Leonard G' Epstein, MSW

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HRSAs Perspective on Health Literate Culturally
Linguistically Competent Services to Improve
Patient Outcomes Reduce Health
Disparities Technical Assistance Teleseminar on
Cultural Competence in Rural Health Care Systems
February 18, 2009

• Leonard G. Epstein, MSW
• Senior Advisor on Clinical Quality Culture
• U.S. Department of Health and Human Services
• Health Resources and Services Administration
• Office of Minority Health Health Disparities

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Factors Impacting Health Disparities
Race Ethnicity
Culture
Language (LEP)
Social class
Health Literacy, Illiteracy
Environment (Includes Region)
LEP Limited English Proficiency
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Culture, Language Health Literacy Impact Health
Care System Users

• Affects the entire process
• Registration
• Completing intake, medical, financial and other
  forms
• Interacting with the receptionist, nurse, medical
  assistant, clinician, providing and receiving
  information
• Understanding prescriptions, adhering to therapy,
• Follow up appointments and referrals,
• Living will, health care proxy

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Basic Principles

• Culture, LEP and Health Literacy are Minority
  Health and Quality Issues
• Culture, LEP and Health Literacy are Civil Rights
  Issues see Title VI Civil Rights Act
• LEP and Health Literacy Must be Viewed Within a
  Cultural Context

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HRSAs Unified Health Communications Approach

• HRSA supports and promotes a unified health
  communications perspective that
• ? Addresses cultural competency, limited
  English Proficiency, and health literacy in an
  integrated approach
• Develops the skills and abilities needed by
  HRSA-funded providers and staff to deliver the
  best quality health care effectively to the
  diverse populations they serve.

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HRSAs Unified Health Communications Approach
Appears in Grants Policy

• In order to assure that cultural and linguistic
  competence factors are integrated into HRSA
  funding opportunities, Policy Operations Memo
  2007-01 is designed to inform HRSA staff of the
  new language to be considered when developing
  funding guidances.
• Bureau/Office staff preparing funding guidances
  must review the attached language carefully for
  items appropriate for inclusion in the program
  guidance.
• A copy of Policy Operations Memo 2007-01 is in
  your resource packet.

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HRSAs Unified Health Communication (UHC)
Training Course
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Why Training?

• Health care providers funded through HRSA grants
  need to understand how to be effective in
  cross-cultural and language appropriate health
  communication, as well as general health literacy
  issues.
• Over 65 percent of patients in HRSA-funded
  programs are culturally diverse
• More than 1 in 3 adults lack sufficient health
  literacy to interpret an OTC drug label, know
  when a child should receive a vaccine

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Course Information

• Five interactive Modules
• Introduction to Health Communication
• Health Literacy
• Cultural Competency
• Limited English Proficiency
• The Capstone
• Course Length
• 4-5 hours with ability to start and stop during
  course
• Knowledge Checks
• During modules and upon completion
• Course Completion Certificate and CMEs/CEUs

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Accessing the new Training
Accessing CourseAccess the course on the HRSA
Internet www.hrsa.gov/healthliteracy/training.htm
You will be linked to TRAIN (TrainingFinder
Real-time Affiliate Integrated Network), the
premier learning resource for professionals who
protect the publics health.  It is a free
service of the Public Health Foundation. On
TRAIN, the user can create an account and then
access the course.
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Example of TRAIN Welcome Screen
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Main Screen for Training Course
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Knowledge Check
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UHC Data

• Since the Course was launched in November 2007,
  June 2008 data showed that 1,486 took the UHC
  Course for credit.
• Majority of Participants took the Course in
  Pennsylvania (146), Texas (92), New York (88),
  Virginia (83), North Carolina (79), and
  California (73).

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Continuing Education Credits Available

• Currently Available
• CHES, CMEs, CNEs, CEs for Certified Health
  Education Specialists, Medical Librarians,
  Physicians, Nurses, Physician Assistants, and
  Pharmacists
• In Progress
• CEs for Dentists, Dietitians, Social Workers,
  Nurse Practitioners

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TAKE THE PLEDGE!

• Please make an organizational commitment to take
  and complete this wonderful training
• Encourage staff and colleagues who work in the
  health care field to take this free, interactive,
  web-based course!

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For more UHC course information

• Access the UHC at http//www.hrsa.gov/healthlitera
  cy/training.htm
• Contact the HRSA Center for Quality at
  301-443-0458 or tgrandison_at_hrsa.gov

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Selected Resources

• HRSA Cultural Competence Web Page
• The Portal for HRSA Funded Cross-Cultural
  Resources
• www.hrsa.gov/culturalcompetence
• HRSA Health Literacy Web Page
• www.hrsa.gov/health literacy

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HRSA CONTACTS

• Maria White, M.A.
• Senior Civil Rights Analyst
• Office of Equal Opportunity and Civil Rights
• [phone] mewhite_at_hrsa.gov
• Len Epstein, M.S.W.
• Senior Advisor, Clinical Quality Culture
• Office of Minority Health Health Disparities
• [phone] lepstein_at_hrsa.gov
• UHC Course tgrandison_at_hrsa.gov or 301-443-0599
• http//www.hrsa.gov/healthliteracy/training.htm

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THANK YOU
RESPECT