National Conference on Quality Health Care for Culturally Diverse Populations Connecting the Desire with the Need: Culturally Competent Care Baltimore,

National Conference on Quality Health Care for Culturally Diverse Populations

Connecting the Desire with the Need: Culturally Competent Care

Baltimore, Maryland October 21, 2010

Samia Hussein, B.S, CCSUBrenda P. DelGado, Executive Director PhD (ABD)

Central Area Health Education Center, Inc

AgendaLearning ObjectivesCentral Area Health Education Center (AHEC) OverviewNational Statistics

o Primary Care Shortages and Cultural DiversityCT Statistics

o MUA, Immigrant Populations, Linguistic Isolation, ER Visits

International Health Professional Bridge Centero Key Partners in Healthcare (Social Capital)o Goalso Vision/Mission o Survey Tool/Resultso Services to be providedo Accomplishmentso Benefits

• Next Steps/Recap


Learning Objectives

Identify 5 Key Areas Impacting the Healthcare System

Engage Foreign Trained Health Professionals (FTHP) in the decision making process

Support Entry of FTHP into the Healthcare Workforce

Describe the Benefits to the Healthcare SystemCentral Area Health Education Center, Inc

What the Heck is AHEC?(Area Health Education Center)

Federally funded 1971 by US Dept. of Health & Human Services, Health Resources & Services Administration (HRSA), CT Department of Higher Ed

49 States have over 350 AHEC Centers and 130 program offices as lead agency., UCONN School of Medicine four regional centers

Each state requires a statewide Advisory committee Established in 1976 as the Hartford Primary Care Consortium,

(HPPC) by five neighborhood health centers to address health care needs of Hartford’s medically underserved and

AHEC became a program of HPCC in 1995 and agency took on its current name in 2000

Our mission is “to eliminate health disparities among diverse populations of central Connecticut by providing and coordinating programs that improve the health status of all”


AHEC AROUND USA


Staff: 5

Staff: 5

Staff: 5

Staff: 28


HEALTH CARE SERVICES

CT Aids Drug Assistance Program (MAI)

Ambulatory Primary Care

Early Intervention Services

Substance Abuse Counseling

Mental Health

Counseling

Medical Case Management

Client Emergency Funds

Mobile Health Van

Healthy Relationships

Drug Treatment Advocacy

HEALTH CAREER EXPLORATION

Youth Health Service

Corps

Collegiate Health Service Corps

“Careers for the Future”Summer Medical Camps

AHEC Summer Institute

International Health Professional Bridge

Center

Voices of the Future

Health Debate Clubs

AmeriCorps Volunteers

HEALTH EDUCATION

Heart Strong (Heart Disease & Stroke

Prevention)

Elders Ready for Action (Emergency

Preparedness)

Healthy Outcomes for Pregnancy

Empowerment

NEC Program (EMT)

CENTRAL AHEC PROGRAM SERVICES


Cited from New York Times


Current Realities & Needs

A health care system lacks diversity

The physician diversity ratio in CT is 3.74, which means that in order to have a physician workforce that marches its population, CT would need to increase its current number of underrepresented minority physicians 3.74 times.


Number of Health Professional Shortage Area Designations by CT County, January 2007

Source: CT DPH Health Care for CT's Underserved Population Article, Jan. 2007

10

10

1

2

7

3

2

3

9

9

2

1

8

4

2

3

3

4

1

4

1

2

2

0 5 10 15 20 25

Fairfield

Hartford

Litchfield

Middlesex

New Haven

New London

Tolland

Windham

Number of Designations

Dental

PrimaryCare

MentalHealth



Increase in Immigrants

Lingustic Isolation in CT TownsSource: US Census Bureau, ACS 2006 B05006 Table 2

02468

101214161820

% Isolation


Health Inequities- ER VisitsIn 2008: 435 per 1000 in CT vs. 404 per 1000

in USABetween 2000-2006, preventable

hospitalizations up 4%; racial/ethnic minorities contribute 100% of 4% growth

Preventable hospitalizations among whites decreased 3% over that same period

Hispanics & African Americans represented 44% & 31% respectively

o Factors: No primary care physician, no insurance, language/culture (linguistic isolation), lack of resources, etc


Key Partners in the Healthcare Community Center Advisory Committee

Community Health Center Association of Connecticut

City of Hartford Department of Health & Human Services

UCONN AHEC Program OfficeUCONN- School of Public HealthCCSU- Center for Public Policy & Social

ResearchConcerned Citizens for HumanityConnecticut Department of Public Health


International Bridge Center Goals

Increase quality of a diverse healthcare workforce

Increase access & response of the healthcare delivery system

Increase delivery of healthcare for limited English proficiency individuals

Decrease impact of language barriers on quality of healthcare


To shape Connecticut's health care system so that underserved, culturally diverse populations will experience better health outcomes.

