1. Healthcare Interpreter Certificate Program A Community College and Health Care Service Training Opportunity

2. The Problem Limited English skills of many immigrants Difficulties in communicating with California healthcare providers

3. California Data 1 in 4 Californians was born in another country.** More than 12 million Californians speak a primary language other than English at home.**  Over 8 million speak Spanish  Over 2.7 million speak an Asian or Pacific Islander language  Over 300,000 speak Armenian or Persian.** *California County Profiles: limited English Proficient Population June 2006, The California Endowment ** California Speaks: Language Diversity and English Proficiency by Legislative District, The California Endowment

4. California Data 1 of every 5 people (more than 6 million!) is Limited English Proficient (LEP)* Most are Latino and Asian. **  For a county-by-county report see http://www.calendow.org/reference/public ations/pdf/cultural/CA%20County%20Profile sALL.pdf *California County Profiles: limited English Proficient Population June 2006, The California Endowment ** California Speaks: Language Diversity and English Proficiency by Legislative District, The California Endowment

5. Language Assistance is Needed One quarter of Asian and Latino households include no one 14 years or older who speaks English “very well.” Reliance on children to navigate complex situations like HEALTHCARE.

6. Service Barriers for Limited English Proficient Patients Impaired communication (provider- patient) Access to care Medical jargon Poor compliance Use of minors as interpreters Linguistic variations Untrained interpreters Undermined informed consent

8. The Programs City College of San Francisco, in partnership with Kaiser Permanente founded a Healthcare Interpreter Certificate Program 10 years ago. Other community colleges also offer this program:  Mt. San Antonio College  Reedley College  Santa Rosa Junior College

9. Mission Statement Develop linguistically and culturally competent interpreters who can function effectively and efficiently in the healthcare setting

10. Course Content Interpreter Role & Responsibilities Interpreting Skills Cultural competency & diverse populations Medical knowledge Healthcare systems knowledge DETAILED CURRICULUM MATERIALS AVAILABLE:  Lesson plans  Handouts  Quizzes & exams  Readers, glossaries  Videos, DVD and other interactive materials

11. Lab Coach a key to learning Specialist in for the language of service (LOS) Teaches medical terminology in LOS Assists students to understand cultural nuances Facilitates practice through simulations Helps to clarify the principles of interpreting Development of content materials Assists in accent reduction Specialized materials are available to train lab coaches Materials are also available for lab coaches to use in the classroom.

12. CCSF’s HCI Certificate Program First Semester: Health 80: 6 Units. One evening for 3 hours plus Saturdays (full/half days) Classes held at the CCSF Campus or Kaiser Permanente Second Semester Health 81: 6 Units Health 82: 3 Units Clinical Internship One evening for 3 hours plus Saturdays (full days) 349 hours total

13. Mt. SAC HCI Certificate Program First Semester: Voc. English for Health Care. MEDI 90 (Medical terminology) ANATOMY 50 (Basic Anatomy and Physiology) Health Science Skills Lab 05 (Clinical Lab) Second Semester: Voc Health 13 Voc Health 14 Voc Health 15 632 hours total

14. CCSF Student Expenses 15 units tuition @ $20/unit Registration fee: About $25 Books: About $150.00 Graduation/cap&gown: About $45 TOTAL: $530.00

15. Expenses to the college 15 units of full-time instruction per year (per cohort – CCSF runs 2 cohorts/yr) 3 to 12 units of release time for administrative coordinating per year Language Coach funds: (Currently $20/00 per hour for 50 – 75 hours each semester, per language)

16. Disseminating this Curriculum Kaiser Permanente has key elements of the curriculum available RHORC will be distributing the parts of the curriculum developed by CCSF and Mt. SAC Technical assistance will be provided

17. The Procedure 1.Find community colleges that are interested in offering the HCI program 2.Form healthcare partnerships to establish the program 3.Attend 1-day convening in October to begin the implementation (TBA) 4.Work with curriculum committee and administration to approve new courses 5.Attend 5-day Instructors Training Institute in January (TBA) 6.Train language coaches in weekend training (dates to be determined)

19. The Prognosis Rosy!  The CCSF HCI program and Mt SAC have developed a new series of materials making it easy to implement the program at other community colleges  The RHORC is distributing these materials  Many other program components are available from Kaiser Permanente.

20. RESULTS for the Limited English Proficient Population Clear and effective communication between health care providers and patients can contribute not only to increased patient satisfaction, but also improved health outcomes.

21. Project Funding Funding for curriculum revision and lab coach materials were provided by The California Endowment http://calendow.org

22. Supplemental material to follow

23. CLAS “…to understand and respond effectively to the cultural and linguistic needs brought by the patient to the health care encounter.” (DHHS, 2000) http://www.hhs.gov/ocr/lep/

24. Legislative, Regulatory & Accreditation Mandates Title VI of the Civil Rights Act of 1964 is a national law protecting people from discrimination - race - color - national origin (including language). The CLAS standards issued by the OMH are intended to guide required and recommended practices related to culturally and linguistically appropriate health services for all recipients of federal funds (March, 2001).

25. SB853 By July 1 2008 all health plans in California must submit plans showing how their subscribers will be able to access cultural and linguistic responsive health care. By January 1 2009 all health plans in California will need to have the services in place that have been planned.