Language Access At

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Language Access At Edward M. Kennedy Community
Health Center Building Bridges through Language
Access Advocacy and Collaboration
Sue Schlotterbeck Director, Health Equity Edward
M. Kennedy Community Health Center Worcester,
Framingham, Milford sue.schlotterbeck_at_kennedychc.o
rg www.kennedychc.org
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• Community Health Center in Worcester,
  Framingham, Milford, MA
• We provide over 140,000 visits per year to over
  24,000 patients
• Founded in 1972 by 7 mothers from Great Brook
  Valley
• Patients speak 93 languages
• Staff speak 34 languages and represent 35 ethnic
  groups
• 75 of our staff are bilingual, of which 25 are
  trilingual
• At least 51 of board membership must be
  patients
• We help people live healthier lives.

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Health Equity
Health Equity is attainment of the highest level
of health for all people. Achieving health equity
requires valuing everyone equally with focused
and ongoing societal efforts to address avoidable
inequalities, historical and contemporary
injustices, and the elimination of health and
healthcare disparities.
Source US Department of Health and Human
Services, National Partnership for Action to End
Health Disparities
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Health Equity

1. Organizational Commitment
2. Staff Training and Education
3. Workforce Diversity
4. Language Services
5. Community Engagement
6. Address Health Disparities

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Organizational Commitment

• Why is Health Equity and Language Access
  important?
• Federal and State Standards (IOM, Affordable
  Care Act, Office of Civil Rights, Office of
  Management and Budget, Office of Minority Health)
• Patient Centered Medical Home (PCMH) Standard 1-
  Enhance Access and Continuity
• Element F4- Culturally and Linguistically
  Appropriate Services (CLAS)
• Assessing the language needs of its population
• Providing interpretation or bilingual services
  to meet the language needs of its population
• Providing printed materials in the languages of
  its population (for languages that are spoken by
  at least 5 of patient population)
• Health Disparities Exist
• Health Equity and Language Access are Connected
  to Quality and Safety
• Values, Vision, Strategic Action Plan

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Organizational Commitment

• 2002 Health Equity/Cultural Competence
  Committee to improve health equity and cultural
  competence
• Provider Champion(s)
• Diverse Team
• Work Plan
• Address CLAS Standards
• Pilot Ideas (PDSA cycle)
• Policies and Procedures
• Communicate

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Organizational Commitment

• Policies and Procedures
• Culturally Responsive Care Policy
• Limited English Proficiency Policy
• Interpreter Services Procedures
• Procedures for Translating Documents
• Language Testing Policy
• Patient Communication Policy
• Patient Education Policy
• Teach Back Procedures

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Language Services

• Languages of populations you serve and want to
  serve
• Interpreter qualifications
• Recruitment and Collaboration
• In Person and Telephonic
• Track Language Needs, Productivity, Costs
• Feedback from Providers and Patients
• Translations
• Working with Interpreters
• Health Literacy

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Interpreter Services Procedures

• Verbal and written notices about language
  assistance
• Flag, EHR report, interpreter extension, page
• Staff Interpreter
• Staff approved to provide medical interpretation
  with other positions
• Telephonic Interpreter
• Per Diem Interpreters
• TTY on PORTAL
• Pre-book hard to find languages and ASL
  interpreters

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Training Staff To Work With Interpreters

• TIPS FOR WORKING WITH INTERPRETERS
• Always look at the client (not the interpreter)
  when you are speaking or the interpreter is
  speaking.
• Use simple language and short sentences.
• Pause after a full thought for interpretation to
  be accurate and complete.
• Avoid asking multiple questions without breaks.
  
• Speak in the first person rather than asking the
  interpreter to tell something to the patient.
• Remember that everything you say will be
  interpreted.
• Use teach back to confirm patient
  understanding.
• Repeat yourself in different words if your
  message is not understood.