MissionTo build a bridge between qualified,

internationally trained health care professionals and linguistically and culturally competent health care services for Connecticut's diverse, underserved communities.


Vision

Survey Tool Demographics:

o Age o Country of Birth, current Statuso Length in years/months of stay o Native Language

• Languageo Proficiency Reading, Writing, Speaking (English/Other)

• Not Licensed in Connecticut o Degree/License in Native Countryo Current Clinical Work using Degree/License

• Already Licensed in Connecticuto Current Job?o Length of CT Licensing Process? o Cost of process?o What supports helped?

• Interest to entering the Healthcare Workforce in Connecticut• Level of commitment to get licensed?• Three biggest obstacles to get licensed?• Individual and Community support for Center?• Center Name?• Contact information for database


Number/Percentage

Results

61 June 22-July 7, 2009

57.1% 5+ years in USA

40% Speak Spanish

58.3% US Citizens/Permanent Residents (Green Card)

62.3% Other jobs: teller, factory worker, salesman, health counselor, lab assistant, etc

98.3% Interested to enter CT healthcare workforce

82% Biggest obstacle: complicated licensing process

91.8% Program designed to assist in license requirements would be helpful

100% Support establishment of IHPBC


Survey


Reading English easily 88.3%

Writing English easily 78.3%

Speaking English easily 46.7%

Understanding English easily 91.7%

Understanding the licensing process was the

biggest factor!!

English Language is NOT the biggest Factor!!

Individualized academic counseling Individualized career pathways, accelerated & alternative

programsUnderstand CT licensing process Background checks & license verificationPotential educational resources, including workshops

(Intro to US Healthcare System, TOEFL prep, etc)Referrals to financial assistance Mentoring by experienced health professionals Referrals to educational institutions Referrals to English as a Second Language programs Study/support peer groups for exam prep

What the Bridge Center will offer:


AccomplishmentsVisited similar programs (WBC)Funded Business planCenter website (www.centralctahec.org) Marketing brochureOrientation ManualOnline registryOngoing FTHP communication & databaseMapped pathways for six healthcare professionsIdentified potential resourcesType of VISA & opportunities granted Conducted local and statewide presentations


How will Connecticut benefit?Competent FTHP working in their trained professionCommitment to healthcare system in CTCollaboration between current & new providers to

address shortage & lack of diversityContinuity of underrepresented communities to

experience better health outcomes & eliminate health disparities

Confront cultural/language barriers for seeking health care

Create a bridge between culturally & linguistically competent health professionals & healthcare services for diverse underserved communities

Create a strong patient-provider relationship to build patient confidence, leading to frequent medical visitsCentral Area Health Education Center, Inc

Sustainability/Next StepsReconvene Advisory CommitteeNewsletter for FTHP (Updates)Meet with Goodwin Community College

PresidentContinue Grant Seeking OpportunitiesIdentify Fee Structure for ServicesContinue Online Sign-up Registry Plan Regional Meeting of Interested

CollaboratorsMeet with Connecticut Medical Society


Recap/SummaryDecrease linguistic isolationIncrease primary care providersIncrease linguistically & culturally competent

health professionalsIncrease workforce diversityIncrease access to care for underserved

communitiesIncrease the patient-provider relationshipDecrease health inequitiesIncrease healthy outcomes/medical adherence


Connecting the Desire with the NeedRecruitment of Racial/Ethnic students

Medical School

Recruitment and Training of Medical Interpreters

o Language (dialects, slang)o Cultureo Time

Coordination of Telephone Translationso Lost messageso Impersonalo Time


Qualified & Experienced Foreign Trained Health Professionals

BEST ALTERNATIVE

International Health Professional Bridge Center


Thank You


CENTRAL AREA HEALTH EDUCATION CENTER, INC.

Brenda P. DelGado, Executive DirectorSamia Hussein, Coordinator

International Health Professional Bridge Center 20-28 Sargeant Street

Hartford, CT 06105860-920-5149

www.centralctahec.org www.healthcareersinct.com

[email protected] Join Us on

(Central CT AHEC)

Documents

National Conference on Quality Health Care for Culturally Diverse Populations Connecting the Desire with the Need: Culturally Competent Care Baltimore,