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 AHEC-Community collaboration around healthcare policy and advocacy.

Colorado Conversations Grant1. Build Colorado AHEC Capacity for healthcare

policy and advocacy leadership1. 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 leadership1. Partner with additional organizations to fund

Fellowship and provide participants2. Recruit 10-12 community leaders for Fellowship

3. Facilitate a local-statewide conversation about healthcare policy and advocacy1. 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

Provocative Title

• Tell a short story or vignette• Introduce ourselves• Move to the next slide

Here’s how we start a Conversation

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

Language Access to Health Care Services in Colorado

COLORADO CONVERSATIONS

We will go through part of our conversation on Limited English Proficiency and access to healthcare

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: how to do this in your AHEC

San Luis Valley Area Health Education Center

PRESENTS

“Colorado Conversations forBetter 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 inColorado concern you, please attend the

Student Conversation on Better Health Care PolicyDate of presentation: April 23, 2009

Location: Porter Hall - Room 128Time: 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

DATE LOCATION TOPIC CONTACT COMMENTS

11-13-098:30 a.m.

SCWFC Primary Care Workforce Aquino Gallegos Betty Velasquez

Monte Vista Office

11-21-095:00 p.m.

SLV Immigrant Resource Cntr.

Language Access to Health Care Services

Antonio Sandoval Immigrant PopulationTierra Nueva-Ala.

12-11-099:30 a.m.

Costilla County DSS/Nursing Serv.

Language Access to Health Care Services

Ramona Archuleta In conjunction with Nursing Services!!

12-11-09@ Noon

La Llave Language Access to Health Care Services

Robin Leist, Mili Myskiw

Presentation to La Llave Staff

2-17-102:00 p.m.

SLV BOCSMigrant 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 SahudElaine Regan

Adams State College ES 244

TBD SLV DSS6 Individual Counties

Primary Care Workforce Individual Directors

Meet with each Individual county

2-11-109:00 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

Schedule of Conversations

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:(choose up to 4 responses)

1 2 3 4 5 6 7 8

11%

0%

11%

0%0%

78%

0%0%

Select choices, then push “Enter” on keypad.

1. Urge my institution to begin to offer (or increase) clinical placements

2. Become a preceptor3. Post the Workforce Collaborative’s report

on my website4. Contact my state legislator by phone, email,

or mail to express support for some or all of these policies.

5. Testifying during a committee hearing at the Capitol

6. Join the Health Care Workforce group at EngagedPublic.com in order to stay informed and get involved

7. Other8. None of the above

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/program-areas/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.