La Maestra’s Circle of Care - Addressing Social Determinants of Health through Integration of Services Presented by Zara Marselian, FACHE - President & CEO & Carmen Kcomt - Director, Legal Advocacy & Social Services About La Maestra
Mission: “To provide quality healthcare and education, improve the overall well-being of the family, bringing the underserved, ethnically diverse communities into the mainstream of our society, through a caring, effective, culturally and linguistically competent manner, respecting the dignity of all patients.”
First Clinic, opened 1990 LEED Certified Gold Health Center, opened 2010 2 La Maestra Health Services o Clinic formed in 1990 under La Maestra Amnesty Center. Need for culturally competent healthcare identified by council representing over 12,000 students o Now 5 Medical & 8 Dental Centers in San Diego County o Hope Clinic, an Access Point for Homeless o 4 school-based medical/dental clinics o Mobile Clinic – medical, dental, optometry, telehealth o Imaging Services and new Mobile Mammo Coach o Mental Health services at main clinic, high school clinic, and through telemedicine. o All services/programs focus on education, case management and social services – Integrated Approach 3
Serving the Culturally Diverse Community o More than 40,000 patients served per year o 80% of patients indicated they prefer to communicate in a language other than English o Over 28 languages and dialects spoken by the 350+ employees. o Staff represents (is hired from) the cultures served, ensuring cultural and linguistic competency. o Medically Trained Cultural Liaisons provide valuable, ongoing support, education to local residents and identify new needs – two-way communication.
La Maestra’s Circle of Care Physical Health Issues o Obesity/Overweight o Diabetes o Cardiovascular Disease & Hypertension o Liver Disease (Hepatitis B and C) o Increased risk of stroke and cancer and lower screening rates (esp. Breast, Cervical, Colon cancers) o Tooth decay and gum disease o Asthma and Lead Poisoning (children) o Pulmonary conditions o Osteoporosis (seniors) o Co-morbidities Mental Health o Depression/ Anxiety o Isolation o Influence of Chronic Stress o Alzheimer's, Dementia o Unemployment/Under- o Caregivers’ Stress employment o Domestic Violence o Lack of financial resources o Family Violence (Child & o Overcrowded Households Elder Abuse) o Living in high crime o Victims of Trafficking communities o Low self-esteem o Post traumatic stress syndrome o Cultural Diversity Issues o Ulysses syndrome o Substance abuse
Environmental and Cultural Factors o Food deserts - lack of access to affordable nutritious food o Urban environment and housing with no outdoor space o Unhealthy/unsafe living condition (crime, unmaintained housing) o Stigmas, myths and cultural beliefs about health and treatment o Lack of healthcare services in country of origin/refugee camps o Forego preventive care due to cost o Changing generational roles and social order within immigrant families o Grandparents raising grandchildren o Isolation of seniors and people with disabilities Other Barriers to Health and Wellbeing
o High cost of doctor visits
o High cost of medication, glucose strips, etc.
o Linguistic and cultural barriers
o Lack of health literacy
o Lower screening rates
o Misunderstanding of health coverage programs
o Lack of transportation
o Managed Care default
9 La Maestra’s Circle of Care Wellbeing in the Circle of Care
Network goes beyond the field of medicine, bringing greater resources to our patients in the Circle of Care New Skills, Independence, Self-Esteem, Helping and Teaching Others, Working in Healing Environments
o Healthy Choices Food Pantry with nutrition education plus eligibility assistance for CalFRESH (SNAP), Medi-Cal, Energy Bill Discounts, etc.
o Urban Community Gardens
o Exercise – Zumba
Zumba
Food Pantry Community Garden & Healthy Recipe Potlucks Wellbeing in the Circle of Care o Microcredit Program for Women & Blossoms Florist Social Enterprise o Microenterprise Assistance o Supportive Housing I Choose Recovery (Housing) o Help with Affordable Housing o Job Training and Placement o Generations - Youth and Intergenerational o “Culture and Healing through Art” Program Generations
Healing Arts Class Senior Job Trainee Microcredit Entreprenuer Microcredit Weekly Group Legal Advocacy & Social Services o Legal Advocacy launched in 2011 to provide assistance and support to survivors of crimes: Human Trafficking, Domestic Violence, Violent Crime, Political Torture o National Human Trafficking Victim Assistance Program o Immigration Services added in 2015 o Legal advocates do not act as attorneys, but give information to help patients understand their rights and options o Referrals to Network of attorneys for Free / Low-Cost Services o Assistance with application for Restraining Orders, Safe Housing, Victims Compensation Program, Family Law Forms o Community Education and Training for Service Providers Legal Advocacy & Social Services Contact Information
Zara Marselian, President & CEO
Phone: 619-584-1612 ext 3018 / Email: [email protected]
Call Center for Appointments/Info about Services: (619) 779-7900
Website: www.lamaestra.org facebook.com/LaMaestraCHC