HSMP 576: Advanced Health Policy

Stacie Balkaran HSMP 576: Advanced Health Policy April 25, 2017

Background

Oregon’s racial and ethnic populations are growing at a faster rate than the nation, with one in five Oregonians identified as people of color. Changing demographics, especially in low-income populations, are apparent: Nearly 40% of Oregon Health Plan clients identify as non-white. With racial and ethnic diversity comes linguistic diversity. In 2010, at least 137 languages were spoken in Oregon, making this state one of the 15 most language-diverse states in the nation.

This rapid growth presents a challenge and opportunity for public health and health care systems. In our discussion, I would like to focus upon health delivery as a means of advancing health equity and responding to the rising linguistic diversity of this state. Oregon House Bill 2419, which went into effect January 1st, 2016, states that “it is the policy of the Legislative Assembly to require the use of certified health care interpreters (HCIs) or qualified HCIs whenever possible.” There are only about 400 registered health care interpreters listed on the Oregon Health Care Interpreter Association (OHCIA) website—not enough to serve the state’s needs nor the diversity of languages necessary to serve populations effectively.

The Office of Equity and Inclusion (part of OHA) is charged with overseeing and regulating the certification process for HCIs. There are two main entities through which HCIs can be certified, both of which cost about $200 to complete and require in-person testing—potential barriers to becoming certified. Additionally, so much of this information (how to get certified, the process, trainings and public meetings offered, etc.) are disseminated through online methods. There is some programming centered on addressing these barriers (especially through OHCIA), but even these are not being utilized nearly enough in general, nor is there enough linguistic diversity in the existing HCI list to address the growing needs of Oregon’s health systems.

Questions

1. With the knowledge of how effective referent power can be for racial/linguistic-minority individuals in health care settings, how do we bring this opportunity (to become an HCI and work with one’s own community and people) to the “right” people? Framing? Incentives? How do we ease their access to the information? 2. How do we address the underuse of HCIs in clinical settings? Is this part of the problem, that there is a perceived lack of need from the clinician point-of-view? 3. Any other thoughts regarding this that I am missing? Perhaps related to funding?

Readings (3) – two links (below) and other on AHP website. http://www.modernhealthcare.com/article/20140830/MAGAZINE/308309945 http://www.npr.org/sections/health-shots/2014/10/27/358055673/in-the-hospital-a-bad-translation- can-destroy-a-life