On July 1, Health Share of Oregon, the state’s largest coordinated care organization, intends to submit its first “cultural competency platform” to Oregon Health Authority’s Office of Equity and Inclusion.
“’Cultural competency’ is already an outdated term,” Rosa Klein, chief health strategy officer, told its advisory council. Still, Health Share wants to create an organizational culture that “honors the diversity of our membership and people’s need to be recognized and empowered to be who they are.”
Half of Health Share members are people of color, with more than 50,000 members identifying themselves as Hispanic/Latino, 18,000 as African-American, 14,000 as Asian/Pacific Islander and as 1,800 Native American. Some 46,507 prefer a language other than English with more than 70 languages listed. As of May 15, Health Share reported a total of 223, 751 members.
A workgroup of 15-20 partners composed of primary care, mental health/substance abuse and local service providers worked on the draft platform, according to Klein, looking specifically at language and workforce issues.
“If you’re a member of a health plan, you should be able to read it and understand,” said Klein. Interpreters also are needed in clinical settings. But basic language access – not using a child or other family member as an interpreter – is not as widespread as needed to truly respect confidentiality and privacy.
Improving written communication such as handbooks, ID cards and “redetermination” communications is also critical. Klein said it is not enough to just translate words when someone faces the risk of losing coverage. Potentially disrupting someone’s care requires more extensive communication.
Klein said recruiting, retaining and educating a diverse workforce also is a priority. Patients want providers who look like them, talk like them, “work with them in a way that‘s not going to be foreign to them,” and integrating traditional health workers on a patient’s care team can be a useful tool.
Advisory council members offered suggestions for next steps.
Sonja Ervin, who served on the workgroup, suggested adding human resource staff to future meetings and Dalila Sarabia, one of only two consumers on the workgroup, suggested adding more consumers.
Joseph Lowe suggested that issues surround the LGBT and those with developmental and physical disabilities also need cultural competency. Ronda Harrison and Amy Anderson suggested that the culture of poverty presents another area for future work.
Dr. Ryan Skelton suggested focus groups to help check the relevancy of translations and also echoed concerns about the culture of “disentitlement” among poor. “They may not ask their provider for appropriate care because they don’t believe they have a right,” he said. “It’s about whether the person feels comfortable and is able to ask for it.”
Jan can be reached at [email protected].
