1. THE STORY

2. INFORMATION AT INITIAL ENCOUNTER
who? what? where? when? how? why?
Lives with the father of the baby in a poor house- hold, but doing ok
Social contacts limited to hus- band’s unstable, risky job and some neighbors
Migra-ted recen-tly due to higher levels of pover-ty in Mexico
LAURA
Illegal status as undo-cumen-ted immi-grant in the US
Young healthy Latina woman pregnant for the first time
First winter in Wis-consin

3. ACCESS COMPONENTS IN PLACE
Place for care
Necessary skills present
New policy!!
Old policy
Provider
Works at a Community Health Center near Laura’s home.
Jan ’06: new state health policy!!
Badger Care coverage for pregnant undocu-mented women
Federal and state funding for CHC’s to take care of the under-served (low)
KAREN
Bilingual, culturally sensitive nurse midwife
Mission of the CHC: providing language- and culture- sensitive care

4. KAREN LAURA resources need
OUR MISSION: To improve the health of Latinos in Wisconsin
KAREN
LAURA
Make sure interaction happens
resources
need
OUTREACH
Laura was informed of available access

5. KAREN
The interaction never happened
Laura’s baby died
LAURA
Why?

6. Laura’s poor level of functionality
was stressed and lonely, got depressed
Did not eat well, the baby was born 8 weeks early
Breast feeding became problematic
Did not know how to dress for winter
Did not know how to take care of a sick baby
Was not able to reach baby’s dad at work
Did not get a good interpreter at the emergency room, did not understand the baby’s condition
She knew she had no rights to services and was afraid that any institution would deport her if she ask for help
She knew LHO was a struggling non-profit that did health education only (not care) so she didn’t call us

7. Information gathered after access failed
Without her family’s approval, she and her boyfriend used the money saved for their wedding to pay the “coyote” to cross the border, her parents didn’t want her leaving
The baby’s dad depended on a friend to get to work so he was saving to buy a car, the baby was an unexpected expense, she waited to tell him about the pregnancy
She wanted to wait until she could send money to contact her family so they could see the benefit of her leaving, and she didn’t call her mother or sister for advice about the baby

8. Information gathered after access failed
They considered it too risky to ask the employer for a poof of (low) income, a requirement to receive the coverage
She knew she had no rights to services and was afraid that any institution would deport her if she ask for help
She knew LHO, as many other non-profits, is struggling for resources and that only gave health education, not health care so she didn’t call us