engage their communities, and identify
possible relevant topics for healthcare policy conversations in their regions and states.
The second portion of the workshop will deal directly with the use of real-time polling in
conducting Conversations. Real-time polling is a valuable tool for engaging the audience. We
will provide ample opportunity to experience ways to use the polling devices to stimulate
conversation, encourage participation from the audience, and collect data. Participants will be
provided full access to the Colorado Conversations slide shows that may be customized for
their local community.
This interactive workshop will provide participants with the knowledge and skills to begin
engaging communities in healthcare policy work using tangible real-time polling technology.